贾第虫病是否是墨西哥西北部学龄儿童缺锌状况的一个风险因素？一项具有纵向随访的横断面研究。
Could giardiasis be a risk factor for low zinc status in schoolchildren from northwestern Mexico? A cross-sectional study with longitudinal follow-up.
机构信息
Department of Public Nutrition and Health, Centro de Investigación en Alimentación y Desarrollo A, C, Hermosillo, Sonora, México.
出版信息
BMC Public Health. 2010 Feb 20;10(1):85. doi: 10.1186/1471-2458-10-85.
BACKGROUND
Both giardiasis and zinc deficiency are serious health problems worldwide. In Mexico, the prevalence of G. intestinalis was estimated at 32% in 1994. It remains a health problem in northwestern Mexico. Recent surveys (1987, 1995, and 1999) reported zinc deficiency in the Mexican population. The association of giardiasis and malabsorption of micronutrients has been well documented, although the association with zinc remains controversial. This study investigated the association between giardiasis and zinc deficiency in schoolchildren from northwestern Mexico.
METHODS
We combined a cross-sectional design with a longitudinal follow-up six months after parasite treatment. The baseline sample consisted of 114 schoolchildren (mean age 8.8 yr) from seven suburban public schools, grouped as Giardia-free (n = 65, 57%) and Giardia-infected (n = 49, 43%). Three stool analyses per child were done using Faust's method. Children with giardiasis received secnidazole. Serum zinc was determined by atomic absorption spectrophotometry. Height and weight were measured. Socioeconomic information was obtained in an oral questionnaire, and daily zinc intake was assessed using 24 hour-recalls. Pearson's correlation and ANCOVA and paired t-test analyses were used to determine the association between giardiasis and zinc status.
RESULTS
Longitudinal analysis demonstrated a significant increase of the mean serum zinc levels in the Giardia-infected group six months after treatment (13.78 vs. 19.24 mumol/L mumol/L; p = 0.001), although no difference was found between the Giardia-free and the Giardia-infected groups (p = 0.86) in the baseline analysis. Z scores for W/A and H/A were lower in the Giardia-infected than in the Giardia-free group (p < 0.05). No difference was observed in the socioeconomic characteristics and mean daily intakes of zinc between the groups (p > 0.05).
CONCLUSIONS
Giardiasis may be a risk factor for zinc deficiency in schoolchildren from northwestern Mexico.
背景
贾第虫病和缺锌都是全球范围内严重的健康问题。1994 年，墨西哥估计有 32%的人群感染贾第虫病。在该国西北部，这种疾病仍然是一个健康问题。最近的调查（1987 年、1995 年和 1999 年）显示，墨西哥人口存在缺锌现象。贾第虫病会导致多种微量营养素吸收不良，这种关联已得到充分证实，但其与锌之间的关联仍存在争议。本研究旨在调查墨西哥西北部地区学龄儿童中贾第虫病与锌缺乏症之间的关联。
方法
我们采用了横断面设计，并在寄生虫治疗后进行了为期六个月的纵向随访。基线样本包括来自七所郊区公立学校的 114 名学龄儿童（平均年龄 8.8 岁），分为贾第虫病阴性组（65 名，占 57%）和贾第虫病阳性组（49 名，占 43%）。对每个儿童进行了三次粪便分析，采用 Faust 法。感染贾第虫病的儿童接受了硝唑尼特治疗。通过原子吸收分光光度法测定血清锌含量。测量身高和体重。通过口头问卷获取社会经济信息，并通过 24 小时回忆法评估每日锌摄入量。采用 Pearson 相关分析、ANCOVA 和配对 t 检验分析来确定贾第虫病与锌状态之间的关联。
结果
纵向分析显示，治疗六个月后，贾第虫病阳性组的平均血清锌水平显著升高（13.78 与 19.24 微摩尔/升；p = 0.001），而基线分析中，贾第虫病阴性组与贾第虫病阳性组之间的血清锌水平无差异（p = 0.86）。贾第虫病阳性组的 W/A 和 H/A 锌评分低于贾第虫病阴性组（p < 0.05）。两组间的社会经济特征和平均每日锌摄入量无差异（p > 0.05）。
结论
在墨西哥西北部地区的学龄儿童中，贾第虫病可能是锌缺乏症的一个危险因素。
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