Ruganuza Deodatus M, Mazigo Humphrey D, Waihenya Rebecca, Morona Domenica, Mkoji Gerald M
Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-00200, Nairobi, Kenya.
Parasit Vectors. 2015 Jul 16;8:377. doi: 10.1186/s13071-015-0997-9.
Recent evidence indicates that pre-school children (PSC) living in S. mansoni highly endemic areas are at similar risk of schistosomiasis infection and morbidity as their school aged siblings. Recognizing this fact, the World Health Organization (WHO) is considering including this age group in highly endemic areas in control programmes using mass drug administration (MDA). However, detailed epidemiological information on S. mansoni infection among PSC is lacking for many endemic areas, specifically in Tanzania. This study was conducted to determine the prevalence of S. mansoni infection and its associated risk factors among PSC in Ukerewe Island, North-Western Tanzania.
This was a cross-sectional study, which studied 400 PSC aged 1-6 years. The Kato-Katz (K-K) technique and the point of care circulating cathodic antigen (CCA) immunodiagnostic test were used to diagnose S. mansoni infection in stool and urine samples respectively. A pre-tested questionnaire was used to collect demographic data and water contact behaviour of the children from their parents/guardians.
Based on the K-K technique, 44.4% (95% CI: 39.4-49.4) pre-school children were infected with S. mansoni and the overall geometric mean eggs per gram of faeces (GM-epg) was 110.6 epg with 38.2 and 14.7% having moderate and heavy intensity infections respectively. Based on the CCA, 80.1%, (95% CI: 76.0-84.0) were infected if a trace was considered positive, and 45.9%, (95% CI: 40.9-50.9), were infected if a trace was considered negative. Reported history of lake visits (AOR = 2.31, 95% CI: 1.06-5.01, P < 0.03) and the proximity to the lake shore (<500 m) (AOR = 2.09, 95% CI: 1.05-4.14, P < 0.03) were significantly associated with S. mansoni infection. Reported lake visit frequency (4-7 days/week) was associated with heavy intensities of S. mansoni infection (P < 0.00).
The prevalence of S. mansoni infection in the study population using K-K and CCA-trace-negative was moderate. The frequency of lake visits and the proximity to the lake shore were associated with the infection of S. mansoni and its intensity. These findings call for the need to include the PSC in MDA programmes, public health education and provision of safe water for bathing.
最近的证据表明，生活在曼氏血吸虫高度流行地区的学龄前儿童感染血吸虫病和发病的风险与其学龄期兄弟姐妹相似。认识到这一事实后，世界卫生组织（WHO）正在考虑将高度流行地区的这一年龄组纳入使用大规模药物治疗（MDA）的控制计划中。然而，许多流行地区，特别是坦桑尼亚，缺乏关于学龄前儿童曼氏血吸虫感染的详细流行病学信息。本研究旨在确定坦桑尼亚西北部乌克雷韦岛学龄前儿童曼氏血吸虫感染的患病率及其相关危险因素。
这是一项横断面研究，研究了400名1 - 6岁的学龄前儿童。分别使用加藤-卡茨（K-K）技术和即时检测循环阴极抗原（CCA）免疫诊断试验来诊断粪便和尿液样本中的曼氏血吸虫感染。使用预先测试的问卷从儿童的父母/监护人那里收集人口统计学数据和儿童的水接触行为。
基于K-K技术，44.4%（95%可信区间：39.4 - 49.4）的学龄前儿童感染了曼氏血吸虫，每克粪便的总体几何平均虫卵数（GM-epg）为110.6 epg，分别有38.2%和14.7%的儿童感染程度为中度和重度。基于CCA检测，如果将微量视为阳性，则80.1%（95%可信区间：76.0 - 84.0）的儿童被感染；如果将微量视为阴性，则45.9%（95%可信区间：40.9 - 50.9）的儿童被感染。报告有去过湖泊的经历（比值比[AOR] = 2.31，95%可信区间：1.06 - 5.01，P < 0.03）以及靠近湖岸（<500米）（AOR = 2.09，95%可信区间：1.05 - 4.14，P < 0.03）与曼氏血吸虫感染显著相关。报告的去湖泊的频率（每周4 - 7天）与曼氏血吸虫的重度感染相关（P < 0.00）。
使用K-K技术和CCA微量阴性检测，研究人群中曼氏血吸虫感染的患病率为中度。去湖泊的频率和靠近湖岸与曼氏血吸虫感染及其感染强度相关。这些发现表明有必要将学龄前儿童纳入MDA计划、开展公共卫生教育并提供安全的沐浴用水。
