Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador.
Clin Exp Allergy. 2010 Nov;40(11):1669-77. doi: 10.1111/j.1365-2222.2010.03559.x. Epub 2010 Sep 8.
The low prevalence of allergic disease in the rural tropics has been attributed to the protective effects of chronic helminth infections. There is concern that treatment-based control programmes for these parasites may lead to an increase in the prevalence of allergic diseases.
We measured the impact of 15-17 years of anthelmintic treatment with ivermectin on the prevalence of allergen skin test reactivity and allergic symptoms in school-age children.
The prevalence of allergen skin test reactivity, exercise-induced bronchospasm and allergic symptoms was compared between school-age children living in communities that had received community-based treatments with ivermectin (for onchocerciasis control) for a period of 15-17 years with those living in geographically adjacent communities that had received no ivermectin.
The prevalence of allergen skin test reactivity was double in children living in treated communities compared with those in untreated communities (16.7% vs. 8.7%, adjusted OR 2.10, 95% CI 1.50-2.94, P<0.0001), and the effect was mediated partly by a reduced prevalence of Trichuris trichiura among treated children. Ivermectin treatments were associated with an increased prevalence of recent eczema symptoms (adjusted OR 2.24, 95% CI 1.05-4.78, P=0.04) but not symptoms of asthma or rhino-conjunctivitis. The effect on eczema symptoms was not associated with reductions in geohelminth infections.
Long-term periodic treatments with ivermectin were associated with an increased prevalence of allergen skin test reactivity. There was some evidence that treatment was associated with an increased prevalence of recent eczema symptoms but not those of asthma or rhino-conjunctivitis.
农村热带地区过敏疾病的低患病率归因于慢性寄生虫感染的保护作用。有人担心，针对这些寄生虫的基于治疗的控制方案可能会导致过敏疾病的患病率增加。
我们测量了用伊维菌素进行 15-17 年驱虫治疗对学龄儿童过敏原皮肤试验反应性和过敏症状流行率的影响。
比较了在接受伊维菌素社区治疗（用于控制盘尾丝虫病）15-17 年的社区与接受伊维菌素治疗的社区之间，生活在这些社区中的学龄儿童的过敏原皮肤试验反应性、运动引起的支气管痉挛和过敏症状的流行率。
与未接受治疗的社区相比，生活在接受治疗的社区的儿童过敏原皮肤试验反应性的流行率高出一倍（16.7%比 8.7%，调整后的 OR 2.10，95%CI 1.50-2.94，P<0.0001），这种影响部分是由于接受治疗的儿童中 Trichuris trichiura 的患病率降低所致。伊维菌素治疗与近期湿疹症状的流行率增加相关（调整后的 OR 2.24，95%CI 1.05-4.78，P=0.04），但与哮喘或鼻结膜炎症状无关。治疗对湿疹症状的影响与减少肠道寄生虫感染无关。
长期定期用伊维菌素治疗与过敏原皮肤试验反应性增加有关。有证据表明，治疗与近期湿疹症状的流行率增加有关，但与哮喘或鼻结膜炎症状无关。
