越南南部儿童钩端螺旋体病的血清流行病学

Seroepidemiology of leptospirosis in southern Vietnamese children.

作者信息

Thai Khoa T D, Binh Tran Quang, Giao Phan Trong, Phuong Hoang Lan, Hung Le Quoc, Van Nam Nguyen, Nga Tran Thanh, Goris Marga G A, de Vries Peter J

机构信息

Division of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, Amsterdam, the Netherlands, and Tropical Diseases Clinical Research Center, Cho Ray Hospital, Ho Chi Minh City, Vietnam.

出版信息

Trop Med Int Health. 2006 May;11(5):738-45. doi: 10.1111/j.1365-3156.2006.01619.x.

DOI:10.1111/j.1365-3156.2006.01619.x

PMID:16640627

Abstract

OBJECTIVE

To estimate the seroprevalence of human leptospirosis in southern Vietnam.

METHODS

All pupils (n=961) of two primary schools in two communes in southern Vietnam were screened for the presence of serum Leptospira immunoglobulin (Ig)G. Leptospira IgM was tested in 92 randomly selected samples. IgM and IgG were tested with a commercially available enzyme-linked immunosorbent assay (ELISA).

RESULTS

Leptospira IgG was found in 123 (12.8%, 95% CI: 10.8-15.1) children with a male:female ratio of 1.5:1. At the age of 7 years the prevalence was 11%. Log-linear binary regression of the IgG seroprevalence by age showed a mean seroconversion rate of 1.5% (95% CI: 1.23-1.75) per year. Five (5.4%, 95% CI: 2.3-12.1) samples were definitely positive for IgM. Presence of serum Leptospira IgG antibodies was significantly associated with swimming in rivers (RR: 1.745, 95% CI: 1.117-2.724) and wading through water (RR 1.793, 95% CI: 1.181-2.722).

CONCLUSION

Our data emphasize the importance of leptospirosis among children in Vietnam, despite the absence of severe disease, and stress the need for adequate and cheap diagnostics.

摘要

目的

评估越南南部人类钩端螺旋体病的血清流行率。

方法

对越南南部两个公社的两所小学的所有学生（n = 961）进行血清钩端螺旋体免疫球蛋白（Ig）G检测。对92个随机选择的样本检测钩端螺旋体IgM。使用市售酶联免疫吸附测定（ELISA）检测IgM和IgG。

结果

在123名儿童（12.8%，95%可信区间：10.8 - 15.1）中发现钩端螺旋体IgG，男女比例为1.5:1。7岁时的患病率为11%。按年龄对IgG血清流行率进行对数线性二元回归显示，每年的平均血清转化率为1.5%（95%可信区间：1.23 - 1.75）。5个样本（5.4%，95%可信区间：2.3 - 12.1）的IgM呈明确阳性。血清钩端螺旋体IgG抗体的存在与在河中游泳（相对风险：1.745，95%可信区间：1.117 - 2.724）和涉水（相对风险1.793，95%可信区间：1.181 - 2.722）显著相关。