[Schistosomiasis mansoni in Bahia, Brazil: historical trends and control measures].
[Schistosomiasis mansoni in Bahia, Brazil: historical trends and control measures].
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DOI：
10.1590/s0102-311x1994000400002
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发表时间：
1994-12-01
影响因子：
2.8
通讯作者：
Barreto, M L
中科院分区：
文献类型：
--
作者：
Carmo, E H;Barreto, M L
为了帮助开发血吸虫病控制的新方法，分析了20世纪50年代至90年代巴伊亚州县级流行率的变化，以及决定因素和社区化疗的效果。总的来说，感染流行的空间分布的基本模式没有观察到实质性的变化。然而，在研究期间，流行率从15.6%总体下降到9.5%，而巴伊亚西部、东南部和北部地区的一些县的流行率上升，表明有新的传播区。对大规模化疗的效果进行分析。在巴拉圭盆地，大规模使用了这一控制措施，与没有使用这一措施的地区一样，流行率有所下降。相关和回归分析也未能显示大规模化疗与长期发病率下降之间的联系。解释这些变化的最有力的变量是那些与种群动态有关的变量。这些调查结果有力地表明，在该州某些地区观察到的发病率下降，必须归因于与该地区的空间组织有关的因素，导致传播率普遍下降，继而是大规模化疗。同时，城市化进程的不完全形态和空间不平等为曼氏血吸虫病的传播和新疫源地的建立创造了有利条件。
In order to aid the development of new approaches to schistosomiasis control, changes were analyzed in prevalence at the county level in the State of Bahia from the 1950s to the 1990s, as were determinants and the effect of community-based chemotherapy. In general, no substantial changes were observed in the basic pattern of spatial distribution of the prevalence of infection. However, during the period studied, there was an overall reduction in prevalence from 15.6% to 9.5% and an increase in prevalence rates in some counties from the western, southeastern, and northern areas of Bahia, indicative of new transmission areas. The effect of mass chemotherapy was analyzed. In the Paraguacu Basin, where this control measure was used on a large scale, there was a reduction in prevalence similar to areas where this measure was not used. Correlation and regression analysis also failed to show links between mass chemotherapy and long term reduction in prevalence. The most powerful variables to explain these changes were those related with population dynamics. These findings strongly suggest that the reduction in prevalence observed in some areas of the State must be attributed to factors related with the spatial organization of this territory, causing a general decrease in the transmission rate, secondary to mass chemotherapy. At the same time, the incomplete form and the spatial inequalities that characterized the urbanization process created favorable conditions for the spread of schistosomiasis mansoni and the establishment of new foci.