کنترل و مدیریت بیماری های منتقله بوسیله حشرات در حوادث غیرمترقبه

نوع مقاله : مروری

نویسندگان

1 مرکز تحقیقات بهداشت نظامی، پژوهشکده سبک زندگی، دانشگاه علوم پزشکی بقیه‌الله (عج)، تهران، ایران

2 حشره شناسی پزشکی، دانشکده بهداشت، دانشگاه علوم پزشکی مازندران، ساری، ایران

3 بخش تحقیقات مالاریا و ناقلین، مرکز تحقیقات بیوتکنولوژی، انستیتو پاستور ایران، تهران، ایران

4 حشره شناسی پزشکی، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران

چکیده

حوادث غیرمترقبه مجموعه رخدادهای غیرقابل پیش­ بینی هستند که در اثر بلایای طبیعی و یا دستکاری­ های انسانی رخ می ­دهند. با توجه به نوع، زمان و مکان وقوع حوادث، جمعیت حشرات ناقل بیماری‌ها تحت تاثیر قرار گرفته که در نهایت ممکن است به بروز اپیدمی‌های گسترده بینجامد. بیماری­های انگلی مانند مالاریا، لیشمانیوز و بیماریهای آربوویروسی از قبیل تب دنگی، انسفالیت نیل غربی و تب کریمه کنگو که در حوادث غیرمترقبه توسط پشه ها و کنه ها به انسان منتقل می ­شوند، در کانون های بیماری افزایش یافته و حتی ممکن است به ایجاد کانونهای جدید نیز منجر شود. به عنوان نمونه، ایجاد آب های راکد به واسطه بارندگی­ های شدید، باعث بوجود آمدن لانه­ های لاروی مساعد برای ازدیاد پشه ­های خانواده کولیسیده می ­شود که بسته به مناطق انتشار و وجود یا عدم وجود عوامل بیماری زا در منطقه، امکان تکثیر تصاعدی گونه ­های مختلف بومی پشه­ های جنس های آنوفلس (ناقل انگل مالاریا)، کولکس (ناقل اصلی ویروس نیل غربی) و آئدس (ناقل اصلی ویروس دنگی و چیکونگونیا) را فراهم می نماید. در همین حال از هم گسیختگی سیستم های جاری کنترل حشرات در شبکه ­های بهداشتی، باعث تکثیر سریع حشرات ناقل مکانیکی بیماری ها مانند مگس­ ها و سوسری­ ها می­گردد. برای مقابله با شرایط بحران باید از قبل، تمهیدات مربوطه اندیشیده شده و برنامه ­های مدون اجرایی و احتیاطی تهیه گردد که شامل مجموعه اقدامات قبل از شرایط بحران، در روزهای ابتدایی و بعد از وقوع حوادث غیرمترقبه می باشد. در برنامه ­های مذکور می ­بایست متخصصین و کارشناسان کنترل ناقلین سازماندهی شده و جایگاه و نقش آنها مشخص شود. همچنین این اقدامات باید به منظور تعیین منابع موجود و تهیه تجهیزات و وسایل کنترل ناقلین و حفاظت فردی، تدوین نقشه ­های انتشار بندپایان حایز اهمیت پزشکی و همچنین کانونهای اندمیک بیماری های منتقله انجام گیرد. در نهایت، تدوین پروتکل ­های تشخیصی و ارائه راهکارهای عملیاتی کنترل ناقلین متناسب با امکانات و توانمندی­ های هر منطقه نیز لازم و ضروری است. در مطالعه حاضر، تغییرات بیماری های منتقله بوسیله بندپایان و جمعیت­ های ناقلین و همچنین راهکارهای مدیریت و کنترل آنها در شرایط حوادث و بحران در کشور جمهوری اسلامی ایران مورد بحث و بررسی قرار می گیرد.

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