Prociv P, Luke R
Department of Parasitology, University of Queensland.
Med J Aust. 1993 Feb 1;158(3):160-3. doi: 10.5694/j.1326-5377.1993.tb121693.x.
To report the prevalence and distribution of infections with the parasitic nematode Strongyloides stercoralis in the Aboriginal and Torres Strait Islander communities of Queensland.
A 20-year retrospective survey of computerised data and selected files from the former Aboriginal Health Programme (AHP) of the State Health Department of Queensland, based on cases diagnosed by the microscopic examination of preserved faecal specimens. Findings were compared with figures published in annual reports.
Children under 15 years of age from 122 Aboriginal and Torres Strait Islander communities.
Numbers of specimens examined varied widely according to time and place, as did detected infection rates. In 32,145 faecal samples examined by AHP microscopists during 1972-1991 the overall infection prevalence was 1.97%. Strongyloides larvae were found in only 52 of 122 communities. The parasite was absent from many small, southern inland communities, and the prevalence of infection increased in northern regions with summer wet seasons. On average, it was highest in Doomadgee (12%), where a peak prevalence of 27.5% (92/334 children examined) was detected in a wet season survey. Some infections resolved spontaneously, while others persisted for more than four years. At Gununa (Mornington Island), the prevalence fell from 26.2% to below 7% after thiabendazole treatment of most infected children, and remained at this level for at least four years. Single stool examinations by experienced microscopists may have failed to diagnose at least 26% of infected cases. The records give no indication of the clinical impact of strongyloidiasis.
Strongyloidiasis is well established in many Aboriginal communities of north-eastern Australia. Children appear to be the major reservoirs of infection; the prevalence in adults is probably much lower. Failing improvements in community sanitation and hygiene, it may be possible to reduce significantly, if not eradicate, the infection by selectively treating diagnosed children with thiabendazole.
报告昆士兰原住民及托雷斯海峡岛民社区中寄生线虫粪类圆线虫感染的患病率及分布情况。
基于对保存粪便标本进行显微镜检查诊断的病例，对昆士兰州卫生部原原住民健康项目（AHP）的计算机数据及选定文件进行为期20年的回顾性调查。将调查结果与年度报告中公布的数据进行比较。
来自122个原住民及托雷斯海峡岛民社区的15岁以下儿童。
根据时间和地点的不同，所检查标本数量差异很大，检测到的感染率也是如此。1972年至1991年期间，AHP显微镜检查人员共检查了32145份粪便样本，总体感染患病率为1.97%。在122个社区中，只有52个社区发现了粪类圆线虫幼虫。许多南部内陆小社区未发现该寄生虫，北部地区夏季雨季时感染患病率有所上升。平均而言，杜马吉（Doomadgee）的患病率最高（12%），在一次雨季调查中，检测到的患病率峰值为27.5%（92/334名接受检查的儿童）。一些感染会自行痊愈，而另一些则会持续四年以上。在古努纳（莫宁顿岛，Gununa），对大多数受感染儿童进行噻苯达唑治疗后，患病率从26.2%降至7%以下，并至少维持了四年。经验丰富的显微镜检查人员进行的单次粪便检查可能至少漏诊了26%的感染病例。记录中未显示粪类圆线虫病的临床影响。
粪类圆线虫病在澳大利亚东北部的许多原住民社区中已广泛存在。儿童似乎是主要的感染源；成年人中的患病率可能要低得多。如果社区环境卫生和个人卫生状况得不到改善，通过有选择地用噻苯达唑治疗已确诊的儿童，即使不能根除感染，也可能显著降低感染率。
