The epidemiology of schistosomiasis in Egypt: Menofia Governorate
The epidemiology of schistosomiasis in Egypt: Menofia Governorate
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DOI：
10.4269/ajtmh.2000.62.28
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发表时间：
2000-02-01
影响因子：
3.3
通讯作者：
Strickland, GT
中科院分区：
文献类型：
--
作者：
Abdel-Wahab, MF;Esmat, G;Strickland, GT
1992年，对埃及梅诺菲亚省27个农村社区的1,537户家庭的10,899人进行了分层随机抽样的健康问卷和尿便寄生虫学检查，以调查该省血吸虫的流行率、危险因素和感染模式的变化。每五分之一的家庭或1,480名受试者进行体检和超声波检查，以调查患病率和发病率的风险因素。曼氏血吸虫感染率为0.3%~72.9%，平均为28.5%。几何平均卵数为81.3粒/克大便。从10岁开始，按年龄分层的感染率和感染强度分别为30-40%和60-80个虫卵/克大便；在所有年龄组&10岁，男性的感染率和卵子数均高于女性。血吸虫是罕见的，只在1个社区有影响。S，曼氏杆菌感染的危险因素有男性性别；年龄10岁；居住在较小的社区；接触运河水；血吸虫病病史或粪便中有血吸虫病的治疗史；通过物理或超声检测脾肿大；以及超声检测的门脉周围纤维化(PPF)。较严重的PPF级别很少被检测到(1450次检查中有21次)。发病的危险因素，即超声检测的PPF，与感染的危险因素相似。曼氏血吸虫几乎完全取代了梅诺菲亚地区的血吸虫。曼氏血吸虫在农村社区的流行率仍然很高，平均感染强度为中等。发病率与血吸虫感染的相关性是不同的，而且明显地受到梅诺菲亚社区频繁使用抗血吸虫化疗和人群中慢性病毒性肝炎并发症的流行的影响：肝肿大与感染无关；然而，在个人和社区中，PPF和脾肿大与曼氏血吸虫感染有关。
Health questionnaires and parasitologic examinations of urine and stool were performed upon a stratified random sample of 10,899 individuals from 1,537 households in 27 rural communities in Menofia Governorate in Egypt in 1992 to investigate the prevalence of, risk factors for, and changing pattern of infection with Schistosoma sp, in the governorate. A subset, every fifth household, or 1,480 subjects, had physical and ultrasound examinations to investigate prevalence of and risk factors for morbidity. The prevalence of S. mansoni ranged from 0.3% to 72.9% and averaged 28.5%. The geometric mean egg count was 81.3 eggs/gram of stool. Age-stratified prevalence and intensity of infection was 30-40% and 60-80 eggs/gram of stool from the age of 10-onward; males had higher infection rates and ova counts than females in all age groups > 10 years old. Schistosoma haematobium was rare, being consequential in only 1 community. Risk factors for S, mansoni infection were male gender; age > 10 years; living in smaller communities; exposures to canal water; history of or treatment for schistosomiasis or blood in the stool; detection of splenomegaly by either physical or ultrasound; and ultrasound-detected periportal fibrosis (PPF). The more severe grades of PPF were rarely (21 of 1,450 examinations) detected. Risk factors for morbidity, i.e., ultrasound-detected PPF, were similar to those for infection. Schistosoma mansoni has almost totally replaced S. haematobium in Menofia. The prevalence of S. mansoni In rural communities remains high and average intensities of infection are moderate. The association of morbidity with schistosomal infection was variable and is obviously markedly influenced by both the frequent use of antischistosomal chemotherapy in communities in Menofia and by the prevalence of complications from chronic viral hepatitis in the population: hepatomegaly did not correlate with infection; PPF and splenomegaly, however, were related to S. mansoni infection in both individuals and communities.