National Institute of Health Research, Box CY 573, Causeway, Harare, Zimbabwe.
Acta Trop. 2010 Jul-Aug;115(1-2):103-11. doi: 10.1016/j.actatropica.2010.02.010. Epub 2010 Feb 20.
The effect of concomitant infection with schistosomes, Plasmodium falciparum and soil transmitted helminths (STHs) on anaemia was determined in 609 Zimbabwean primary school children. P. falciparum, haemoglobin levels and serum ferritin were determined from venous blood. Kato Katz, formal ether concentration and urine filtration techniques were used to assess prevalence of Schistosoma mansoni, STHs and Schistosoma haematobium infections. The prevalence of S. haematobium, S. mansoni, P. falciparum, hookworm, Trichuris trichiura and Ascaris lumbricoides were 52.3%, 22.7%, 27.9%, 23.7%, 2.3% and 2.1%, respectively. The overall prevalence of anaemia and iron deficiency anaemia (IDA) were 48.4% (277/572) and 38.1% (181/475). Haemoglobin levels among children who had P. falciparum, S. haematobium and hookworm were lower than negative individuals, p<0.001, p<0.001 and p=0.030, respectively. The prevalence of anaemia and IDA in co-infections was almost double that in single infection. Children with P. falciparum/STHs/schistosome and schistosomes/P. falciparum co-infections recorded higher prevalence of anaemia and IDA (80.8% and 57.4%, respectively) than other combinations, p<0.001. Logistic regression revealed that, age group > or = 14 years, P. falciparum, S. haematobium light and heavy infections, and S. mansoni moderate and heavy infection, hookworm light infection were predictors of anaemia. This study suggests that integrated school based de-worming and malaria control have the potential to reduce the burden of anaemia.
本研究旨在探讨在津巴布韦 609 名小学生中，同时感染血吸虫、疟原虫和土壤传播性蠕虫（STHs）对贫血的影响。通过静脉血检测疟原虫、血红蛋白水平和血清铁蛋白，采用加藤厚涂片法、改良加藤厚涂片法、粪便直接涂片法和尿液过滤法检测曼氏血吸虫、STHs 和埃及血吸虫感染情况。结果显示，埃及血吸虫、曼氏血吸虫、疟原虫、钩虫、鞭虫和蛔虫的感染率分别为 52.3%、22.7%、27.9%、23.7%、2.3%和 2.1%。总体贫血和缺铁性贫血（IDA）的发生率分别为 48.4%（277/572）和 38.1%（181/475）。与阴性个体相比，感染疟原虫、埃及血吸虫和钩虫的儿童血红蛋白水平较低（p<0.001，p<0.001 和 p=0.030）。在混合感染中，贫血和 IDA 的发生率几乎是单一感染的两倍。同时感染疟原虫/STHs/血吸虫和血吸虫/疟原虫的儿童贫血和 IDA 的发生率更高（分别为 80.8%和 57.4%），明显高于其他组合（p<0.001）。Logistic 回归分析显示，年龄≥14 岁、感染疟原虫、埃及血吸虫轻度和重度感染、曼氏血吸虫中度和重度感染、轻度钩虫感染是贫血的预测因素。综上所述，在学校开展驱虫和疟疾控制综合措施，可能有助于降低贫血负担。
