Almeda J, Corachan M, Sousa A, Ascaso C, Carvalho J M, Rollinson D, Southgate V R
Sección de Medicina Tropical, Hospital Clinic, Barcelona, Spain.
Trans R Soc Trop Med Hyg. 1994 Jul-Aug;88(4):406-9. doi: 10.1016/0035-9203(94)90402-2.
The only schistosome species found in stool specimens in the local population of the republic of São Tomé is Schistosoma intercalatum. An initial survey of schoolchildren showed an overall prevalence of 10.9%, with some schools reaching 29%. No S. haematobium egg was found in 782 urine specimens from the local population, although some were seen in the urine of Angolan soldiers stationed near the capital city. One village in the endemic area, San Marçal, had an S. intercalatum prevalence of 43%, with 14 persons > 40 years of age harbouring severe infections. The transmission area is restricted to the north-east of the main island, where 5 foci apparently account for most of the infections. Seven cases recorded from Principe may be explained by the fact that the children were attending school at São Tomé. Women carrying out domestic activities are more at risk of contracting the infection because of longer periods of water contact than men. The morbidity produced by the infection is restricted to splenomegaly and blood in the stools. High prevalences have been found of Ascaris lumbricoides and Trichuris trichiura, and hookworm and Stronglyloides stercoralis were also observed. Praziquantel was well tolerated and appears to be a good tool for control purposes, although reinfection in the transmission area apparently occurs rapidly. Control strategies based on chemotherapy should take into account an older age group as well as the schoolchildren. Focal mollusciciding and the introduction of washing facilities may also have a role to play in control. The possible recent introduction of the infection to the island is discussed.
在圣多美和普林西比共和国当地居民粪便样本中发现的唯一血吸虫种类是间插血吸虫。对学童的初步调查显示总体感染率为10.9%，有些学校高达29%。在当地居民的782份尿液样本中未发现埃及血吸虫卵，不过在首都附近驻扎的安哥拉士兵尿液中发现了一些。流行区的一个村庄圣马尔萨尔，间插血吸虫感染率为43%，14名40岁以上的人感染严重。传播区域局限于主岛的东北部，5个疫源地显然导致了大部分感染。在普林西比记录的7例病例可能是因为这些儿童在圣多美上学。从事家务活动的女性比男性感染风险更高，因为她们接触水的时间更长。该感染导致的发病情况仅限于脾肿大和便血。已发现蛔虫和鞭虫的感染率很高，还观察到钩虫和粪类圆线虫。吡喹酮耐受性良好，似乎是控制血吸虫病的一个有效工具，尽管在传播区域再次感染显然很快就会发生。基于化疗的控制策略应考虑到年龄较大的人群以及学童。局部灭螺和引入洗涤设施在控制血吸虫病方面也可能发挥作用。文中还讨论了该感染近期可能传入该岛的情况。
