Şark Çıbanı, Kırım Kongo Kanamalı Ateşi, Batı Nil Virüsü ve Sıtma’nın Adana İlindeki Epidemiyolojisi

Öz

Amaç: Çalışmamızın amacı Adana ilinde Şark Çıbanı, Kırım‐Kongo Kanamalı Ateşi (KKKA), Batı Nil

Virüsü (BNV) ve Sıtma’nın dahil olduğu bazı vektörel hastalıkların biyolojik ve güncel epidemiyolojik

özelliklerini tanımlayarak birinci basamak ve halk sağlığı alanında çalışanlara yol göstermesini

sağlamaktır.

Materyal ve Metot: Bu çalışma Çukurova Üniversitesi Halk Sağlığı Anabilim Dalı ve Adana İl Sağlık

Müdürlüğü Halk Sağlığı Hizmetleri Başkanlığı ile ortaklaşa yapılmıştır. Gerekli izinler alındıktan sonra

Adana İl Sağlık Müdürlüğü Halk Sağlığı Hizmetleri Başkanlığı Vektörel ve Zoonotik Hastalıklar

Birimi’nin elde ettiği Şark Çıbanı, KKKA, BNV ve Sıtma içeren ve 01.01.2016 ile 15.11.2018 zaman aralığını

kapsayan yaklaşık 3 yıllık kayıtlar incelenmiştir. Veriler STATISTICA 8.0 yazılımı kullanılarak analiz

edilmiştir. Verilerin niteliğine göre uygun χ2 ikili veya çoklu karşılaştırma testlerinden yararlanılmıştır.

Tüm istatistik analizlerde p<0,05 değeri anlamlı kabul edilmiştir.

Bulgular: Yaklaşık üç yıllık dönemde sık görülen bu dört vektörel hastalıktaki toplam 638 vakanın

%86,20’si (n: 550) etkenle temasın Adana’da olduğu yerel vaka, %13,80’i (n: 88) importe vakadır.

Vakaların %89,34’ü (n: 570) Şark Çıbanı, %5,32’si (n: 34) Sıtma, %2,83’ü (n: 18) BNV, %2,51 (n: 16)

KKKA’dır. Şark çıbanında vakaların %50,35’i (n: 287) erkek ve yaş ortalaması 23,97 yıldır. Şark çıbanının

%54,1’i (n: 317) Suriyeli göçmenlerde görülmüştür. Şark çıbanının Suriyeli göçmenlerde Türk

vatandaşlarına göre daha fazla (p=0,023) ve Ocak ile Mayıs aralığında, diğer aylara göre daha yüksek

sıklıkta görülmesi istatistiksel olarak anlamlı bulunmuştur (p<0,001). Kırım Kongo Kanamalı Ateşi’nde

vakaların yaş ortalaması 35,68 yıl, %75,00’i (n: 12) erkek ve %6,25’sinin (n: 1) ölüm ile sonuçlandığı

görülmektedir. Haziran ile ağustos aralığında, diğer aylara göre daha fazla görülmesi istatistiksel olarak

anlamlı bulunmuştur (p<0,01). BNV’de yaş ortalaması 36,52 yıl, %88,9’u (n: 16) erkek, %22,22’sinde (n: 4)

BNV kaynaklı nörolojik hastalık görülmüş ve %5,55’sı da (n: 1) ölümle sonuçlanmıştır. BNV’nin temmuz

ile eylül aralığında diğer aylara göre daha fazla görüldüğü istatistiksel olarak anlamlı bulunmuştur

(p<0,001). Sıtma vakalarının yaş ortalaması 38,54 yıl, %2,94’ü (n: 1) yabancı uyruklu ve tamamı (n: 34)

erkek ve importe vakadır.

Sonuç: Şark Çıbanı, KKKA, BNV ve Sıtma tüm dünyada olduğu gibi ülkemizde de ciddi sağlık etkileri

olması bakımından günümüzde hala önemini korumaktadır. Hastalıkların farklı özelliklerini tanımlayan

güncel epidemiyolojik çalışmaların, koruyucu sağlık hizmetlerinin uygulanmasına rehberlik ettiği

bilinen bir gerçektir. Çalışmamızda yer alan bu vektörel hastalıklarla ilgili güncel verilerin, alanda

çalışan tüm sağlık sunucularına yol göstereceğini umuyoruz.

Anahtar Kelimeler

• Şark çıbanı
• Kırım‐Kongo Kanamalı Ateşi
• Batı Nil virüsü
• sıtma
• vektörel

Epidemiology of Cutaneous Leishmaniasis, Crimean Congo Hemorrhagic Fever, West Nile Virus and Malaria in Adana Province

Abstract

Objectives: Aim of this study was to determine the biological and current epidemiological characteristics of some vector-borne diseases including Cutaneous Leishmaniasis (CL), Crimean-Congo Hemorrhagic Fever (CCHF), West Nile Virus (WNV) and Malaria in Adana to provide guidance for employees in public health.
Materials and Methods: This study was carried out in cooperation with Public Health Department of Çukurova University and Public Health Services of Adana Provincial Health Directorate. After the necessary permissions, records of Vectorial and Zoonotic Diseases Unit including approximately 3 years period between 01.01.2016 and 15.11.2018 have been examined. Data were analyzed using STATISTICA 8.0 software and χ2 binary or multiple comparisons were used. p<0.05 was considered significant level.
Results: 86.20% (n: 550) of 638 cases were local cases in which contact with the agent was inside Adana and the rest (n: 88) were import cases. 89.34% (n: 570) of all cases were belong to CL, followed by Malaria, WNV and CCHF with 5.32% (n: 34), 2.83% (n: 18) and 2.51% (n: 16), respectively. 50,35% (n: 287) of CL patients were male and the mean age was 23.97 years. Also 54.10% (n: 317) of CL was seen in Syrian migrants. It was found statistically significant that number of CL in Syrian migrants was higher than that of Turkish citizens (p=0.023) and higher in January and May than in other months (p<0.001). The mean age of the cases in CCHF was 35.68 years, 75.00% (n: 12) was male and 6.25% (n: 1) resulted in death. It was found statistically significant that CCHF was seen in June-August period more than the other months (p<0.01). The mean age of WNV was 36.52 years, 88.9% (n: 16) was male, 22.22% (n: 4) had WNV-induced neurological disease and 5.55% (n: 1) resulted in death. It was also found that WNV was more common in July and September than in other months (p<0.001). The mean age of malaria cases was 38.54 years, 2.94% (n: 1) was foreigners and all (n: 34) were males and import cases.
Conclusion: All these diseases are still important today in our country as they have serious health effects. It is a known fact that current epidemiological studies that define the different characteristics of diseases guide the implementation of preventive health services. We hope that the current data on these vector-borne diseases will guide all healthcare providers working in the field.

Keywords

• Cutaneous Leishmaniasis
• Crimean Congo Hemorrhagic Fever
• West Nile Virus
• malaria
• vector-borne
• Turkey

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