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

Yıl 2018, Cilt: 18 Sayı: 4, 479 - 491, 27.12.2018

Onur Acar , Burak Akbaba Ali Tanju Altınsu Yakup Yılancıoğlu

https://doi.org/10.17098/amj.497507

Cited By: 1

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

• 1) World Health Organization [Internet]. Vector-borne diseases. Available from: http://www.who.int/news-room/fact-sheets/detail/vector-borne-diseases , Date of Access: October 15, 2018.
• 2) European Centre for Disease Prevention and Control [Internet]. Vector-borne diseases. Available from: https://ecdc.europa.eu/en/climate-change/climate-change-europe/vector-borne-diseases , Date of Access: October 15, 2018.
• 3) Kilpatrick AM, Randolph SE. Drivers, Dynamics, and control of emerging vector-borne zoonotic diseases. Lancet 2012;380(9857):1946-55.
• 4) Reiter P. Climate change and mosquito-borne disease. Environ Health Perspect 2001; 109(Suppl 1):141-61.
• 5) Rogers DJ, Randolph SE. Climate change and vector-borne diseases. Adv Parasitol 2006;62:345-81.
• 6) Vector-borne diseases Report of an informal expert consultation SEARO, New Delhi, 7-8 April 2014. World Health Organization 2014. Available from: http://apps.who.int/iris/bitstream/handle/10665/206531/B5139.pdf?sequence=1&isAllowed=y, Date of Access: October 15, 2018.
• 7) Aradaib IE, Erickson BR, Mustafa ME et al. Nosocomial outbreak of Crimean-Congo hemorrhagic fever, Sudan. Emerg Infect Dis 2010;16(5):837-39.
• 8) Chen LH, Wilson ME. Nosocomial Dengue by mucocutaneous transmission. Emerg Infect Dis. 2005;11(5):775.
• 9) Gruell H, Hamacher L, Jennissen V et al. On taking a diffirent route: An unlikely case of Malaria by nosocomial transmission. Clin Infect Dis 2017;65(8):1404-06.
• 10) Ser O, Cetin H. Cutaneous leishmaniasis and its status in Antalya, Turkey. Turkish J Parasitology 2013;37(2):84-91.
• 11) Khosravi A, Sharifi I, Fekri A et al. Clinical features of anthroponotic cutaneous leishmaniasis in a major focus, Southeastern Iran, 1994-2014. Iran J Parasitol 2017;12 (4):544-53.
• 12) Sucaklı MB, Saka G. Epidemiology of cutaneous leishmaniasis in Diyarbakir, 2002-2006. Turkish J Parasitology 2007;31 (3):165-9.
• 13) Atakan E, Akbaba M, Sütoluk Z, Alptekın D, Demırhındı H, Uludağ SK. Population density of phlebotomus (Diphtera; Psychodidae; Phlebotomine) species and their relationship with cutaneous leishmaniasis in Hocallı and Turunçlu villages (Adana). Turkish J Parasitology 2010;34(2):106-11.
• 14) Ministry of İnterior Directorate General of Migration Management [İnternet]. Statistics of Temporary Protection. Available from: http://www.goc.gov.tr/icerik6/temporary-protection_915_1024_4748_icerik , Date of Access: October 22, 2018.
• 15) Culha G, Akcali C. Detection of cutaneous leishmaniasis cases in Hatay and surrounding areas. Turkish J Parasitology 2006;30(4):268-71.
• 16) Uzun S, Uslular C, Yucel A, Acar MA, Ozpoyraz M, Memisoglu HR. Cutaneous leishmaniasis: Evaluation of 3,074 cases in the Cukurova region of Turkey. British J Dermatology 1999;140(2):347-50.
• 17) Ok UZ, Balcioglu IC, Taylan Ozkan A, Ozensoy S, Ozbel Y. Leishmaniasis in Turkey. Acta Tropica 2002;84(1):43-8.
• 18) Yilmaz GR, Buzgan T, Irmak H et al. The epidemiology of Crimean- Congo hemorrhagic fever in Turkey, 2002- 2007. Int J Infect Dis. 2009;13(3):380-6.
• 19) Ince Y, Yasa C, Metin M et al. Crimean- Congo hemorrhagic fever infections reported by ProMED. Int J Infect Dis 2014;26:44-6.
• 20) Sharififard M, Alavi SM, Salmanzadeh S, Safdari F, Kamali A. Epidemiological survey of Crimean- Congo hemorrhagic fever (CCHF), a fatal infectious disease in Khuzestan province, Southwest Iran, during 1999- 2015. Jundishapur J Microbiol 2016;9(5):e30883.
• 21) Chinikar S, Ghiasi SM, Moradi M et al. Geographical distribution and surveillance of Crimean- Congo hemorrhagic fever in Iran. Vector Borne Zoonotic Dis. 2010;10(7):705-8.
• 22) Aker S, Akıncı H, Kılıçoğlu C, Leblebicioglu H. The geographic distribution of cases of Crimean- Congo hemorrhagic fever: Kastamonu, Turkey. Ticks Tick Borne Dis 2015;6(6):730- 6.
• 23) Swanepoel R, Struthers JK, Shepherd AJ, McGillivray GM, Nel Mj, Jupp PG. Am J Trop Med Hyg. 1983;32(6):1407-15.
• 24) Ergönül O. Crimean-Congo hemorrhagic fever. Lancet Infect Dis 2006;6(4):203-14.
• 25) Fisher-Hoch SP, McCormick JB, Swanepoel R, Van Middlekoop A, Harvey S, Kustner HG. Risk of human infections with Crimean-Congo hemorrhagic fever virüs in a South African rural community. Am J Trop Med Hyg 1992;47(3):337-45.
• 26) Izadi S, Naieni KH, Madjdzadeh SR, Nadim A. Crimean-Congo hemorrhagic fever in Sistan and Baluchestan province of Iran, a case-control study on epidemiological characteristics. Int J Infect Dis 2004;8(5):299-306.
• 27) Türk Tabipleri Birliği Merkez Konseyi. Türk Tabipleri Birliği Kırım Kongo Kanamalı Ateşi Bilimsel Değerlendirme Raporu. 1.Baskı, Ankara: Türk Tabipleri Birliği Yayınları; 2010. Available from: https://www.ttb.org.tr/kutuphane/kirim_kongo_rpr.pdf Date of Access: October 23, 2018.
• 28) Biçeroğlu SU, Karatayli E, Bayram A et al. Investigation of West Nile virus among healthy blood donors in the western part of Turkey. Turk J Med Sci 2015;45(1):84-8.
• 29) Kalaycioglu H, Korukluoglu G, Ozkul A et al. Emergence of West Nile virus infections in humans in Turkey, 2010 to 2011. Euro Surveill. 2012;17(21):20182.
• 30) Napoli C, Iannetti S, Rizzo C et al. Vector borne infections in Italy: results of the integrated surveillance system for West Nile disease in 2013. Biomed Res Int 2015;2015:643439.
• 31) Bassal R, Shohat T, Kaufman Z et al. The seroprevalence of West Nile virus in Israel: A nationwide cross-sectional study. PLoS One 2017;12(6):e0179774.
• 32) European Centre for Disease Prevention and Control [Internet]. Epidemiological update: West Nile virus transmission season in Europe, 2017. Available from: https://ecdc.europa.eu/en/news-events/epidemiological-update-west-nile-virus-transmission-season-europe-2017 Date of Access: October 24, 2018.
• 33) European Centre for Disease Prevention and Control [Internet]. Table. Transmission of West Nile fever, May to November 2017- Table of cases, 2017. Available from: https://ecdc.europa.eu/en/publications-data/table-transmission-west-nile-fever-may-november-2017-table-cases-2017 , Date of Access: October 24, 2018.
• 34) European Centre for Disease Prevention and Control [Internet]. Weekly updates: 2018 West Nile fever transmission season. Available from: https://ecdc.europa.eu/en/west-nile-fever/surveillance-and-disease-data/disease-data-ecdc , Date of Access: October 24, 2018.
• 35) Napp S, Petric D, Busquets N. West Nile virus and other mosquito-borne viruses present in Eastern Europe. Pathog Glob Health. 2018;112(5):233-48.
• 36) Yentur Doni N, Yıldız Zeyrek F, Seyrek A, Simsek Z, Gurses G, Topluoglu S. Evaluation of epidemiological data of Malaria between 2001-2011 in Sanliurfa, Turkey. Mikrobiyol Bul 2016;50(2):307-14.
• 37) Aydin MF, Sahin A. Malaria epidemiology in Mersin province, Turkey from 2002 to 2011. Iran J Parasitol 2013;8(2):296-301.
• 38) Sarafraz S, Ghabouli Mehrabani N, Mirzaei Y et al. Epidemiology of malaria in East Azerbaijan province, Iran, from 2001 to 2013. J Parasit Dis 2016;40(3):813-7.
• 39) Kuscu F, Ozturk DB, Gül S, Babayigit ML. The epidemiology of Malaria in Adana between 2002 and 2012. Turkish J Parasitol 2014;38(3):147-50.
• 40) Ser O, Cetin H. Evaluation of Malaria cases in Antalya between 2001 and 2011. Turkish J Parasitol 2012;36(1):4-8.
• 41) Norouzinezhad F, Ghaffari F, Raeisi A, Norouzinejad A, Kaveh F. Malaria Four-year epidemiological trends in Sistan and Baluchistan province, Iran. Electron Physician 2017;9(1):3660-4.
• 42) Karadag A, Unal N, Yanık K, Borucu R, Gunaydin M, Hokelek M. Evaluating of Plasmodium species isolated from peripheral blood samples in a non-endemic region. Turkish J Parasitol 2015;39(1):5-8.
• 43) Fekri S, Vatandoost H, Daryanavard A et al. Malaria situation in an endemic area, Southeastern Iran. J Anthropod Borne Dis 2013;8(1):82-90.