Elephantiasis of non-filarial origin (podoconiosis) in the highlands of north-western Cameroon
Elephantiasis of non-filarial origin (podoconiosis) in the highlands of north-western Cameroon
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DOI：
10.1179/136485908x311849
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发表时间：
2008-09-01
影响因子：
--
通讯作者：
Hoerauf, A.
中科院分区：
文献类型：
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作者：
Wanji, S.;Tendongfor, N.;Hoerauf, A.
淋巴水肿是一种局部液体滞留的情况，是淋巴系统受损的结果。虽然热带地区的一种常见原因是感染丝虫，但据报道，非洲、中美洲和南美洲以及印度西北部火山高地地区的赤脚农民中也出现了非丝虫性淋巴水肿，也称为足滴虫病。关于喀麦隆高原地区淋巴水肿的原因，有相互矛盾的报告，那里的情况对公共卫生具有重大意义。为了描述喀麦隆西北部高地淋巴水肿的特点并调查其真正原因，对居住在Ndop和Tubah卫生区社区的成年人(年龄=15岁)进行了一项横断面研究。受试者必须在研究地区生活至少10年，他们接受了采访，进行了临床检查，并在可能的情况下检查了微丝贫血。超声确诊的淋巴水肿病例和其他受试者的随机样本也进行了丝虫抗原血症检测。这些采访探讨了与淋巴水肿有关的知识、态度和看法(KAP)，发现这种情况是众所周知的，每个研究社区都有一个当地的名称。在接受临床检查的834人中，66人(8.1%)出现了小腿淋巴水肿症，包括了这种疾病的所有临床分期。然而，在792名被寄生虫学检查的人中，没有一人在其外周血中检出班氏微丝虫(或任何其他丝虫)，而在399名接受班氏丝虫循环抗原检测的人中，只有一人(0.25%)呈阳性结果。此外，在研究区域捕获的504只蚊子在人类诱饵上着陆并解剖后，没有发现有任何阶段的班克罗夫蒂蚊子。这些发现表明，喀麦隆西北部省份出现的象皮病是非丝虫病起源的。
Lymphoedema, a condition of localized fluid retention, results from a compromised lymphatic system. Although one common cause in the tropics is infection with filarial worms, non-filarial lymphoedema, also known as podocomosis, has been reported among barefoot farmers in volcanic highland zones of Africa, Central and South America and north-western India. There are conflicting reports on the causes of lymphoedema in the highland regions of Cameroon, where the condition is of great public-health importance. To characterise the focus of lymphoedema in the highlands of the North West province of Cameroon and investigate its real causes, a cross-sectional study was carried out on the adults (aged >= 15 years) living in the communities that fall within the Ndop and Tubah health districts. The subjects, who had to have lived in the study area for at least 10 years, were interviewed, examined clinically, and, when possible, checked for microfilaraemia. The cases of lymphoedema confirmed by ultrasonography and a random sample of the other subjects were also tested for filarial antigenaemia. The interviews, which explored knowledge, attitudes and perceptions (KAP) relating to lymphoedema, revealed that the condition was well known, with each study community having a local name for it. Of the 834 individuals examined clinically, 66 (8.1%) had lymphoedema of the lower limb, with all the clinical stages of this condition represented. None of the 7 92 individuals examined parasitologically, however, had microfilariae of W. bancrofti (or any other filarial parasite) in their peripheral blood, and only one (0.25%) of the 399 individuals tested for the circulating antigens of W. bancrofti gave a positive result. In addition, none of the 504 mosquitoes caught landing on human bait in the study area and dissected was found to harbour any stage of W. bancrofti. These findings indicate that the elephantiasis seen in the North West province of Cameroon is of non-filarial origin.