The potential for emergence of Chagas disease in the United States
The potential for emergence of Chagas disease in the United States
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DOI：
10.4081/gh.2008.246
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发表时间：
2008-05-01
影响因子：
1.7
通讯作者：
Paulson, Sally L.
中科院分区：
文献类型：
--
作者：
Lambert, Rebecca Click;Kolivras, Korine N.;Paulson, Sally L.
为了确定美国恰加斯病（美洲锥虫病）的风险，勾勒出锥蝽媒介有效的特征以及最有传播风险的地区。此外，还确定了存在该疾病潜在风险地区的医生对南美锥虫病的认识状况。地理信息系统（GIS）被用来分析美国境内已知含有克氏锥虫并表现出驯养特性的三种锥蝽物种。对锥蝽活动增加的最低温度阈值的分析描绘了当前面临增加风险的人口，并且通过结合 2030 年的温度预测，还描绘了未来气候情景下面临风险的人口。考虑到环境和社会因素，基于 GIS 分析结果的基于小插曲的医生调查被用来衡量在划定的较高风险范围内对恰加斯病的认识水平。目前恰加斯病风险增加的地区包括美国南部大部分地区，根据政府间气候变化专门委员会 (IPCC) 预测，到 2030 年气温将上升 1 摄氏度（1.8 华氏度），较高风险范围预计将扩大到美国中部。调查结果表明，在鉴别诊断过程中对恰加斯病的考虑有限，这表明美国发现的恰加斯病病例数量较少可能是由于缺乏疾病意识，而不是缺乏疾病意识。的疾病威胁。这项研究结合了 GIS 和调查分析，以评估温度变化和医生的疾病意识在美国恰加斯病潜在出现中所起的作用。这种方法表明恰加斯病有可能在美国出现。
To determine the risk for Chagas disease (American trypanosomiasis) in the United States, the characteristics that make the triatomine vector effective and the areas most at risk for transmission were delineated. In addition, the status of Chagas disease awareness among physicians in areas with a potential risk for the disease was determined. A geographical information system (GIS) was used to analyze three triatomine species within the United States known to harbor Trypanosoma cruzi and that exhibit qualities of domesticity. An analysis of the minimum temperature threshold for increased triatomine activity delineates the current population at increased risk, and by incorporating temperature predictions for 2030, the population at risk under a future climate scenario was also delineated. Considering both environmental and social factors, a vignette-based physician survey, based on the results of the GIS analysis, was used to gauge the level of awareness of Chagas disease within the delineated higher risk range. The current area at increased risk for Chagas disease includes much of the southern United States, and the higher risk range is expected to expand into the central United States based upon the 1 degrees C (1.8 degrees F) increase in temperature predicted by the Intergovernmental panel on Climate Change (IPCC) by rile year 2030. Survey results indicate a limited consideration of Chagas disease during differential diagnosis, illustrating that the low number of Chagas disease cases discovered in the United States may be attributable to a lack of disease awareness as opposed to a lack of disease threat. This study combines GIS and survey analyses to evaluate the role that temperature variability and disease awareness among physicians play in rile potential emergence of Chagas disease in the United States. This approach indicates that there is a potential of Chagas disease to emerge in the United States.