Preliminary observations on factors responsible for long persistence and continued outbreaks of plague in Lushoto district, Tanzania
Preliminary observations on factors responsible for long persistence and continued outbreaks of plague in Lushoto district, Tanzania
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DOI：
10.1016/s0001-706x(97)00096-x
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发表时间：
1997-11-01
期刊：
影响因子：
2.7
通讯作者：
Mbise, TJ
中科院分区：
文献类型：
--
作者：
Kilonzo, BS;Mvena, ZSK;Mbise, TJ
一个多世纪以来，人类瘟疫一直是坦桑尼亚的一个重要公共卫生问题。自1886年以来，坦桑尼亚各地，包括伊林加、卡盖拉、辛吉达、姆布鲁、阿鲁沙和乞力马扎罗，都报告了有记录的疫情暴发。然而，自1980年以来，只有卢绍托、辛吉达和卡拉图地区经历了该疾病的暴发。在这些地区中，卢绍托的疾病发病率高得不成比例，而且这种情况已经持续了近17年。每年都努力通过常规方法遏制疾病，包括控制病媒和宿主、化疗和化学预防、加强卫生条件改善以及健康教育，但迄今为止，该地区仍有鼠疫病例和死亡病例。1980年4月至1996年12月期间，共记录了6599例病例，其中580例死亡(8.8%)。生物因素，如适当的啮齿动物宿主、有效的跳蚤媒介和鼠疫杆菌的存在，可能是该病长期持续和复发的部分原因。由于这种因素在疾病从未持续复发的其他鼠疫疫源地也很常见，而且土著人民在文化上与卢绍托的土著居民不同，因此认为社会文化因素在后一地区的疾病决定因素中发挥着重要作用。本文报告了对社会文化、生物和环境因素的初步观察，这些因素被认为是该地区鼠疫长期持续和反复爆发的至少部分原因。这些问题包括关于鼠疫病因和寻求健康治疗行为的传统观念、睡眠和食物储存习惯、大量啮齿动物和跳蚤，以及邻近环境的状况。(C)1997年爱思唯尔科学公司。
Human plague has been an important public health problem in Tanzania for over a century. Recorded outbreaks of the disease have been reported from various parts of Tanzania, including Iringa, Kagera, Singida, Mbulu, Arusha and Kilimanjaro since 1886. Since 1980 however, only Lushoto, Singida and Karatu districts have experienced outbreaks of the disease. Of these areas, Lushoto has disproportionately high incidences of the disease and this has persisted for nearly 17 years. Efforts to curb the disease through conventional methods, including control of vectors and reservoirs, chemotherapy and chemoprophylaxis, enforcement of sanitation improvement as well as health education, have been applied every year, but plague cases and deaths continue to occur in the area to date. During the period April 1980 to December 1996, a total of 6599 cases with 580 (8.8%) deaths were recorded. Biological factors, such as the presence of suitable rodent reservoirs, efficient flea vectors and plague bacillus, could be partly responsible for the long persistence and reccurence of the disease. Since such factors are also common in other plague foci where the disease has never been persistently recurrent, and where indigenous people are culturally different from those in Lushoto, it is assumed that socio-cultural factors play an important role as determinants of the disease in the latter district. This paper reports preliminary observations on socio-cultural, biological and environmental factors which are thought to be, at least partly, responsible for the long persistence and repeated outbreaks of plague in the district. These include traditional beliefs on the cause and health seeking behaviour for treatment of plague, sleeping and food storage habits, large populations of rodents and fleas, and status of the immediate environment. (C) 1997 Elsevier Science B.V.