Alvarado Beatriz Eugenia, Vásquez Luis Reinel
Grupo AntroPacífico, Unidad de Epidemiología Clínica, Facultad de Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia.
Biomedica. 2006 Mar;26(1):82-94.
Studies on intestinal intestinal parasitism in children under 2 years of age have rarely been performed. The nutritional consequences and feasibility of parasite prevention justify the current study.
The study was undertaken with 3 goals: (1) to identify the prevalence of pathogenic intestinal parasites (PIP), (2) to determine the social factors, sanitary conditions and nutritional practices that predict PIP, and (3) to evaluate PIP effects on infant nutritional status.
All mothers with children under 18 months of age and living in an urban community of coastal Colombia were invited to participate in the PIP study. A fecal sample was obtained from each of 136 children; they represented 62% of the total 7-18 month-old population in the community. Presence of intestinal parasites was identified by direct microscopy and confirmed by a concentration test (Ritchie-Frick procedure). Logistic regressions were used to predict presence of PIP. The Z scores of length-for-age (< -2 SD-chronic malnutrition) and weight-for-length (< -2 SD-acute malnutrition) and covariance analysis were done to detect associations between intestinal parasitism and nutritional status.
Of the 136 children, 30.6% were infected; 26.2% had helminth infections (A. lumbricoides, T. trichiura, S. stercoralis), 14.9% had protozoan infections (G. lamblia) and 11.8% had mixed infections. Wasting and stunting were present in 2.9% and 12.5%, respectively. Lack of sanitary toilet facilities and low maternal education were related to mixed infections and presence of helminths (p < 0.05). Weaned children were at greater risk of mixed infections (Odds Ratio (OR) 6.5; 90% CI: 1.9-21.5) and of G. lamblia infections (OR: 2.89; 90% CI: 1.0-8.34). Children infected with T. trichiura and with mixed infections were more likely to show wasting (p < 0.05).
The high infections in young children indicate that they be included in periodic antiparasitic chemotherapy. Burden of disease associated to intestinal parasitism may be reduced if breastfeeding is continued beyond 6 months of age.
针对2岁以下儿童肠道寄生虫感染的研究很少。寄生虫预防的营养后果及可行性证明了当前这项研究的合理性。
本研究有3个目标：（1）确定致病性肠道寄生虫（PIP）的感染率；（2）确定可预测PIP的社会因素、卫生条件和营养习惯；（3）评估PIP对婴儿营养状况的影响。
邀请了所有居住在哥伦比亚沿海城市社区、孩子年龄在18个月以下的母亲参与PIP研究。从136名儿童中每人获取一份粪便样本；他们占该社区7至18个月大儿童总数的62%。通过直接显微镜检查确定肠道寄生虫的存在，并通过浓缩试验（里奇 - 弗里克法）予以确认。采用逻辑回归来预测PIP的存在情况。计算年龄别身长Z评分（< -2标准差 - 慢性营养不良）和身长别体重Z评分（< -2标准差 - 急性营养不良），并进行协方差分析，以检测肠道寄生虫感染与营养状况之间的关联。
136名儿童中，30.6%受到感染；26.2%有蠕虫感染（蛔虫、鞭虫、粪类圆线虫），14.9%有原生动物感染（蓝氏贾第鞭毛虫），11.8%有混合感染。消瘦和发育迟缓的发生率分别为2.9%和12.5%。缺乏卫生厕所设施和母亲受教育程度低与混合感染及蠕虫感染有关（p < 0.05）。断奶儿童发生混合感染（优势比（OR）6.5；90%置信区间：1.9 - 21.5）和蓝氏贾第鞭毛虫感染（OR：2.89；90%置信区间：1.0 - 8.34）的风险更高。感染鞭虫和混合感染的儿童更有可能出现消瘦（p < 0.05）。
幼儿中感染率高表明应将他们纳入定期抗寄生虫化疗。如果母乳喂养持续超过6个月，与肠道寄生虫感染相关的疾病负担可能会降低。
