Seroepidemiology of schistosomiasis in Puerto Rico: Evidence for vanishing endemicity
Seroepidemiology of schistosomiasis in Puerto Rico: Evidence for vanishing endemicity
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DOI：
10.4269/ajtmh.1999.60.827
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发表时间：
1999-05-01
影响因子：
3.3
通讯作者：
de Galanes, MS
中科院分区：
文献类型：
--
作者：
Hillyer, GV;de Galanes, MS
目前的研究总结了我们的发现，抗寄生虫卵抗体的环卵沉淀试验在波多黎各两个不同的人群。其中一组是来自岛上所有城市的40岁以上男性，1988年至1997年期间来自退伍军人管理局医院。第二批人居住在圣胡安东南部，卡瓜斯市周围和卡瓜斯以东的邻近城市，男女都有，1993-1997年期间，大多数人的年龄未定。结果显示，退伍军人管理局医院的检测请求逐年减少，从1988年和1989年的148例（阳性率为16%）减少到1996年至1998年的3例（无阳性）。检测请求的减少是因为这一群体中对血吸虫病的怀疑减少。来自卡瓜斯地区的其他患者人群显示，血清反应阳性者逐渐但持续下降，从1993年的21%降至1996年的12%，1997年急剧下降至5%，1998年仅为1%。此外，有4名患者至少间隔1年或2年获得了2份血清样本并进行了检测。在每种情况下，最近获得的样品的抗体反应都比第一个样品低，这反映在阳性鸡蛋反应者的百分比较低。他们在第一次检测后接受吡喹酮治疗的事实也表明，受感染的人口正在通过化疗消除。这些综合结果表明，在波多黎各没有采取任何主动控制措施的情况下，在圣胡安以东的传统高发地区消除了曼氏血吸虫感染。由于波多黎各的快速城市化，一个可识别的控制努力是经济发展和福祉。
The current study summarizes our findings of anti-schistosome egg antibody by the circumoval precipitin test for two different populations in Puerto Rico. One group, exclusively males more than 40 years of age and from all municipalities on the island, was from the Veterans Administration Hospital for the period 1988-1997. The second group resided southeast of San Juan, around the municipality of Caguas and adjacent municipalities east of Caguas, was of both sexes and mostly until 1997 of undetermined ages for the period 1993-1997. Results reveal a yearly decrease in testing requests from the Veterans Administration Hospital from 148 in 1988 and 1989 with 16% positive to three in 1996 through 1998 with none positive. This decrease in testing requests was because of a decrease of suspicion of schistosomiasis in this group. The other patient population from the Caguas region showed a gradual but continuous decrease in seropositive individuals from 21% in 1993 to 12% in 1996, with precipitous decrease to 5% in 1997 and only 1% in 1998. Moreover, there were four patients from which at least two serum samples were obtained one or two years apart and tested. In each instance the more recently obtained sample had lower antibody reactions than the first as reflected in lower percentages of positive egg reactors. The fact that they were treated with praziquantel after the first testing also suggests that the infected population was being eliminated through chemotherapy. These combined results suggest the elimination of infections with Schistosoma mansoni in the traditionally high prevalence regions east of San Juan in the absence of any proactive control efforts in Puerto Rico. Because of the rapid urbanizing of Puerto Rico, the one identifiable control effort is economic development and well being.