Dancesco Paul, Akakpo Claude, Iamandi Ileana, Abeu Jérôme, Tshipeta Moutombo, Kacou Emmanuel
Tropical Medicine Consultants Regd, 245, boulevard Laird, Mont-Royal, Qc, H3R 1Y3, Canada.
Sante. 2005 Jan-Mar;15(1):11-6.
In a village situated at the border of the Ebrié lagoon, with economical problems, 343 school and preschool children, aged 4 to 15 (195 boys and 148 girls), considered by the school and their families to be in good health, were submitted for clinical and coproparasitologic examination. Basic clinical tests, anthropometric examination, spleen rate, nutrition status assessment (brachial perimeter of children aged 4 to 10 years) and the puberty level evaluation (using Tanner's scale) were independently completed. Splenomegaly rate among children between 4 and 9 years old was particularly important (78.0 %). Intestinal parasites were found in 84.8% of cases during the first examination (70.4% of children were diagnosed with multiple parasitosis). The most frequent parasite identified was Ascaris lumbricoides, being in 62.1 % of the cases, with a parasitic intensity between 1.000 and 52.000 OPG and worm burden between 1 and 16. According to the age, the highest prevalence of A. lumbricoides was higher (78.6 %) in children between 7 and 10 years. Results of anthropometric data, interpreted using NCHS percentile chart, indicated a significant stature-ponderal underdevelopment. Thus, concerning the height, 22.7% of all children were below normal value (below the 5th percentile), 74.3% between normal values and only 2.9% were above the 95th percentile. Among the 255 children with values between the normal limits, 73.7% (more than two thirds) were in the lower half, below the 50th percentile and only 26.3% (less than one third) were between the 50th and 95th percentile. According to the weight, 20.7% of children were below the normal value (below the 5th percentile), 77.8% had normal weight and 1.5% were above the 95th percentile. Even among children with normal weight, two thirds were in the lower half, below the 50th percentile. The underdevelopment was more evident after 9 years of age, particularly in girls. This coincided with higher rates of infection with roundworms. Regarding the nutritional status, 76.9% of the boys and 77.2% of the girls had a lower brachial perimeter than normal data, most frequently by one or two centimeters. A deficit of 3 to 4 cm. was found in 16.2% of the children, and it was higher among girls. The evaluation of pubertal development highlighted a certain delay in girls aged 10 to 12, with a preadolescence state of 76.0 % at age 10, 20.0 % at age 11 and 15.8 % at age 12. Between 13 and 15 years of age, all girls began pubertal development, but none reached Tanner's stage 5. It is concluded that the highest intestinal parasitism (particularly roundworms) can have a negative effect on the staturo-ponderal development of children, their nutrition status and pubertal development. Paludism and alimentary deficiencies have to be also considered.
在位于埃布里耶泻湖边境、存在经济问题的一个村庄，343名4至15岁的学童和学龄前儿童（195名男孩和148名女孩），学校和他们的家庭认为他们身体健康，接受了临床和粪便寄生虫学检查。独立完成了基本临床测试、人体测量检查、脾肿大率、营养状况评估（4至10岁儿童的臂围）以及青春期水平评估（使用坦纳量表）。4至9岁儿童的脾肿大率尤为突出（78.0%）。首次检查时，84.8%的病例发现肠道寄生虫（70.4%的儿童被诊断为多重寄生虫感染）。鉴定出的最常见寄生虫是蛔虫，占病例的62.1%，寄生虫强度在1000至52000个每克粪便虫卵数之间，虫负荷在1至16条之间。按年龄划分，7至10岁儿童蛔虫的患病率最高（78.6%）。使用美国国家卫生统计中心百分位数图表解释人体测量数据的结果表明，身高体重发育明显不足。因此，就身高而言，所有儿童中有22.7%低于正常值（低于第5百分位数），74.3%在正常值之间，只有2.9%高于第95百分位数。在255名数值在正常范围内的儿童中，73.7%（超过三分之二）处于下半部分，低于第50百分位数，只有26.3%（不到三分之一）在第50至95百分位数之间。按体重计算，20.7%的儿童低于正常值（低于第5百分位数），77.8%体重正常，1.5%高于第95百分位数。即使在体重正常的儿童中，三分之二也处于下半部分，低于第50百分位数。9岁以后发育不足更为明显，尤其是女孩。这与蛔虫感染率较高相吻合。关于营养状况，76.9%的男孩和77.2%的女孩臂围低于正常数据，最常见的是低1至2厘米。16.2%的儿童臂围 deficit为3至4厘米，女孩中更高。青春期发育评估突出显示10至12岁女孩有一定延迟，10岁时青春期前状态为76.0%，11岁时为20.0%，12岁时为15.8%。13至15岁之间，所有女孩开始青春期发育，但无人达到坦纳第5阶段。结论是，最高的肠道寄生虫感染（尤其是蛔虫）会对儿童的身高体重发育、营养状况和青春期发育产生负面影响。还必须考虑疟疾和营养缺乏问题。
