Olsen A, Magnussen P, Ouma J H, Andreassen J, Friis H
Danish Bilharziasis Laboratory, Charlottenlund, Denmark.
Trans R Soc Trop Med Hyg. 1998 Nov-Dec;92(6):643-9. doi: 10.1016/s0035-9203(98)90795-7.
A cross-sectional study of 729 children and adults in western Kenya investigated the impact of infection with hookworm, Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni and malaria on iron status. In bivariate analyses, hookworm intensities as low as 300 eggs/g of faeces were negatively related to levels of haemoglobin (Hb) and serum ferritin (SF). Malaria parasitaemia was negatively related to Hb and positively related to SF, while S. mansoni intensities were negatively related to SF. Multivariate regression analysis was done to identify predictors of Hb and SF levels. In children, age (in years) was the only predictor for Hb (B = 1.7 g/L) and only malaria parasitaemia (negative, light, moderate, heavy) was retained in the model for log10 SF (B = 0.097 microgram/L). In adults, hookworm infection and malaria parasitaemia together with age, sex, pregnancy, SF levels < 12 micrograms/L and elevated body temperature were significant predictors of low Hb. The regression coefficient for hookworm egg count (for increments of 100 eggs/g) was -1.3 g/L. Significant interactions between sex and age and between sex and malaria parasitaemia were revealed. Age and malaria parasitaemia were significant predictors only among females, with a regression coefficient for malaria parasitaemia of -6.9 g/L. The regression coefficient for hookworm did not change when SF < 12 micrograms/L was taken out of the model, indicating that the effect of hookworm cannot be explained by low iron stores alone. Using SF as the dependent variable, hookworm and S. mansoni intensities together with age and sex were retained in the model. The regression coefficients for hookworm egg count (increments of 100 eggs/g) and S. mansoni egg count (increments of 10 eggs/g) were -0.011 microgram/L and -0.012 microgram/L, respectively. Iron deficiency was a problem in this population and hookworm infections contributed significantly to this situation.
一项针对肯尼亚西部729名儿童和成人的横断面研究，调查了钩虫、蛔虫、鞭虫、曼氏血吸虫感染及疟疾对铁状态的影响。在双变量分析中，粪便中钩虫强度低至300个卵/克与血红蛋白（Hb）水平和血清铁蛋白（SF）呈负相关。疟原虫血症与Hb呈负相关，与SF呈正相关，而曼氏血吸虫强度与SF呈负相关。进行多变量回归分析以确定Hb和SF水平的预测因素。在儿童中，年龄（岁）是Hb的唯一预测因素（B = 1.7 g/L），log10 SF模型中仅保留疟原虫血症（阴性、轻度、中度、重度）（B = 0.097微克/升）。在成人中，钩虫感染、疟原虫血症以及年龄、性别、妊娠、SF水平<12微克/升和体温升高是低Hb的显著预测因素。钩虫卵计数（每增加100个卵/克）的回归系数为-1.3 g/L。揭示了性别与年龄之间以及性别与疟原虫血症之间的显著相互作用。年龄和疟原虫血症仅在女性中是显著预测因素，疟原虫血症的回归系数为-6.9 g/L。当将SF < 12微克/升从模型中剔除时，钩虫的回归系数不变，表明钩虫的影响不能仅由低铁储备来解释。以SF作为因变量，模型中保留了钩虫和曼氏血吸虫强度以及年龄和性别。钩虫卵计数（每增加100个卵/克）和曼氏血吸虫卵计数（每增加10个卵/克）的回归系数分别为-0.011微克/升和-0.012微克/升。缺铁是该人群中的一个问题，钩虫感染对这种情况有显著影响。
