Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
PLoS Negl Trop Dis. 2011 Aug;5(8):e1292. doi: 10.1371/journal.pntd.0001292. Epub 2011 Aug 23.
Infections with Strongyloides stercoralis and other helminths represent important, yet often neglected issues in developing countries. Indeed, strongyloidiasis can be fatal, but only a few studies provide information regarding its health relevance in Africa. Moreover, clinical data on symptomatology and typical recognition patterns mainly originate from Western travel clinics.
A cross-sectional epidemiological survey was carried out in a rural part of south-central Côte d'Ivoire. Stool samples from 292 randomly selected individuals were examined for intestinal helminths, using a suite of diagnostic techniques (i.e., Kato-Katz, Baermann funnel, and Koga agar plate). Participants were interviewed with a pre-tested questionnaire and clinically examined. Multivariate logistic regression analysis was done to relate perceived morbidity and clinical findings to helminth infection status.
The prevalence of hookworm and S. stercoralis was 51.0% and 12.7%, respectively. Both infections were strongly associated with each other (adjusted odds ratio, 6.73; P < 0.001) and higher prevalences were observed with age. S. stercoralis-infected individuals expressed self-reported morbidity considerably more often than those with hookworm infection. Clinical examination identified high prevalences of various pathologies and detected tendencies to worse health conditions in helminth-infected subjects.
CONCLUSIONS/SIGNIFICANCE: The use of multiple diagnostic tools showed that S. stercoralis and hookworm are co-endemic in rural Côte d'Ivoire and that each infection causes clinical symptoms and sequelae. Our findings are important for (re-)estimating the burden of helminth infections, and highlight the need for integrating epidemiological surveys, rigorous diagnostic approaches, and clinical assessments in the developing world.
在发展中国家，感染旋毛虫和其他蠕虫是一个重要但常被忽视的问题。事实上，类圆线虫病可能是致命的，但只有少数研究提供了有关其在非洲健康相关性的信息。此外，关于症状和典型识别模式的临床数据主要来自西方旅行诊所。
在科特迪瓦中南部的一个农村地区进行了横断面流行病学调查。从 292 名随机选择的个体中采集粪便样本，使用一系列诊断技术（即加藤厚涂片、贝曼漏斗和 Koga 琼脂平板）检查肠道蠕虫。对参与者进行了预测试问卷访谈和临床检查。使用多变量逻辑回归分析将感知发病率和临床发现与寄生虫感染状况联系起来。
钩虫和旋毛虫的流行率分别为 51.0%和 12.7%。这两种感染相互强烈关联（调整后的优势比，6.73；P < 0.001），且随着年龄的增长而呈现更高的流行率。感染旋毛虫的个体比感染钩虫的个体更频繁地报告自我报告的发病率。临床检查发现了各种病理的高流行率，并在寄生虫感染的受试者中检测到健康状况恶化的趋势。
结论/意义：使用多种诊断工具表明，旋毛虫和钩虫在科特迪瓦农村地区共同流行，并且每种感染都会导致临床症状和后遗症。我们的研究结果对于（重新）估计寄生虫感染的负担很重要，并强调在发展中国家需要整合流行病学调查、严格的诊断方法和临床评估。
