Cabada Miguel M, Lopez Martha, Arque Eulogia, Clinton White A
Pathog Glob Health. 2014 Jun;108(4):200-5. doi: 10.1179/2047773214Y.0000000142. Epub 2014 Jun 17.
Few data are available on the epidemiology of soil-transmitted helminths (STHs) in indigenous populations of the Peruvian Amazon. While albendazole is being increasingly used in deworming campaigns, few data exist on the impact of mass drug administration in isolated populations. We studied the prevalence of STHs, anemia, and malnutrition in a Matsigenka ethnic group from the Peruvian Amazon. Participants had received two doses of albendazole on consecutive days, 3 months before and again 2 weeks before data collection. Overall, 290 subjects were included. Most were female (53.7%) and 63.9% were ≤19 years old. Half of the participants had helminth infections. Trichiuris (30.2%), hookworm (19.1%), Ascaris (17.7%), and Strongyloides (5.6%) were the most common helminths. Other helminth ova included Capillaria hepatica and Fasciola-like eggs. Subjects of 5-19 years (51.8 %) and 20-35 years (68.6 %) old had helminths more often than those under 5 years (38%) and older than 35 years (41.5%) (P = 0.02). Anemia was detected in 41% of children and this was more common in children under 5 years that in those of 5-19 years [odd ratio (OR) = 5.68; 95% CI: 2.71-11.88]. Overall, 72.1% of children were malnourished. Stunting was common in children (70.7%), but wasting was not (2.9%). Despite repeated albendazole administration, this population continued to have a high prevalence of STHs, anemia, and malnutrition. In addition, we detected unusual organisms and organisms that do not respond to albendazole. Further studies are needed to assess the rationale and efficacy of mass chemotherapy for STHs in the Amazon.
关于秘鲁亚马逊地区原住民土壤传播蠕虫(STH)的流行病学数据很少。虽然阿苯达唑在驱虫运动中的使用越来越多,但关于群体给药对与世隔绝人群影响的数据却很少。我们研究了秘鲁亚马逊地区一个马奇根加族人群中STH、贫血和营养不良的患病率。参与者在数据收集前3个月和2周连续两天接受了两剂阿苯达唑。总共纳入了290名受试者。大多数为女性(53.7%),63.9%年龄≤19岁。一半的参与者有蠕虫感染。鞭虫(30.2%)、钩虫(19.1%)、蛔虫(17.7%)和粪类圆线虫(5.6%)是最常见的蠕虫。其他蠕虫卵包括肝毛细线虫和类片形吸虫卵。5至19岁(51.8%)和20至35岁(68.6%)的受试者感染蠕虫的频率高于5岁以下(38%)和35岁以上(41.5%)的受试者(P = 0.02)。41%的儿童检测出贫血,5岁以下儿童比5至19岁儿童更常见[比值比(OR)= 5.68;95%置信区间:2.71 - 11.88]。总体而言,72.1%的儿童营养不良。发育迟缓在儿童中很常见(70.7%),但消瘦不常见(2.9%)。尽管反复使用阿苯达唑,该人群中STH、贫血和营养不良的患病率仍然很高。此外,我们检测到了不常见的生物体以及对阿苯达唑无反应的生物体。需要进一步研究以评估亚马逊地区针对STH进行群体化疗的基本原理和疗效。