Steketee Richard W
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Nutr. 2003 May;133(5 Suppl 2):1661S-1667S. doi: 10.1093/jn/133.5.1661S.
In the developing world, young women, pregnant women, and their infants and children frequently experience a cycle where undernutrition (macronutrient and micronutrient) and repeated infection, including parasitic infections, lead to adverse consequences that can continue from one generation to the next. Among parasitic infections, malaria and intestinal helminths coexist widely with micronutrient deficiencies and contribute importantly to anemia and this cycle of retarded growth and development. In somewhat more limited or focal geographic settings, other parasitic diseases (e.g., schistosomiasis, filariasis) contribute similarly to this cycle. It is undoubtedly much better to enter a pregnancy free of infection and nutritionally replete than the various alternatives. Existing intervention strategies for micronutrient support and for the control of common parasitic infections before or during pregnancy, particularly malaria and intestinal helminths, should be followed. However, further research to identify barriers and priority approaches to achieving this goal remain very important in resource-poor settings where targeted public health efforts are required.
在发展中世界,年轻女性、孕妇及其婴幼儿经常经历一个循环:营养不良(宏量营养素和微量营养素缺乏)以及反复感染,包括寄生虫感染,会导致不良后果,并可能代代相传。在寄生虫感染中,疟疾和肠道蠕虫与微量营养素缺乏广泛共存,对贫血以及生长发育迟缓的这个循环有重要影响。在一些范围较有限或呈局部性的地理区域,其他寄生虫病(如血吸虫病、丝虫病)对这个循环也有类似影响。毫无疑问,孕期没有感染且营养充足比其他各种情况要好得多。应遵循现有的微量营养素支持以及孕期前或孕期控制常见寄生虫感染,特别是疟疾和肠道蠕虫的干预策略。然而,在需要有针对性公共卫生努力的资源匮乏地区,进一步开展研究以确定实现这一目标的障碍和优先方法仍然非常重要。