科学家对霍乱流行地区的霍乱发病率进行了估计,结果发现该病造成了相当高的负担,对低龄儿童的影响最大。
他们说,这样的估计在决定应该把干预措施对准何处的时候非常重要,这些措施包括水供应、卫生设施的改善和免疫接种等。
该研究的论文发表在了2月20日出版的《公共科学图书馆·被忽视的热带病》(PLoS Neglected Tropical Diseases)上。研究是在印度的加尔各答、印度尼西亚的雅加达和莫桑比克的贝拉这三个城市进行的。这个国际研究小组为在这些地区的卫生中心就诊的全年龄组腹泻患者进行了霍乱的检测。霍乱是由霍乱弧菌导致的。
他们发现整体霍乱发病率最低的是雅加达,发病率是每年每千人0.5例。加尔各答的发病率是雅加达的3倍(每年每千人1.6例),而在贝拉,发病率是雅加达的8倍(每年每千人4例)。
在所有这些地区,儿童受到的影响最严重,在5岁以下儿童中的发病率最高。
该研究的作者之一、印度加尔各答国立霍乱和肠道疾病研究所的副所长Dipika Sur说:“该研究表明霍乱仍然是发展中国家的一个大问题,而许多科学家和决策者并没有意识到这一点。”
Sur说在霍乱地方流行的地区,儿童容易染上这种疾病,因为成年人已经有了免疫力,而刚接触到这种疾病的儿童还没有产生免疫力。他还表示,为加尔各答的数量庞大的人口提供安全的水和卫生设施,这在近期是无法实现的。“接种疫苗是一个有吸引力的替代方案。然而,目前还没有低成本的霍乱疫苗。”
南非斯坦陵布什大学卫生科学系的Jo Barnes说,由于目前持续的洪水和不良的基础设施,莫桑比克面临的风险最高。
“人们被迫离开家园,生活在类似于难民营的地方——这让霍乱流行的环境成熟了。”她警告说,该病可以在环境中潜伏数年,只要条件适宜,它就会重新露面。
但是她说,接种霍乱疫苗可能效果不大。“接种疫苗只能在3到6个月内有效,而且只有50%的有效率。目前急需的是坑式厕所、清洁的饮用水和卫生学方面的教育。”(来源:科学与发展网络 Sanjit Bagchi and Carol Campbell)
生物谷推荐原始出处:
(PLoS Neglected Tropical Diseases), doi:10.1371/journal.pntd.0000173,Jacqueline L. Deen,John D. Clemens
The High Burden of Cholera in Children: Comparison of Incidence from Endemic Areas in Asia and Africa
Jacqueline L. Deen, Lorenz von Seidlein, Dipika Sur, Magdarina Agtini, Marcelino E. S. Lucas, Anna Lena Lopez, Deok Ryun Kim, Mohammad Ali, John D. Clemens
Abstract
Background
Cholera remains an important public health problem. Yet there are few reliable population-based estimates of laboratory-confirmed cholera incidence in endemic areas around the world.
Methods
We established treatment facility–based cholera surveillance in three sites in Jakarta (Indonesia), Kolkata (India), and Beira (Mozambique). The annual incidence of cholera was estimated using the population census as the denominator and the age-specific number of cholera cases among the study cohort as the numerator.
Findings
The lowest overall rate was found in Jakarta, where the estimated incidence was 0.5/1000 population/year. The incidence was three times higher in Kolkata (1.6/1000/year) and eight times higher in Beira (4.0/1000/year). In all study sites, the greatest burden was in children under 5 years of age.
Conclusion
There are considerable differences in cholera incidence across these endemic areas but in all sites, children are the most affected. The study site in Africa had the highest cholera incidence consistent with a growing impression of the large cholera burden in Africa. Burden estimates are useful when considering where and among whom interventions such as vaccination would be most needed.