Kunwar Ritu, Acharya Lokendra, Karki Surendra
School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia.
Kathmandu Medical College, Kathmandu University, Kathmandu, Nepal.
Trop Med Int Health. 2016 Jun;21(6):703-19. doi: 10.1111/tmi.12700. Epub 2016 May 11.
To assess the trends in prevalence of soil-transmitted helminths (STHs), Entamoeba histolytica and Giardia lamblia among school-aged children in Nepal between 1990 and 2015.
Systematic literature search in PubMed, MEDLINE, EMBASE, Google Scholar and local peer-reviewed journals for papers published between 1990 and December 2015. We conducted metaregression and meta-analyses to pool studies where applicable.
Thirty-nine studies that examined a total of 14 729 stool specimens were included in the meta-analyses. The metaregression of prevalence of hookworms, roundworm, and whipworm showed a significantly decreasing trend over time. In or after 2004, the pooled prevalence of hookworm infections was 1.53% (95% CI, 0.73-2.59), of roundworm 4.31% (95% CI, 2.52-6.53) and of whipworm 2.89% (95% CI, 1.33-4.97) vs. 16.54% (95% CI, 7.64-27.97) for hookworm, 25.20% (95% CI, 13.59-38.97) for roundworm and 11.54% (95% CI 4.25-21.76) for whipworm in 1993-2003. E. histolytica and G. lamblia had stable prevalence since early 1990s, with a pooled prevalences of 4.12% (95% CI, 2.73-5.77) and 9.40% (95% CI, 7.15-11.92), respectively. The prevalence of G. lamblia was significantly higher in urban areas.
We observed a sharp decrease in prevalence of STHs among school-aged children in Nepal in the past decade with prevalences dropping below 5% for STHs with no variation in prevalence in rural and urban areas. However, the prevalence of E. histolytica and G. lamblia remained stable over time. These results suggest that school-based deworming programmes rolled out during the study period had an observable impact on prevalence of STHs.
评估1990年至2015年间尼泊尔学龄儿童中土源性蠕虫、溶组织内阿米巴和蓝氏贾第鞭毛虫的感染率变化趋势。
在PubMed、MEDLINE、EMBASE、谷歌学术以及当地同行评审期刊中系统检索1990年至2015年12月期间发表的论文。在适用的情况下，我们进行了元回归和荟萃分析以汇总研究结果。
共有39项研究纳入了荟萃分析，这些研究共检测了14729份粪便样本。钩虫、蛔虫和鞭虫感染率的元回归显示，随着时间的推移呈显著下降趋势。在2004年或之后，钩虫感染的合并感染率为1.53%（95%CI，0.73 - 2.59），蛔虫为4.31%（95%CI，2.52 - 6.53），鞭虫为2.89%（95%CI，1.33 - 4.97）；而在1993 - 2003年期间，钩虫感染率为16.54%（95%CI，7.64 - 27.97），蛔虫为25.20%（95%CI，13.59 - 38.97），鞭虫为11.54%（95%CI 4.25 - 21.76）。自20世纪90年代初以来，溶组织内阿米巴和蓝氏贾第鞭毛虫的感染率保持稳定，合并感染率分别为4.12%（95%CI，2.73 - 5.77）和9.40%（95%CI，7.15 - 11.92）。蓝氏贾第鞭毛虫在城市地区的感染率显著更高。
我们观察到在过去十年中，尼泊尔学龄儿童中土源性蠕虫感染率急剧下降，感染率降至5%以下，且农村和城市地区感染率无差异。然而，溶组织内阿米巴和蓝氏贾第鞭毛虫的感染率随时间保持稳定。这些结果表明，在研究期间开展的以学校为基础的驱虫计划对土源性蠕虫感染率产生了明显影响。
