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巴西亚马逊雨林萨努马美洲印第安人中的沙蚤病:患病率、感染强度及发病率

Tungiasis in the Sanumás Amerindians in the Amazon Rainforest, Brazil: Prevalence, Intensity and Morbidity.

作者信息

Santana Yago Ranniere Teixeira, Oliveira Lucas Felipe Carvalho, Lima Gabriela Mafra, Timbó Renata Velôzo, Pires Eliane Mateus, de Brito Amanda Ramos, Martins Ana Carolina Tardin, Magalhães Vivyanne Santiago, de Faria Ana Carolina Mota, Urdapilleta Ada Amalia Ayala, Roger Isabelle, de Andrade Rafael Rocha, Martins Luciana Pereira Freire, Pellegrini Marcos, de Carvalho Fabiola Christian Almeida, Araújo David Dias, Barroso Daniel Holanda, Garcia Carina Nogueira, Feldmeier Hermann, Gomes Ciro Martins

机构信息

Secretaria Especial de Saúde Indígena (SESAI), Ministério da Saúde do Brasil, Brasília 70.910-900, Brazil.

Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília, Brasília 70.910-900, Brazil.

出版信息

Trop Med Infect Dis. 2023 Jul 28;8(8):386. doi: 10.3390/tropicalmed8080386.

Abstract

BACKGROUND

Tungiasis is a disease associated with extreme poverty. We aimed to evaluate the prevalence of tungiasis in six different settlements of the Sanumás indigenous community in a remote area in the Auaris region, Yanomami territory, Brazil.

METHODS

We conducted an observational study to detect clinical and epidemiological factors associated with tungiasis using a cross-sectional strategy and multivariate logistic regression. Soil analysis was performed by visual and microscopic methods.

RESULTS

We examined 555 persons, 45 of whom had active tungiasis; 18 cases were classified as mild, 16 as moderate and 11 as severe. The disease was significantly more prevalent in children than in adults (odds ratio (OR) 15.77; 95% confidence interval (CI) = 5.34-67.91; < 0.001). Soil infestation was significantly related to the occurrence of human tungiasis (OR = 12.29; 95% CI = 3.75-45.88). The sex and GPS location of the houses were not related to the occurrence of tungiasis.

CONCLUSIONS

We conclude that tungiasis is an important problem in the Sanumás community, especially for children. We suggest that interruption of the off-host transmission cycle, together with regular treatment [human and animal interventions], must be prioritized to achieve control of tungiasis in indigenous populations.

摘要

背景

沙蚤病是一种与极端贫困相关的疾病。我们旨在评估巴西亚诺马米地区奥阿里斯偏远地区萨努马印第安社区六个不同定居点的沙蚤病患病率。

方法

我们采用横断面研究策略和多因素逻辑回归进行了一项观察性研究,以检测与沙蚤病相关的临床和流行病学因素。通过视觉和显微镜方法进行土壤分析。

结果

我们检查了555人,其中45人患有活动性沙蚤病;18例为轻度,16例为中度,11例为重度。该疾病在儿童中的患病率显著高于成人(优势比(OR)15.77;95%置信区间(CI)=5.34 - 67.91;<0.001)。土壤感染与人类沙蚤病的发生显著相关(OR = 12.29;95%CI = 3.75 - 45.88)。房屋的性别和全球定位系统位置与沙蚤病的发生无关。

结论

我们得出结论,沙蚤病在萨努马社区是一个重要问题,尤其是对儿童而言。我们建议,必须优先中断宿主外传播周期,并进行定期治疗(人类和动物干预),以实现对土著居民沙蚤病的控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/054b/10459173/bc26cfc0cd1a/tropicalmed-08-00386-g001.jpg

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