Bjorland J, Bryan R T, Strauss W, Hillyer G V, McAuley J B
Danchurchaid and Instituto Nacional de Laboratorios de Salud, La Paz, Bolivia.
Clin Infect Dis. 1995 Nov;21(5):1228-33. doi: 10.1093/clinids/21.5.1228.
Fasciola hepatica is a common and important parasite of sheep, cattle, and other ruminants. In May 1991, 30 persons with possible acute fascioliasis were identified by health care providers at a district hospital in the Bolivian Altiplano, and two deaths were associated with this illness. A cross-sectional survey of a random sample of 30 (20%) of the 148 households in the community and a case-control study were performed to determine the extent of the outbreak and the vehicle of transmission. Ninety-one members from 23 of the 30 selected families participated in the cross-sectional survey. Twenty-one of the 91 members met the case definition for acute fascioliasis (illness since 16 February 1991 that was characterized by fever and abdominal pain plus serum IgG antibodies to F. hepatica), and 38 (49%) of 78 members had serum IgG antibodies to F. hepatica. If this rate is extrapolated to the entire community, an estimated 116 individuals (23% of 504) would have acute fascioliasis and 247 individuals (49% of 504) would have evidence of current or previous infection. Case-control analysis indicated that the only factor associated with illness was eating kjosco (an aquatic plant) while tending animals in the fields; 27 (52%) of the 52 case-patients vs. 9 (14%) of the 66 controls ate kjosco (OR = 6.84; 95% CI = 2.60, 18.44). The cause of the two deaths attributed to fascioliasis could not be firmly established. Fascioliasis is a significant human health problem and is highly endemic in the Aymara Indian community in the Bolivian Altiplano. Efforts to prevent fascioliasis should include educating people to avoid eating uncooked aquatic plants such as kjosco.
肝片吸虫是绵羊、牛和其他反刍动物常见且重要的寄生虫。1991年5月，玻利维亚高原地区一家区级医院的医护人员确认了30例可能患有急性肝片吸虫病的患者，其中两例死亡与该病相关。对该社区148户家庭中的30户（20%）进行随机抽样横断面调查，并开展病例对照研究，以确定疫情的范围和传播媒介。30个选定家庭中的23户的91名成员参与了横断面调查。91名成员中有21人符合急性肝片吸虫病的病例定义（自1991年2月16日起发病，症状为发热和腹痛，外加针对肝片吸虫的血清IgG抗体），78名成员中有38人（49%）有针对肝片吸虫的血清IgG抗体。如果将这一比例推算至整个社区，估计有116人（504人的23%）患有急性肝片吸虫病，247人（504人的49%）有当前或既往感染的证据。病例对照分析表明，与患病相关的唯一因素是在田间照料动物时食用kjosco（一种水生植物）；52例病例中有27例（52%）与66例对照中有9例（14%）食用了kjosco（比值比=6.84；95%可信区间=2.60, 18.44）。归因于肝片吸虫病的两例死亡原因无法确切判定。肝片吸虫病是一个严重的人类健康问题，在玻利维亚高原的艾马拉印第安社区高度流行。预防肝片吸虫病的措施应包括教育人们避免食用未煮熟的水生植物，如kjosco。
