CHARACTERISTICS OF MALARIA TRANSMISSION IN KATARAGAMA, SRI-LANKA - A FOCUS FOR IMMUNO-EPIDEMIOLOGIC STUDIES
CHARACTERISTICS OF MALARIA TRANSMISSION IN KATARAGAMA, SRI-LANKA - A FOCUS FOR IMMUNO-EPIDEMIOLOGIC STUDIES
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DOI：
10.4269/ajtmh.1990.42.298
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发表时间：
1990-04-01
影响因子：
3.3
通讯作者：
MENDIS, KN
中科院分区：
文献类型：
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作者：
MENDIS, C;GAMAGEMENDIS, AC;MENDIS, KN
对斯里兰卡南部间日疟原虫疟疾流行区的 3,625 名居民进行了为期 17 个月的疟疾传播寄生虫学和昆虫学参数监测；研究区域由 7 个相连的村庄组成，这些村庄正在进行例行的国家疟疾控制行动。对每位居民的疟疾情况进行监测；对发热患者进行筛查，并进行4次定期大规模血液调查。在此期间，疟疾年发病率为 23.1%：9.3% 为间日疟，13.8% 为恶性疟；该地区最近曾发生过后者的流行，而过去10年的恶性疟发病率可以忽略不计。疟疾发病率存在较大的季节性波动，发病高峰紧随季风降雨之后。 4 次大规模血液调查中检测到的两种疟疾患病率范围为 0.98%（低传播期）至 2.35%（传播高峰期）。成人和儿童出现疟疾的急性临床表现。昆虫学测量证实了间日疟原虫和恶性疟原虫的地方性程度较低，估计接种率分别为 0.0029 和 0.0109（传染性叮咬/人/夜）。几种按蚊物种促成了传播，总体人类叮咬率（MBR）显示出明显的季节性变化。卡塔拉格马的疟疾是斯里兰卡的典型流行区，因此呈现出“不稳定”传播的特征。疟疾在人群中聚集。与大多数人终生接触过间日疟原虫相比，人们对恶性疟原虫疟疾的临床耐受性较低，大多数人最近才接触过恶性疟原虫。
Parasitological and entomological parameters of malaria transmission were monitored for 17 months in 3,625 residents in a Plasmodium vivax malaria endemic region in southern Sri Lanka; the study area consisted of 7 contiguous villages where routine national malaria control operations were being conducted. Malaria was monitored in every resident; fever patients were screened and 4 periodical mass blood surveys were conducted. An annual malaria incidence rate of 23.1% was reported during the period: 9.3% was due to P. vivax and 13.8% was due to P. falciparum; there had been a recent epidemic of the latter in this region, whereas the P. falciparum incidence rate in the previous 10 years had been negligible. There was a wide seasonal fluctuation in the malaria incidence, with the peak incidence closely following the monsoon rains. The prevalence of malaria due to both species detected at the 4 mass blood surveys ranged from 0.98% (at low transmission) to 2.35% (at peak transmission periods). Adults and children developed acute clinical manifestations of malaria. Entomological measurements confirmed a low degree of endemicity with estimated inoculation rates of 0.0029 and 0.0109 (infectious bites/man/night) for P. vivax and P. falciparum, respectively. Several anopheline species contributed to the transmission, and the overall man biting rates (MBR) showed a marked seasonal variation. Malaria at Kataragama, typical of endemic areas of Sri Lanka, thus presents characteristics of ''unstable'' transmission. Malaria was clustered in the population. There was a low clinical tolerance to P. falciparum malaria, to which most had only recently been at risk, compared to P. vivax, to which most had had a life-long exposure.