Fuller G K, Lemma A, Haile T, Gemeda N
Ann Trop Med Parasitol. 1979 Oct;73(5):417-30. doi: 10.1080/00034983.1979.11687281.
The Leishmanin skin test was performed on 1353 people in a kala-azar endemic region of south-west Ethiopia. Physical examinations were also carried out on 2723. Two of these individuals, both males, had active visceral leishmaniasis with Leishmania organisms demonstrated by spleen puncture. Two other males, including one member of the research team, had parasitologically proven cutaneous leishmaniasis. Because there was negligible migration and little movement of individuals outside of their tribal territories, the geographical distribution of skin test positivity and clinical findings could be determined and correlated with environmental parameters. The level of positive skin tests for the groups tested ranged from over 64% for the three tribes collectively inhabiting the lower regions of the Omo Valley (altitude approx. 500 m) to 6.4% for the Suri tribe, which lives at 1400 m. Skin test positivity was highest in areas of deeply fissuring montmorillonite soils and where Phlebotomus langeroni orientalis have been collected. Termite mounds of the pipe-organ type seemed to occur independently of the proportion of positive skin tests, possibly because alternative resting and breeding sites for sandflies were available in the cotton clay soil or because of the cultural patterns of the people. Almost always, males had a markedly higher prevalence of positive skin tests than did females. The degree of positivity was strongly correlated with increasing age, most positive conversions occurring in the ten to 20 year olds, the age at which males join cattle camps as part of their herding activities. Splenomegaly reached a prevalence of nearly 50% among the Hamar speaking people to the east of the Omo River, where the pattern of disease suggests malaria as the principal cause. Hepatomegaly, however, was highest in the lower Omo Basin among the Nyangatom, Dassanetch and Kerre, where hydatid disease was a major cause of liver enlargement, but seemed unrelated to the proportion of positive Leishmanin skin tests.
在埃塞俄比亚西南部黑热病流行地区，对1353人进行了利什曼原虫皮肤试验。还对2723人进行了体格检查。其中两名男性被确诊为活动性内脏利什曼病，通过脾穿刺发现了利什曼原虫。另外两名男性，包括一名研究团队成员，经寄生虫学证实患有皮肤利什曼病。由于该地区人口迁移极少，且人们很少离开部落领地，因此可以确定皮肤试验阳性率和临床症状的地理分布，并将其与环境参数进行关联分析。接受检测的人群中，皮肤试验阳性率从共同居住在奥莫河谷下游地区（海拔约500米）的三个部落的64%以上，到生活在1400米处的苏里部落的6.4%不等。在蒙脱石土壤深度开裂且采集到东方朗格尼白蛉的地区，皮肤试验阳性率最高。管风琴类型的白蚁丘似乎与皮肤试验阳性率无关，这可能是因为在棉黏土中有白蛉的替代栖息和繁殖场所，或者是由于当地居民的文化模式。几乎在所有情况下，男性皮肤试验阳性率明显高于女性。阳性程度与年龄增长密切相关，大多数阳性转变发生在10至20岁之间，这一年龄段的男性会作为放牧活动的一部分加入牛群营地。在奥莫河以东说哈马尔语的人群中，脾肿大患病率接近50%，该地区的疾病模式表明疟疾是主要病因。然而，肝肿大在奥莫河下游盆地的尼扬加托姆、达萨内奇和凯雷部落中最为常见，在这些地区，包虫病是肝脏肿大的主要原因，但似乎与利什曼原虫皮肤试验阳性率无关。
