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哥斯达黎加一个地方性流行区恰加斯病的流行病学模式。

Epidemiological pattern of Chagas' disease in an endemic area of Costa Rica.

作者信息

Zeledón R, Solano G, Burstin L, Swartzwelder J C

出版信息

Am J Trop Med Hyg. 1975 Mar;24(2):214-25. doi: 10.4269/ajtmh.1975.24.214.

DOI:10.4269/ajtmh.1975.24.214
PMID:804266
Abstract

Triatoma dimidiata was found in association with 34.6% of the houses in a representative town within the dispersion area of the insect. The mean density over the entire study period was 21.5 insects per house, but it tended to be lower in the majority of the houses. Insects usually were associated with dirt floors, poor sanitary condition of dwellings, and piles of firewood. The infection rate of 3,276 insects for Trypanosoma cruzi was 30.9%. The infection was demonstrated in several synanthropic animals: 25 dogs (9.9%); 3 cats (2.9%); 121 Rattus rattus (30.6%); 1 R. norwegicus (3.8%); and 11 mice (10.7%). Among six species of wild reservoirs from the surrounding bush found infected with T. cruzi, the common opossum (together with the black rat) was considered the most important reservoir of the parasite. Besides the relative abundance and the high infection rate of the opossum (62.5% by direct methods), its natural association with T. dimidiata was likewise demonstrated. Among 1,420 persons examined serologically, 166 (11.7%) were positive; xeno-diagnosis was positive in 14 (2.2%) out of 636 persons, and electrocardiograms (EKG's) were compatible with Chagas' cardiopathy in 60 (6.0%) of 1,006 persons examined. The EKG alterations were significantly higher in serologically positive persons. Studies in a control town, free of vectors, showed complete absence of the infection in both humans and animals.

摘要

在昆虫分布区域内的一个代表性城镇中,34.6%的房屋发现有二色锥蝽。整个研究期间的平均密度为每户21.5只昆虫,但大多数房屋中的密度往往较低。昆虫通常与泥土地面、居住环境卫生条件差以及柴堆有关。3276只昆虫中克氏锥虫的感染率为30.9%。在几种与人类共生的动物中发现了感染情况:25只狗(9.9%);3只猫(2.9%);121只黑家鼠(30.6%);1只褐家鼠(3.8%);以及11只小鼠(10.7%)。在从周围灌木丛中发现感染克氏锥虫的六种野生宿主物种中,普通负鼠(与黑家鼠一起)被认为是该寄生虫最重要的宿主。除了负鼠相对丰富的数量和较高的感染率(直接检测法为62.5%)外,还证明了它与二色锥蝽的自然关联。在1420名接受血清学检测的人中,166人(11.7%)呈阳性;在636人中,14人(2.2%)异种诊断呈阳性,在1006名接受检查的人中,60人(6.0%)的心电图与恰加斯心脏病相符。血清学阳性者的心电图改变明显更高。在一个没有病媒的对照城镇进行的研究表明,人和动物均未感染。

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