Kaneko A, Taleo G, Kalkoa M, Yaviong J, Reeve P A, Ganczakowski M, Shirakawa C, Palmer K, Kobayakawa T, Björkman A
Department of International Affairs and Tropical Medicine, Tokyo Women's Medical College, Japan.
Acta Trop. 1998 Jul 30;70(3):285-302. doi: 10.1016/s0001-706x(98)00035-7.
Vanuatu is located at the southeast margin of the malarious band extending from southeast Asia to eastern Melanesia. We analysed the malaria situation on different islands of Vanuatu, using passive case detection and malariometric survey data from 1985 to 1992, i.e. after the DDT residual programme ceased and before the impregnated bed-nets programme started on a larger scale. Malaria was mainly hypo-mesoendemic but with hyperendemic spots in certain years and on some islands. The transmission was generally more intense in the northern islands than in the south. In the late 1980s, annual parasite incidence per one thousand population (API) was around 180. The overall parasite rate was 11.9% with Plasmodium falciparum, P. vivax and P. malariae rate of 5.2, 6.7, and 0.1%, respectively. There was a seasonal fluctuation of P. falciparum incidence, whereas the P. vivax incidence was rather stable. Vivax malaria was confined to children less than 10 years old, while the intense in the northern islands than in the south. In the late 1980s, annual parasite incidence per one thousand population (API) was around 180. The overall parasite rate was 11.9% with Plasmodium falciparum, P. vivax and P. malariae rate of 5.2, 6.7, and 0.1%, respectively. There was a seasonal fluctuation of P. falciparum incidence, whereas the P. vivax incidence prevalence of P. falciparum only changed moderately with age. The mean rate of glucose 6-phosphate dehydrogenase (G6PD) deficiency among male subjects was in 7.4% but with a wide variation of 0-14.3% on different islands. A positive rank-order correlation was found between malaria incidence and G6PD deficiency rate on the different islands. A reasonable hypothesis is that malaria was introduced to the islands with the first human settlement 4000 years ago, with a geographical malaria distribution similar to the present situation. Different malaria endemicities possibly then selected different prevalences of G6PD deficiency over many generations.
瓦努阿图位于从东南亚延伸至美拉尼西亚东部的疟疾带东南边缘。我们利用1985年至1992年的被动病例检测和疟疾病理学调查数据，分析了瓦努阿图不同岛屿的疟疾情况，即滴滴涕残留计划停止后、大规模推广浸渍蚊帐计划之前的那段时间。疟疾主要为低 - 中度流行，但在某些年份和一些岛屿存在高度流行区。北部岛屿的传播通常比南部更为强烈。20世纪80年代后期，每千人口的年度寄生虫发病率（API）约为180。总体寄生虫率为11.9%，其中恶性疟原虫、间日疟原虫和三日疟原虫的发病率分别为5.2%、6.7%和0.1%。恶性疟原虫发病率存在季节性波动，而间日疟原虫发病率相当稳定。间日疟局限于10岁以下儿童，而恶性疟的流行在北部岛屿比南部更为强烈。20世纪80年代后期，每千人口的年度寄生虫发病率（API）约为180。总体寄生虫率为11.9%，其中恶性疟原虫、间日疟原虫和三日疟原虫的发病率分别为5.2%、6.7%和0.1%。恶性疟原虫发病率存在季节性波动，而间日疟原虫发病率相当稳定。恶性疟原虫的流行率仅随年龄有适度变化。男性受试者中葡萄糖 - 6 - 磷酸脱氢酶（G6PD）缺乏的平均发生率为7.4%，但不同岛屿上的发生率差异很大，在0 - 14.3%之间。在不同岛屿上，发现疟疾发病率与G6PD缺乏率之间存在正秩相关。一个合理的假设是，疟疾在4000年前随着第一批人类定居点被引入这些岛屿，其地理疟疾分布与目前情况相似。在许多代人中，不同的疟疾流行程度可能选择了不同的G6PD缺乏流行率。
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