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[智利恰加斯病的流行病学。1991 - 1993年对第四大区一个地方性农村地区1906名居民的血清学随访]

[Epidemiology of Chagas' disease in Chile. Serological follow-up of 1,906 inhabitants from an endemic rural area, IV Region, 1991-1993].

作者信息

Valdés J, Contreras M C, Mercado R, Rojas A, Correa V, Schenone H

机构信息

Departamento de Programas sobre el Ambiente, Ministerio de Salud, Chile.

出版信息

Bol Chil Parasitol. 1994 Jul-Dec;49(3-4):75-8.

PMID:7654291
Abstract

The IV Region (29 degrees 30'-32 degrees 13' south lat.) is located in the center of the geographical area of distribution of Chagas' disease in Chile. Triatoma infestans is the main and almost exclusive vector of Trypanosoma cruzi in this country. The mean prevalence rate of T. cruzi human infection in urban and periurban sections of IV Region is 24.7%. To assess the impact of anti-T. infestans activities, by means of health education and sprayings of dwellings with insecticides, carried out in the IV Region since 1980, during January-February (summer) a serological follow-up to residents from 46 rural chagasic localities was performed. An indirect hemagglutination test and an indirect immunofluorescence test were done to each of the surveyed persons. In 1991, 303 (15.9%) out of 1,906 examined people resulted serologically positive. In 1992, previous discarding the positive individuals found in 1991, 1,334 persons were examined resulting positive 9 (0.7%). In 1993, 1,398 persons were surveyed and 26 (1.9%) were positive. It is noteworthy that none of these 35 positive persons had been surveyed in 1991, being difficult to assert if any was positive before. Two infants, daughters of positive mothers, serologically positive at the beginning, changed to negative in the following survey, indicating that it was a passive transfer of maternal specific antibodies. According to the results of this study, it is concluded that dwelling spraying with persistent-activity insecticides against T. infestans and health education are good tools in the control of T. cruzi human infection, particularly when the involved community participates.

摘要

第四大区(南纬29°30′ - 32°13′)位于智利恰加斯病地理分布区域的中心。侵扰锥猎蝽是该国克氏锥虫的主要且几乎唯一的传播媒介。第四大区城市和城郊地区克氏锥虫人体感染的平均患病率为24.7%。为评估自1980年起在第四大区开展的针对侵扰锥猎蝽的活动(通过健康教育和用杀虫剂喷洒住所)的影响,在1月至2月(夏季)对46个农村恰加斯病流行地区的居民进行了血清学随访。对每位被调查者进行了间接血凝试验和间接免疫荧光试验。1991年,在1906名受检者中,有303人(15.9%)血清学呈阳性。1992年,在排除1991年发现的阳性个体后,对1334人进行检查,9人(0.7%)呈阳性。1993年,对1398人进行调查,26人(1.9%)呈阳性。值得注意的是,这35名阳性者中没有一人在1991年接受过调查,因此很难确定之前是否有人呈阳性。两名婴儿,其母亲呈阳性,最初血清学呈阳性,但在随后的调查中转为阴性,这表明这是母体特异性抗体的被动转移。根据本研究结果,得出结论:用具有持久活性的杀虫剂喷洒住所以及开展健康教育是控制克氏锥虫人体感染的有效手段,特别是当相关社区参与时。

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