Tsang V C, Hillyer G V, Noh J, Vivas-Gonzalez B E, Ahn L H, Pilcher J B, Hightower A W, Deseda C, de Melecio C F
Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Am J Trop Med Hyg. 1997 Jan;56(1):107-12. doi: 10.4269/ajtmh.1997.56.107.
A systematic, island-wide survey for schistosomiasis in Puerto Rico has not been conducted for more than 40 years. In 1974, a thorough survey of Boqueron de Las Piedras, a small community, showed a prevalence of 40%. No additional information on prevalence in Puerto Rico has been obtained during the ensuing 21 years. Concern for the public health of residents and visitors prompted the formation of the Bilharzia Commission in 1994 and the systematic serosurvey reported herein. Two thousand nine hundred fifty-five plasma samples from healthy donors were obtained randomly from the Red Cross in March and April 1995. Sex, resident municipalities, and age of the donors were recorded. The donors were from all but three of 79 municipalities in Puerto Rico. No sample was available from the three out island municipalities of Mona, Vieques, and Culebra. Male donors (n = 2,027) outnumbered females (n = 928) by more than 2:1, ages ranged from nine to 76 years with most (85.3%) between 19 and 51 years of age. All samples were tested with the Falcon assay screening test:enzyme-linked immunosorbent assay (FAST:ELISA) with microsomal antigens of Schistosoma mansoni. All FAST:ELISA+ samples were confirmed by enzyme-linked immunoelectrotransfer blot (EITB). Our data showed that 15.4% were FAST:ELISA+, and 10.6% were confirmed by EITB; 13.5% of the males and 4.1% of the females were EITB+. If we exclude those municipalities with fewer than five samples, the prevalence of EITB+ ranged from 0% to 38.5%, with the highest seroprevalence rates (21.1-38.5%) concentrated in 17 municipalities, which accounted for 48% of all seropositive samples. These 17 municipalities, however, contain only 18% of the total population of Puerto Rico. Two areas of high seroprevalence rates center around Jayuya (38.5%) and Naguabo (36.4%). The previously surveyed area of Boqueron is located in Las Piedras (35.3%), adjacent to Naguabo. In addition, we found 10% (21) of our total 215 donors less than 25 years of age to be EITB+ and all but two are residents of the high prevalence districts. These data strongly support the contention that schistosomiasis has been transmitted in a focal fashion during the past approximately 20 years.
在波多黎各，40多年来未进行过全岛范围的血吸虫病系统调查。1974年，对一个小社区博克龙德拉斯皮德拉斯进行的全面调查显示，患病率为40%。在随后的21年里，未获得波多黎各患病率的更多信息。出于对居民和游客公共健康的担忧，1994年成立了血吸虫病委员会，并开展了本文所报告的系统血清学调查。1995年3月和4月，从红十字会随机抽取了2955份健康献血者的血浆样本。记录了献血者的性别、居住城市和年龄。献血者来自波多黎各79个城市中的76个。莫纳、别克斯和库莱布拉这三个外岛城市没有样本。男性献血者（n = 2027）比女性献血者（n = 928）多两倍多，年龄范围从9岁到76岁，大多数（85.3%）在19岁至51岁之间。所有样本都用曼氏血吸虫微粒体抗原的猎鹰试验筛选试验：酶联免疫吸附测定（FAST:ELISA）进行检测。所有FAST:ELISA呈阳性的样本都通过酶联免疫电转移印迹（EITB）进行确认。我们的数据显示，15.4%的样本FAST:ELISA呈阳性，10.6%通过EITB得到确认；13.5%的男性和4.1%的女性EITB呈阳性。如果我们排除样本少于5份的城市，EITB呈阳性的患病率范围为0%至38.5%，最高血清阳性率（21.1 - 38.5%）集中在17个城市，这些城市占所有血清阳性样本的48%。然而，这17个城市仅占波多黎各总人口的18%。血清阳性率高的两个地区集中在哈尤亚（38.5%）和纳瓜博（36.4%）周围。之前调查的博克龙地区位于拉斯皮德拉斯（35.3%），与纳瓜博相邻。此外，我们发现215名年龄小于25岁的献血者中有10%（21人）EITB呈阳性，除两人外，其他人都是高患病率地区的居民。这些数据有力地支持了这样一种观点，即在过去约20年里，血吸虫病一直以局部流行的方式传播。
