Gürtler R E, Chuit R, Cécere M C, Castañera M B, Cohen J E, Segura E L
Departamento de Ciencias Biológicas, Universidad de Buenos Aires, Argentina.
Am J Trop Med Hyg. 1998 Nov;59(5):741-9. doi: 10.4269/ajtmh.1998.59.741.
Environmental, demographic, and entomologic variables were analyzed by logistic multiple regression analysis for their association with the likelihood of being seropositive for Trypanosoma cruzi in three highly infested rural villages of northwest Argentina. The prevalence of seropositivity for T. cruzi, as determined by the composite results of three serologic tests, was 34% among 338 persons in 1992. The strongest positive predictors of the adjusted odds of being infected were the household number of dogs, the density of T. cruzi-infected Triatoma infestans in bedroom areas, and each person's age. Dwellers from houses with roofs made completely or partly with a grass called simbol, or which used insecticides rudimentarily and nonsystematically, had a significantly lower odds of being seropositive for T. cruzi than residents from other types of dwellings. The adjusted odds of infection also increased with the number of T. cruzi-infected dogs or cats and the presence of chickens in bedroom areas. No significant effects on the adjusted odds of infection of a community-wide deltamethrin spraying carried out in one of the villages seven years before were detected. Socioeconomic indicators, such as domiciliary area, and numbers of corrals and livestock, were inversely related to being infected. Our study identified several manageable variables suitable for control actions, most of them not examined before in univariate or multivariate analyses. Environmental management based on low-cost housing with appropriate local materials and removal of domestic animals from domiciliary areas have a crucial role to play in the control of Chagas' disease in rural areas.
在阿根廷西北部三个寄生虫高度肆虐的乡村,通过逻辑多元回归分析研究环境、人口统计学和昆虫学变量与克氏锥虫血清阳性可能性之间的关联。根据三项血清学检测的综合结果确定,1992年在338人中克氏锥虫血清阳性率为34%。调整后的感染几率的最强正向预测因素是家中犬只数量、卧室区域感染克氏锥虫的骚扰锥蝽密度以及每个人的年龄。居住在用名为simbol的草完全或部分搭建屋顶的房屋中的居民,或使用简陋且无系统杀虫剂的居民,克氏锥虫血清阳性几率显著低于其他类型房屋的居民。感染的调整几率也随着感染克氏锥虫的犬只或猫的数量以及卧室区域鸡的存在而增加。未检测到七年前在其中一个村庄进行的全社区溴氰菊酯喷洒对调整后的感染几率有显著影响。社会经济指标,如居住面积、畜栏数量和牲畜数量,与感染呈负相关。我们的研究确定了几个适合采取控制行动的可控变量,其中大多数在单变量或多变量分析中未曾研究过。基于使用当地适宜的低成本材料建造房屋以及将家畜从居住区域移走的环境管理,在农村地区恰加斯病的控制中可发挥关键作用。