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尼日利亚赞法拉州巴盖加社区幼儿的高血铅水平及潜在风险因素

High concentration of blood lead levels among young children in Bagega community, Zamfara - Nigeria and the potential risk factor.

作者信息

Ajumobi Olufemi Olamide, Tsofo Ahmed, Yango Matthias, Aworh Mabel Kamweli, Anagbogu Ifeoma Nkiruka, Mohammed Abdulazeez, Umar-Tsafe Nasir, Mohammed Suleiman, Abdullahi Muhammad, Davis Lora, Idris Suleiman, Poggensee Gabriele, Nguku Patrick, Gitta Sheba, Nsubuga Peter

机构信息

Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.

Ministry of Health, Gusau, Zamfara state, Nigeria.

出版信息

Pan Afr Med J. 2014 Jul 21;18 Suppl 1(Suppl 1):14. doi: 10.11694/pamj.supp.2014.18.1.4264. eCollection 2014.

Abstract

INTRODUCTION

In May 2010, lead poisoning (LP) was confirmed among children <5years (U5) in two communities in Zamfara state, northwest Nigeria. Following reports of increased childhood deaths in Bagega, another community in Zamfara, we conducted a survey to investigate the outbreak and recommend appropriate control measures.

METHODS

We conducted a cross-sectional survey in Bagega community from 23rd August to 6th September, 2010. We administered structured questionnaires to parents of U5 to collect information on household participation in ore processing activities. We collected and analysed venous blood samples from 185 U5 with LeadCare II machine. Soil samples were analysed with X-ray fluorescence spectrometer for lead contamination. We defined blood lead levels (BLL) of >10ug/dL as elevated BLL, and BLL ≥45ug/dL as the criterion for chelation therapy. We defined soil lead levels (SLL) of ≥400 parts per million (ppm) as elevated SLL.

RESULTS

The median age of U5 was 36 months (Inter-quartile range: 17-48 months). The median BLL was 71µg/dL (range: 8-332µg/dL). Of the 185 U5, 184 (99.5%) had elevated BLL, 169 (91.4%) met criterion for CT. The median SLL in tested households (n = 37) of U5 was 1,237ppm (range: 53-45,270ppm). Households breaking ore rocks within the compound were associated with convulsion related-children's death (OR: 5.80, 95% CI: 1.08 - 27.85).

CONCLUSION

There was an LP outbreak in U5 in Bagega community possibly due to heavy contamination of the environment as a result of increased ore processing activities. Community-driven remediation activities are ongoing. We recommended support for sustained environmental remediation, health education, intensified surveillance, and case management.

摘要

引言

2010年5月,尼日利亚西北部赞法拉州两个社区的5岁以下儿童中确诊了铅中毒。在赞法拉州另一个社区巴盖加有儿童死亡人数增加的报告后,我们开展了一项调查以调查此次疫情并推荐适当的控制措施。

方法

2010年8月23日至9月6日,我们在巴盖加社区进行了一项横断面调查。我们向5岁以下儿童的家长发放结构化问卷,以收集家庭参与矿石加工活动的信息。我们使用LeadCare II机器采集并分析了185名5岁以下儿童的静脉血样。土壤样本用X射线荧光光谱仪分析铅污染情况。我们将血铅水平(BLL)>10μg/dL定义为血铅水平升高,将BLL≥45μg/dL作为螯合疗法的标准。我们将土壤铅水平(SLL)≥400百万分之一(ppm)定义为土壤铅水平升高。

结果

5岁以下儿童的中位年龄为36个月(四分位间距:17 - 48个月)。中位血铅水平为71μg/dL(范围:8 - 332μg/dL)。在185名5岁以下儿童中,184名(99.5%)血铅水平升高,169名(91.4%)符合螯合疗法标准。5岁以下儿童检测家庭(n = 37)的中位土壤铅水平为1237ppm(范围:53 - 45270ppm)。在院子内破碎矿石的家庭与惊厥相关儿童死亡有关(比值比:5.80,95%置信区间:1.08 - 27.85)。

结论

巴盖加社区5岁以下儿童中爆发了铅中毒,可能是由于矿石加工活动增加导致环境严重污染。社区主导的修复活动正在进行。我们建议支持持续的环境修复、健康教育、强化监测和病例管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4b3/4199350/4a98e0dd04e4/PAMJ-SUPP-18-1-14-g001.jpg

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