Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Am J Trop Med Hyg. 2012 Nov;87(5):874-82. doi: 10.4269/ajtmh.2012.12-0397. Epub 2012 Sep 17.
Schistosomiasis control programs aim to reduce morbidity but are evaluated by infection prevalence and intensity reduction. We present baseline cross-sectional data from a nested cohort study comparing indicators of morbidity for measuring program impact. Eight hundred twenty-two schoolchildren 7-8 years of age from Nyanza Province, Kenya, contributed stool for diagnosis of Schistosoma mansoni and soil-transmitted helminths (STH) and blood smears for malaria, and were evaluated for anemia, quality of life, exercise tolerance, anthropometry, and ultrasound abnormalities. Schistosoma mansoni, STH, and malaria infection prevalence were 69%, 25%, and 8%, respectively. Only anemia and S. mansoni infection (adjusted odds ratio [aOR] = 1.70; confidence interval [CI] = 1.03-2.80), and hepatomegaly and heavy S. mansoni infection (aOR = 2.21; CI = 1.19-4.11) were associated. Though anemia and hepatomegaly appeared most useful at baseline, additional morbidity indicators may be sensitive longitudinal measures to evaluate schistosomiasis program health impact.
血吸虫病控制规划旨在降低发病率，但通过感染率和强度降低来评估。我们从嵌套队列研究中提供了基线横断面数据，该研究比较了衡量规划影响的发病率指标。肯尼亚尼亚萨省 822 名 7-8 岁的学童提供粪便用于诊断曼氏血吸虫和土壤传播性蠕虫（STH），并进行疟疾血涂片检查，同时评估贫血、生活质量、运动耐量、人体测量学和超声异常。曼氏血吸虫、STH 和疟疾感染的患病率分别为 69%、25%和 8%。只有贫血和曼氏血吸虫感染（调整后的优势比[aOR]=1.70；置信区间[CI]=1.03-2.80），以及肝肿大和重度曼氏血吸虫感染（aOR=2.21；CI=1.19-4.11）与感染相关。尽管贫血和肝肿大在基线时似乎最有用，但其他发病率指标可能是评估血吸虫病规划健康影响的敏感纵向措施。
