The relative contribution of immigration or local increase for persistence of urban schistosomiasis in Salvador, Bahia, Brazil.
The relative contribution of immigration or local increase for persistence of urban schistosomiasis in Salvador, Bahia, Brazil.
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DOI：
10.1371/journal.pntd.0003521
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发表时间：
2015-03
影响因子：
3.8
通讯作者：
Reis MG
中科院分区：
文献类型：
--
作者：
Blanton RE;Barbosa LM;Reis EA;Carmo TM;Dos Santos CR;Costa JM;Aminu PT;Blank WA;Reis RB;Guimarães IC;Silva LK;Reis MG
地球仪的城市化进程正在加快，由于人口从农村流行地区迁移、城市内的局部传播或多种因素的结合，曾经被认为是农村的疾病现在也可以在城市地区发现。我们调查了居住在巴西萨尔瓦多附近的城市移民和当地人的流行病学特征，那里是曼氏血吸虫传播的焦点。在一项横断面研究中，对社区3个部分的所有居民进行了访谈和检查。为了确定外来寄生虫与本地寄生虫的分化程度，我们用S.对粪便中的曼氏虫卵进行15个微卫星标记的基因分型。该地区接收了来自全州各地的移民，但大多数受感染的儿童从未离开过城市，受感染的蜗牛出现在水接触点。其他流行病学特征表明，移民对感染的存在贡献不大。移民和本地人的感染强度和患病率是相同的，当调整年龄，移民居住在社区的时间与感染率呈正相关。寄生虫的人口结构也支持移民的贡献很小，因为宿主-宿主分化在城市寄生虫人口中并不比远距离移民的农村人口大，并且在过去7年中城市人口中几乎没有分化。公共卫生工作应侧重于消除本地传播，一旦消除，就不太可能从远距离移民中重新引入。随着农村疾病越来越不常见和城市化程度的提高，人们越来越认识到血吸虫病的城市传播。移民人口对城市的感染特征和寄生虫人口本身的遗传特征表明，当地传播是寄生虫存在的最重要因素，而不是受感染移民的到来。虽然适当卫生设施的覆盖率为70%，但这不足以阻断传播。如果消除，这一重点是不太可能容易重新出现，由于移民。
Urbanization is increasing across the globe, and diseases once considered rural can now be found in urban areas due to the migration of populations from rural endemic areas, local transmission within the city, or a combination of factors. We investigated the epidemiologic characteristics of urban immigrants and natives living in a neighborhood of Salvador, Brazil where there is a focus of transmission of Schistosoma mansoni. In a cross-sectional study, all inhabitants from 3 sections of the community were interviewed and examined. In order to determine the degree of parasite differentiation between immigrants and the native born, S. mansoni eggs from stools were genotyped for 15 microsatellite markers. The area received migrants from all over the state, but most infected children had never been outside of the city, and infected snails were present at water contact sites. Other epidemiologic features suggested immigration contributed little to the presence of infection. The intensity and prevalence of infection were the same for immigrants and natives when adjusted for age, and length of immigrant residence in the community was positively associated with prevalence of infection. The population structure of the parasites also supported that the contribution from immigration was small, since the host-to-host differentiation was no greater in the urban parasite population than a rural population with little distant immigration, and there had been little differentiation in the urban population over the past 7 years. Public health efforts should focus on eliminating local transmission, and once eliminated, reintroduction from distant migration is unlikely. Urban transmission of schistosomiasis is becoming more recognized as rural disease is becoming less common and urbanization increases. Characteristics of infection of the immigrant population to cities and genetic characteristics of the parasite population itself indicate local transmission is the most important factor for the presence of the parasite rather than arrival of infected immigrants. While there is 70% coverage of adequate sanitation, this was insufficient to interrupt transmission. If eliminated, this focus is unlikely to readily reappear due to immigration.
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影响因子：
7.7
作者：
Firmo, JOA;Costa, MFLE;Rocha, RS
通讯作者：
Rocha, RS
DOI：
10.1590/s0074-02762003000600006
发表时间：
2003-09-01
期刊：
Memórias do Instituto Oswaldo Cruz
影响因子：
--
作者：
Enk, Martin J;Amorim, Amanda;Schall, Virginia T
通讯作者：
Schall, Virginia T
影响因子：
4
作者：
Blanton, Ronald E.;Blank, Walter A.;Reis, Mitermayer G.
通讯作者：
Reis, Mitermayer G.
影响因子：
2.8
作者：
Coura-Filho
通讯作者：
Coura-Filho
影响因子：
4.9
作者：
Jost, Lou
通讯作者：
Jost, Lou