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卢旺达胡耶区农村学童中十二指肠贾第虫感染的年龄依赖性下降及其与发育迟缓的关联

Age-dependent decline and association with stunting of Giardia duodenalis infection among schoolchildren in rural Huye district, Rwanda.

作者信息

Heimer Jakob, Staudacher Olga, Steiner Florian, Kayonga Yvette, Havugimana Jean Marie, Musemakweri Andre, Harms Gundel, Gahutu Jean-Bosco, Mockenhaupt Frank P

机构信息

Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Faculty of Social Work, Catholic University of Rwanda, Huye, Rwanda.

出版信息

Acta Trop. 2015 May;145:17-22. doi: 10.1016/j.actatropica.2015.01.011. Epub 2015 Feb 12.

Abstract

Giardia duodenalis infection is highly prevalent and a cause of underweight in pre-school children in rural Rwanda. The present study aimed at assessing the age-pattern of Giardia infection and its manifestation in older children, i.e., during school age. Stool samples were collected from 622 schoolchildren at two schools in the Huye district of southern Rwanda (rural, 301; urban, 321) and subjected to G. duodenalis specific PCR assays. Clinical and anthropometric data, socio-economic status and factors potentially associated with G. duodenalis infection were assessed. Of the 622 children (mean age, 10.4 years), 35.7% were infected with G. duodenalis (rural, 43.9%; urban, 28.0%; P<0.0001). Only few indicators of low socio-economic status were found to be associated with infection. In rural but not urban schoolchildren, infection prevalence declined significantly with age. G. duodenalis infection more than doubled the odds of stunting in both rural (adjusted OR, 2.35 (95%CI, 1.25-4.41)) and urban children (adjusted OR, 2.27 (95%CI, 1.01-5.09)). In the study area of rural southern Rwanda, G. duodenalis prevalence among children declined throughout school-age. The data suggest that while lacking overt clinical manifestation at high endemicity, G. duodenalis infection is a common cause of stunting in schoolchildren.

摘要

十二指肠贾第虫感染在卢旺达农村学龄前儿童中高度流行,是导致体重不足的一个原因。本研究旨在评估贾第虫感染在大龄儿童(即学龄期)中的年龄模式及其表现。从卢旺达南部胡耶区两所学校的622名学童(农村301名,城市321名)采集粪便样本,并进行十二指肠贾第虫特异性PCR检测。评估了临床和人体测量数据、社会经济状况以及与十二指肠贾第虫感染可能相关的因素。在这622名儿童(平均年龄10.4岁)中,35.7%感染了十二指肠贾第虫(农村43.9%,城市28.0%;P<0.0001)。仅发现少数社会经济地位低的指标与感染有关。在农村而非城市学童中,感染率随年龄显著下降。十二指肠贾第虫感染使农村儿童(调整后的OR,2.35(95%CI,1.25 - 4.41))和城市儿童(调整后的OR,2.27(95%CI,1.01 - 5.09))发育迟缓的几率增加了一倍多。在卢旺达南部农村的研究区域,学龄期儿童中十二指肠贾第虫的感染率持续下降。数据表明,虽然在高流行率时缺乏明显的临床表现,但十二指肠贾第虫感染是学童发育迟缓的常见原因。

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