儿童中十二指肠贾第鞭毛虫感染的流行情况和危险因素：葡萄牙的一个病例研究。
Prevalence and risk factors for Giardia duodenalis infection among children: a case study in Portugal.
机构信息
National Institute of Health Dr. Ricardo Jorge, Department of Infectious Diseases, National Reference Laboratory for Gastrointestinal Infections, Av. Padre Cruz, Lisbon, Portugal.
出版信息
Parasit Vectors. 2012 Jan 27;5:22. doi: 10.1186/1756-3305-5-22.
BACKGROUND
Giardia duodenalis is a widespread parasite of mammalian species, including humans. The prevalence of this parasite in children residing in Portugal is currently unknown. This study intended to estimate G. duodenalis infection prevalence and identify possible associated risk factors in a healthy paediatric population living in the District of the Portuguese capital, Lisbon.
METHODS
Between February 2002 and October 2008, 844 children were randomly selected at healthcare centres while attending the national vaccination program. A stool sample and a questionnaire with socio-demographic data were collected from each child. Giardia infection was diagnosed by direct examination of stools and antigen detection by ELISA.
RESULTS
The population studied revealed a gender distribution of 52.8% male and 47.2% female. Age distribution was 47.4% between 0-5 years and 52.6% between 6-15 years.The prevalence of Giardia infection was 1.9% (16/844) when estimated by direct examination and increased to 6.8% (57/844) when ELISA results were added. The prevalence was higher among children aged 0-5 years (7.8%), than among older children (5.8%), and was similar among genders (6.9% in boys and 6.5% in girls). The following population-variables were shown to be associated risk factors for G. duodenalis infection: mother's educational level (odds ratio (OR)= 4.49; confidence interval (CI): 1.20-16.84), father's educational level (OR = 12.26; CI: 4.08-36.82), presence of Helicobacter pylori infection (OR = 1.82; CI: 1.05-3.15), living in houses with own drainage system (OR = 0.10; CI: 0.02-0.64) and reported household pet contact, especially with dogs (OR = 0.53; CI: 0.31-0.93).
CONCLUSION
The prevalence of giardiasis in asymptomatic children residing in the region of Lisbon is high. Several risk factors were associated with Giardia prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between G. duodenalis and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies.
背景
贾第虫是一种广泛存在于哺乳动物物种中的寄生虫，包括人类。目前尚不清楚这种寄生虫在葡萄牙儿童中的流行情况。本研究旨在估计生活在葡萄牙首都里斯本地区的健康儿科人群中贾第虫感染的流行率，并确定可能存在的相关危险因素。
方法
2002 年 2 月至 2008 年 10 月期间，在医疗中心随机选择 844 名儿童，以参加国家疫苗接种计划。从每个孩子处收集粪便样本和一份包含社会人口统计学数据的问卷。通过直接检查粪便和 ELISA 检测抗原来诊断贾第虫感染。
结果
所研究的人群中，男性占 52.8%，女性占 47.2%。年龄分布为 47.4%的儿童年龄在 0-5 岁之间，52.6%的儿童年龄在 6-15 岁之间。直接检查估计的贾第虫感染流行率为 1.9%（16/844），当添加 ELISA 结果时，流行率增加至 6.8%（57/844）。0-5 岁年龄组儿童的感染率（7.8%）高于较大年龄组儿童（5.8%），且男女感染率相似（男孩为 6.9%，女孩为 6.5%）。以下人群变量被证明是 G. duodenalis 感染的危险因素：母亲的教育水平（比值比（OR）= 4.49；置信区间（CI）：1.20-16.84），父亲的教育水平（OR = 12.26；CI：4.08-36.82），幽门螺杆菌感染（OR = 1.82；CI：1.05-3.15），居住在具有独立排水系统的房屋中（OR = 0.10；CI：0.02-0.64），以及报告家庭宠物接触，尤其是与狗接触（OR = 0.53；CI：0.31-0.93）。
结论
居住在里斯本地区的无症状儿童中贾第虫病的流行率很高。几个危险因素与贾第虫的流行有关，突出了父母教育和卫生条件对儿童健康的重要性。十二指肠贾第虫与幽门螺杆菌之间的关联似乎是一个重要问题，值得进一步研究，以促进预防或治疗策略。
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