Lim Y A L, Romano N, Colin N, Chow S C, Smith H V
Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Trop Biomed. 2009 Aug;26(2):110-22.
Orang Asli are the indigenous minority peoples of peninsular Malaysia. Despite proactive socioeconomic development initiated by the Malaysian Government in upgrading the quality of life of the Orang Asli communities since 1978, they still remained poor with a current poverty rate of 76.9%. Poverty exacerbates the health problems faced by these communities which include malnourishment, high incidences of infectious diseases (eg. tuberculosis, leprosy, malaria) and the perpetual problem with intestinal parasitic infections. Studies reported that the mean infection rate of intestinal parasitic infections in Orang Asli communities has reduced from 91.1% in 1978, to 64.1% in the subsequent years. Although the results was encouraging, it has to be interpreted with caution because nearly 80% of studies carried out after 1978 still reported high prevalence (i.e. >50%) of soil-transmitted helminthiases (STH) among Orang Asli communities. Prior to 1978, hookworm infection is the most predominant STH but today, trichuriasis is the most common STH infections. The risk factors for intestinal parasitic infections remained unchanged and studies conducted in recent years suggested that severe STH infections contributed to malnutrition, iron deficiency anaemia and low serum retinol in Orang Asli communities. In addition, STH may also contribute to poor cognitive functions and learning ability. Improvements in socioeconomic status in Malaysia have shown positive impact on the reduction of intestinal parasitic infections in other communities however, this positive impact is less significant in the Orang Asli communities. In view of this, a national parasitic infections baseline data on morbidity and mortality in the 18 subgroups of Orang Asli, will assist in identifying intervention programmes required by these communities. It is hope that the adoption of strategies highlighted in the World Health Organisation- Healthy Village Initiatives (WHO-HVI) into Orang Asli communities will ensure the whole mechanism of delivery and empowerment by the government agencies become more efficient and productive in alleviating intestinal parasitic infections in these communities.
原住民是马来西亚半岛的少数族裔。自1978年以来，马来西亚政府积极推动社会经济发展，以提升原住民社区的生活质量，但他们仍然贫困，目前的贫困率为76.9%。贫困加剧了这些社区面临的健康问题，包括营养不良、传染病（如结核病、麻风病、疟疾）高发以及肠道寄生虫感染这一长期问题。研究报告称，原住民社区肠道寄生虫感染的平均感染率已从1978年的91.1%降至随后几年的64.1%。尽管结果令人鼓舞，但必须谨慎解读，因为1978年以后开展的近80%的研究仍报告称，原住民社区土壤传播的蠕虫病（STH）患病率很高（即>50%）。1978年以前，钩虫感染是最主要的土壤传播蠕虫病，但如今，鞭虫病是最常见的土壤传播蠕虫病感染。肠道寄生虫感染的风险因素保持不变，近年来进行的研究表明，严重的土壤传播蠕虫病感染导致了原住民社区的营养不良、缺铁性贫血和血清视黄醇水平低下。此外，土壤传播蠕虫病也可能导致认知功能和学习能力不佳。马来西亚社会经济地位的改善对其他社区肠道寄生虫感染的减少产生了积极影响，然而，这种积极影响在原住民社区不太显著。有鉴于此，一份关于18个原住民亚群体发病率和死亡率的全国寄生虫感染基线数据，将有助于确定这些社区所需的干预方案。希望将世界卫生组织-健康村倡议（WHO-HVI）中强调的战略应用于原住民社区，将确保政府机构的整个提供和赋权机制在减轻这些社区的肠道寄生虫感染方面变得更加高效和富有成效。
