Baker R H, Abdelnur O M
Trop Med Parasitol. 1986 Dec;37(4):341-55.
The distribution of onchocerciasis and its vectors in Sudan has been reviewed with special emphasis on the hyperendemic foci where there is serious visual handicap caused by the disease. These blinding foci lie primarily in the south-west of the country, along the rivers flowing north and east from the borders with Central African Republic and Zaire, though at least one such focus is known from the eastern part of the country close to the Ethiopian border. In the blinding foci, often small villages localized to short stretches of the rivers, ocular onchocerciasis is as severe as that found in any other African foci. Only the S. damnosum s.l. species complex has been implicated in disease transmission and only the two dangerous, morphologically similar, savanna cytospecies, S. damnosum s.s. and S. sirbanum, have been identified from breeding sites close to known onchocerciasis foci. Near to the Uganda and Zaire borders it is very likely that other, less anthropophilic, cytospecies occur. Different Onchocerca-Simulium complexes (different strains of parasite with different pathogenicities transmitted by different vector species) may be responsible for the different severities of disease found in the 3 main areas of onchocerciasis in North, East and South-West Sudan. The localized, focal distribution of the communities seriously blinded by onchocerciasis, suggests that a strategy of tackling the disease on a focus basis may prove optimal. A control scheme, planned to treat all the vector breeding sites with insecticide, as in West Africa, would receive extensive invasion from the Zaire/Congo River Basin and the headwaters of the White and Blue Niles in neighbouring countries. While some foci are situated beside major river rapids, with vector breeding only controllable by regular insecticide treatments, several foci have been identified as lying close to removable man-made objects which provide excellent breeding sites at certain water levels e.g. causeways. The destruction of such breeding sites should be considered since localized vector control may produce substantial reductions in onchocerciasis transmission.
对苏丹盘尾丝虫病及其传播媒介的分布情况进行了综述，特别强调了那些因该病导致严重视力障碍的高度流行病灶。这些致盲病灶主要位于该国西南部，沿着从与中非共和国和扎伊尔接壤的边境向北和向东流淌的河流分布，不过在该国靠近埃塞俄比亚边境的东部地区也至少有一个这样的病灶。在这些致盲病灶中，通常是位于河流短段区域的小村庄，眼部盘尾丝虫病的严重程度与非洲其他任何病灶一样。只有罗阿罗阿丝虫复合种被认为与疾病传播有关，并且仅从已知盘尾丝虫病病灶附近的繁殖地中鉴定出了两种危险的、形态相似的稀树草原细胞型，即罗阿罗阿丝虫指名亚种和锡尔巴罗阿丝虫。在靠近乌干达和扎伊尔边境的地区，很可能存在其他不太嗜人的细胞型。不同的盘尾丝虫-蚋复合体（由不同媒介物种传播的具有不同致病性的不同寄生虫菌株）可能是苏丹北部、东部和西南部三个主要盘尾丝虫病流行区疾病严重程度不同的原因。盘尾丝虫病导致严重失明的社区呈局部、点状分布，这表明以病灶为基础应对该疾病的策略可能是最佳的。若像在西非那样计划用杀虫剂处理所有媒介繁殖地的控制方案，将会受到来自扎伊尔/刚果河流域以及邻国白尼罗河和青尼罗河源头的大量侵袭。虽然一些病灶位于主要河流的急流旁边，媒介繁殖只能通过定期喷洒杀虫剂来控制，但已确定有几个病灶靠近可移除的人造物体，这些物体在特定水位时可提供绝佳的繁殖场所，例如堤道。应考虑摧毁此类繁殖地，因为局部媒介控制可能会大幅减少盘尾丝虫病的传播。
