Moore Catrin E, Nget Phot, Saroeun Mao, Kuong Suy, Chanthou Seng, Kumar Varun, Bousfield Rachel, Nader Johanna, Bailey J Wendi, Beeching Nicholas J, Day Nicholas P, Parry Christopher M
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ.
Angkor Hospital for Children, Tep Vong (Achamean) Road & Oum Chhay Street, Svay Dangkum, Siem Reap, Kingdom of Cambodia.
PLoS One. 2015 May 7;10(5):e0123719. doi: 10.1371/journal.pone.0123719. eCollection 2015.
Infections with helminths and other intestinal parasites are an important but neglected problem in children in developing countries. Accurate surveys of intestinal parasites in children inform empirical treatment regimens and can assess the impact of school based drug treatment programmes. There is limited information on this topic in Cambodia.
In a prospective study of intestinal parasites in symptomatic children attending Angkor Hospital for Children, Siem Reap, Cambodia, April-June 2012, samples were examined by microscopy of a direct and concentrated fecal sample. Two culture methods for hookworm and Strongyloides stercoralis were employed when sufficient sample was received. Demographic, clinical and epidemiological data were collected.
We studied 970 samples from 865 children. The median (inter-quartile range) age of the children was 5.4 (1.9-9.2) years, 54% were male. The proportion of children with abdominal pain was 66.8%, diarrhea 34.9%, anemia 12.7% and malnutrition 7.4%. 458 parasitic infections were detected in 340 (39.3%) children. The most common parasites using all methods of detection were hookworm (14.3%), Strongyloides stercoralis (11.6%) and Giardia lamblia (11.2%). Giardia lamblia was most common in children aged 1-5 years, hookworm and Strongyloides stercoralis were more common with increasing age. Hookworm, Strongloides stercoralis and Giardia lamblia were more common in children living outside of Siem Reap town. In a multivariate logistic regression increasing age was associated with all three infections, defecating in the forest for hookworm infection, the presence of cattle for S. stercoralis and not using soap for handwashing for G. lamblia.
CONCLUSIONS/SIGNIFICANCE: This study confirms the importance of intestinal parasitic infections in symptomatic Cambodian children and the need for adequate facilities for laboratory diagnosis together with education to improve personal hygiene and sanitation.
在发展中国家，儿童感染蠕虫和其他肠道寄生虫是一个重要但被忽视的问题。对儿童肠道寄生虫进行准确调查可为经验性治疗方案提供依据，并能评估学校药物治疗项目的效果。柬埔寨关于这一主题的信息有限。
在2012年4月至6月对柬埔寨暹粒吴哥儿童医院有症状儿童进行的肠道寄生虫前瞻性研究中，通过直接和浓缩粪便样本显微镜检查对样本进行检测。当收到足够样本时，采用两种钩虫和粪类圆线虫培养方法。收集了人口统计学、临床和流行病学数据。
我们研究了来自865名儿童的970份样本。儿童的年龄中位数（四分位间距）为5.4（1.9 - 9.2）岁，54%为男性。有腹痛的儿童比例为66.8%，腹泻为34.9%，贫血为12.7%，营养不良为7.4%。在340名（39.3%）儿童中检测到458例寄生虫感染。使用所有检测方法最常见的寄生虫是钩虫（14.3%）、粪类圆线虫（11.6%）和蓝氏贾第鞭毛虫（11.2%）。蓝氏贾第鞭毛虫在1 - 5岁儿童中最常见，钩虫和粪类圆线虫随着年龄增长更为常见。钩虫、粪类圆线虫和蓝氏贾第鞭毛虫在暹粒镇以外居住的儿童中更常见。在多变量逻辑回归分析中，年龄增长与所有三种感染相关，在森林中排便与钩虫感染相关，有牛与粪类圆线虫感染相关，不使用肥皂洗手与蓝氏贾第鞭毛虫感染相关。
结论/意义：本研究证实了肠道寄生虫感染在有症状的柬埔寨儿童中的重要性，以及需要有足够的实验室诊断设施，同时进行教育以改善个人卫生和环境卫生。
