Das P K, Srividya A, Pani S P, Ramaiah K D, Vanamail P, Dhanda V
Vector Control Research Centre, Indian Council of Medical Research, Pondicherry.
Southeast Asian J Trop Med Public Health. 1994 Sep;25(3):516-21.
Several hypotheses have been put forth about the factors influencing the dynamics of infection and disease in lymphatic filariasis. However, appropriate validation of these hypotheses by real situation analyses of epidemiological data is lacking. The present analyses examine the relationship between cumulative exposure to infection and prevalence of disease by utilizing the existing entomological and clinical data collected between 1981 and 1986 in Pondicherry, South India, endemic for bancroftian filariasis. While there was a significant negative association when the cumulative exposure was correlated with total prevalence of disease (r = 0.70, p = 0.024) as well as hydrocele alone (r = 0.74, p = 0.014), a significant positive association was found with prevalence of lymphedema (r = 0.72, p = 0.018). These results suggest that hydrocele development follows early after exposure, but prolonged exposure could result either in development of lymphedema or immune tolerance resulting in microfilaremia. These could also suggest that the pathomechanisms in development of hydrocele and lymphedema could follow different pathways. Implications of the present findings are discussed in light of the various hypotheses put forward by earlier studies.
关于影响淋巴丝虫病感染和疾病动态的因素，已经提出了几种假说。然而，缺乏通过对流行病学数据进行实际情况分析对这些假说进行的适当验证。本分析利用1981年至1986年期间在印度南部本地治里收集的现有昆虫学和临床数据，研究了累积感染暴露与疾病患病率之间的关系，本地治里是班氏丝虫病的流行地区。当累积暴露与疾病总患病率（r = 0.70，p = 0.024）以及单独的鞘膜积液（r = 0.74，p = 0.014）相关时，存在显著的负相关，但发现与淋巴水肿患病率存在显著正相关（r = 0.72，p = 0.018）。这些结果表明，鞘膜积液在暴露后早期就会出现，但长期暴露可能导致淋巴水肿的发展或免疫耐受导致微丝蚴血症。这也可能表明鞘膜积液和淋巴水肿发展的病理机制可能遵循不同的途径。根据早期研究提出的各种假说，讨论了本研究结果的意义。
