Household structure and urban services:: neglected targets in the control of visceral leishmaniasis
Household structure and urban services:: neglected targets in the control of visceral leishmaniasis
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DOI：
10.1179/136485905x28018
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发表时间：
2005-04-01
影响因子：
--
通讯作者：
Lima, SS
中科院分区：
文献类型：
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作者：
Costa, CHN;Werneck, GL;Lima, SS
由恰加斯利什曼原虫引起的内脏利什曼病（VL）在新世界的许多地方是一个日益严重的公共卫生问题。虽然有几项研究集中在环境破坏、人口迁移和土地占用对VL发病率的影响上，但尚未详细调查城市化进程往往导致的低于标准的生活条件对疾病的影响。目前的研究是基于巴西的特雷西纳市，那里，自1980年以来，已经有两个大的爆发VL（一个在1981-1985年，另一个在1993-1996年），每个涉及至少1000个新报告的病例。在病例对照调查中，家庭结构和城市服务的提供，作为VL发生的预测因子的作用进行了研究。在控制了受试者居住地区的年龄、拥挤程度和VL背景发病率后，发现居住在污水系统不足的房屋和没有定期垃圾收集的房屋中的人患这种疾病的风险明显更高。改善家庭结构和提供基本的城市服务可能是控制VL在城市地区蔓延的有效策略。
Visceral leishmaniasis (VL) caused by Leishmania chagasi is a growing public-health problem in many parts of the New World. Although several studies have focused on the consequences of environmental damage, human migration and land occupation on the incidence of VL, the effects on the disease of the substandard living conditions that often result from the process of urbanization have not been investigated in detail. The present study was based in the Brazilian city of Teresina, where, since 1980, there have been two large outbreaks of VL (one in 1981-1985 and the other in 1993-1996), each involving at least 1000 newly reported cases. The role of household structure and the provision of urban services in the city, as predictors of the occurrence of VL, was studied in a case-control investigation. After controlling for age, crowding, and the background incidence of VL in the area where the subjects lived, the risk of acquiring the disease was found to be significantly higher for those who lived in houses with an inadequate sewage system and those who had no regular rubbish collection. Improving household structure and providing basic urban services might be effective strategies for controlling the spread of VL in urban areas.