Chami Goylette F, Fenwick Alan, Bulte Erwin, Kontoleon Andreas A, Kabatereine Narcis B, Tukahebwa Edridah M, Dunne David W
Department of Land Economy, University of Cambridge, Cambridge, United Kingdom.
Schistosomiasis Control Initiative, Imperial College London, London, United Kingdom.
PLoS Negl Trop Dis. 2015 Oct 29;9(10):e0004193. doi: 10.1371/journal.pntd.0004193. eCollection 2015.
The association of anaemia with intestinal schistosomiasis and hookworm infections are poorly explored in populations that are not limited to children or pregnant women.
We sampled 1,832 individuals aged 5-90 years from 30 communities in Mayuge District, Uganda. Demographic, village, and parasitological data were collected. Infection risk factors were compared in ordinal logistic regressions. Anaemia and infection intensities were analyzed in multilevel models, and population attributable fractions were estimated.
Household and village-level predictors of Schistosoma mansoni and hookworm were opposite in direction or significant for single infections. S. mansoni was found primarily in children, whereas hookworm was prevalent amongst the elderly. Anaemia was more prevalent in individuals with S. mansoni and increased by 2.86 fold (p-value<0.001) with heavy S. mansoni infection intensity. Individuals with heavy hookworm were 1.65 times (p-value = 0.008) more likely to have anaemia than uninfected participants. Amongst individuals with heavy S. mansoni infection intensity, 32.0% (p-value<0.001) of anaemia could be attributed to S. mansoni. For people with heavy hookworm infections, 23.7% (p-value = 0.002) of anaemia could be attributed to hookworm. A greater fraction of anaemia (24.9%, p-value = 0.002) was attributable to heavy hookworm infections in adults (excluding pregnant women) as opposed to heavy hookworm infections in school-aged children and pregnant women (20.2%, p-value = 0.001).
Community-based surveys captured anaemia in children and adults affected by S. mansoni and hookworm infections. For areas endemic with schistosomiasis or hookworm infections, WHO guidelines should include adults for treatment in helminth control programmes.
在不限于儿童或孕妇的人群中，贫血与肠道血吸虫病和钩虫感染之间的关联尚未得到充分研究。
我们从乌干达马尤格区的30个社区中抽取了1832名年龄在5至90岁之间的个体。收集了人口统计学、村庄和寄生虫学数据。在有序逻辑回归中比较了感染风险因素。在多水平模型中分析了贫血和感染强度，并估计了人群归因分数。
曼氏血吸虫和钩虫的家庭和村庄层面预测因素在方向上相反或对单一感染有显著影响。曼氏血吸虫主要在儿童中发现，而钩虫在老年人中普遍存在。贫血在感染曼氏血吸虫的个体中更为普遍，并且随着曼氏血吸虫重度感染强度增加2.86倍（p值<0.001）。重度感染钩虫的个体患贫血的可能性是未感染参与者的1.65倍（p值 = 0.008）。在重度感染曼氏血吸虫的个体中，32.0%（p值<0.001）的贫血可归因于曼氏血吸虫。对于重度感染钩虫的人，23.7%（p值 = 0.002）的贫血可归因于钩虫。与学龄儿童和孕妇的重度钩虫感染（20.2%，p值 = 0.001）相比，成人（不包括孕妇）中更大比例的贫血（24.9%，p值 = 0.002）可归因于重度钩虫感染。
基于社区的调查发现受曼氏血吸虫和钩虫感染影响的儿童和成人存在贫血现象。对于血吸虫病或钩虫感染流行的地区，世界卫生组织的指南应将成人纳入蠕虫控制计划的治疗范围。
