Hide G
Centre for Molecular Epidemiology and Ecology, Department of Biological Sciences, University of Salford, Salford M5 4WT, United Kingdom.
Clin Microbiol Rev. 1999 Jan;12(1):112-25. doi: 10.1128/CMR.12.1.112.
The history of human sleeping sickness in East Africa is characterized by the appearance of disease epidemics interspersed by long periods of endemicity. Despite the presence of the tsetse fly in large areas of East Africa, these epidemics tend to occur multiply in specific regions or foci rather than spreading over vast areas. Many theories have been proposed to explain this phenomenon, but recent molecular approaches and detailed analyses of epidemics have highlighted the stability of human-infective trypanosome strains within these foci. The new molecular data, taken alongside the history and biology of human sleeping sickness, are beginning to highlight the important factors involved in the generation of epidemics. Specific, human-infective trypanosome strains may be associated with each focus, which, in the presence of the right conditions, can be responsible for the generation of an epidemic. Changes in agricultural practice, favoring the presence of tsetse flies, and the important contribution of domestic animals as a reservoir for the parasite are key factors in the maintenance of such epidemics. This review examines the contribution of molecular and genetic data to our understanding of the epidemiology and history of human sleeping sickness in East Africa.
东非人类昏睡病的历史特点是疾病流行期与长期的地方性流行相互交织。尽管东非大片地区存在采采蝇，但这些流行病往往在特定区域或疫源地多次发生，而非在广大地区蔓延。人们提出了许多理论来解释这一现象，但最近的分子方法和对流行病的详细分析突出了这些疫源地内人类感染性锥虫菌株的稳定性。新的分子数据，结合人类昏睡病的历史和生物学，开始凸显出与流行病发生相关的重要因素。特定的人类感染性锥虫菌株可能与每个疫源地相关联，在合适的条件下，这些菌株可能引发流行病。有利于采采蝇生存的农业实践变化，以及家畜作为寄生虫宿主的重要作用，是维持此类流行病的关键因素。本综述探讨了分子和遗传数据对我们理解东非人类昏睡病流行病学和历史的贡献。
