EPIDEMIOLOGY OF CUTANEOUS LEISHMANIASIS AT A FOCUS MONITORED BY THE MULTINATIONAL FORCE AND OBSERVERS IN THE NORTHEASTERN SINAI DESERT OF EGYPT
EPIDEMIOLOGY OF CUTANEOUS LEISHMANIASIS AT A FOCUS MONITORED BY THE MULTINATIONAL FORCE AND OBSERVERS IN THE NORTHEASTERN SINAI DESERT OF EGYPT
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DOI：
10.4269/ajtmh.1993.49.598
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发表时间：
1993-11-01
影响因子：
3.3
通讯作者：
YOUSSEF, FG
中科院分区：
文献类型：
--
作者：
FRYAUFF, DJ;MODI, GB;YOUSSEF, FG
1989 年 7 月至 1991 年 6 月期间，在埃及和以色列之间的国际维和特派团多国部队和观察员 (MFO) 的监测下，在西奈沙漠东北部 1,200 平方公里的地区进行了一项关于皮肤利什曼病 (CL) 传播的纵向流行病学研究。人类病例的发生、白蛉密度、啮齿动物收集和利什曼原虫隔离证实，四个调查地点中只有一个是 CL 传播的重要焦点。白蛉 (Phlebotomus papatasi) 是该重点地区遇到的唯一嗜人白蛉物种，占白蛉种群的 96% 以上，1990 年人类着陆密度超过 100 只/人/小时。该物种的季节性活动范围为 4 月至 11 月，密度最高出现在 5 月至 9 月期间。 1990 年 7 月期间，在 P. papatasi 中观察到前鞭毛体感染率为 2.4%（534 人中的 13 人）。在该地点白蛉活动剧烈的 6 个月期间，有 60 人中有 12 人（20%）出现了与 CL 一致的病变；其中 9 例 (75%) 病例中分离出 L. Major。同一时期使用的 22 只哨兵仓鼠中的两只 (9%) 感染了利什曼原虫。该地点捕获的 897 只野生啮齿动物中，97% 以上是沙漠沙鼠。重大利什曼原虫是唯一从人类、白蛉、野生啮齿动物（锥体沙鼠）和哨兵仓鼠感染中分离出来的利什曼原虫，这些利什曼原虫起源于检查点 1-Delta，这是 MFO 管辖范围内 CL 传播的焦点。由于修建大坝而改变了该地区的生态，可能会对该焦点的 CL 传输动态产生重大影响。
A longitudinal epidemiologic study of cutaneous leishmaniasis (CL) transmission was conducted between July 1989 and June 1991 in a 1,200-km2 sector of the northeastern Sinai Desert monitored by the Multinational Force and Observers (MFO), an international peace keeping mission between Egypt and Israel. The occurrence of human cases, sand fly density, rodent collection, and isolations of Leishmania confirmed only one of four surveyed locations as a significant focus of CL transmission. Phlebotomus papatasi, the only anthropophilic sand fly species encountered at this focus, comprised more than 96% of the sand fly population and attained human landing densities exceeding 100 sand flies/person/hr during 1990. Seasonal activity of this species ranged from April to November, with highest densities occurring during the period May-September. A peak promastigote infection rate of 2.4% (13 of 534) was observed in P. papatasi during July 1990. Twelve of the 60 (20%) persons at risk during the six months of intense sand fly activity at this site developed lesions consistent with CL; L. major was isolated from nine (75%) of these cases. Leishmania major infection was acquired by two of 22 (9%) sentinel hamsters used during the same period. More than 97% of the 897 wild rodents trapped at this site were desert gerbil species. Leishmania major was the only Leishmania isolated from human, sand fly, wild rodent (Gerbillus pyramidum), and sentinel hamster infections that originated at site Check point 1-Delta, the focus of CL transmission within jurisdiction of the MFO. The altered ecology of this area, created by construction of a dam, may contribute significantly to the transmission dynamics of CL at this focus.