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驱虫治疗对埃塞俄比亚西北部学龄儿童蠕虫感染及相关贫血的影响。

Effect of anthelminthic treatment on helminth infection and related anaemia among school-age children in northwestern Ethiopia.

作者信息

Yimam Yonas, Degarege Abraham, Erko Berhanu

机构信息

Department of Biology, Faculty of Natural and Computational Sciences, Woldia University, P.o. box. 400, Woldia, Ethiopia.

Department of Epidemiology, Robert Stemple College of Public Health, Florida International University, Miami, USA.

出版信息

BMC Infect Dis. 2016 Oct 28;16(1):613. doi: 10.1186/s12879-016-1956-6.

Abstract

BACKGROUND

Information about improvements in the health status of population at-risk of helminth infection after anthelminthic treatment helps to evaluate the effectiveness of the large scale deworming program. The objectives of this study were to assess the impact of anthelminthic treatment on the prevalence and intensity of intestinal helminth infection, haemoglobin level and prevalence of anaemia among school-age children.

METHODS

A total of 403 children attending Tikur Wuha Elementary School in Jiga, northwestern Ethiopia were enrolled in this study between February and March 2011. Formol-ether concentration and Kato-Katz methods were used to examine stool for intestinal helminth infections at baseline and one month after anthelminthic treatment. Haemoglobin level was measured using Hemocue machine at baseline and one month after anthelminthic treatment.

RESULTS

Out of 403 school children examined, 15.4 % were anaemic and 58.3 % were infected with intestinal helminths at baseline. Hookworms (46.9 %), Schistosoma mansoni (24.6 %), Ascaris lumbricoides (4.2 %) and Trichuris trichiura (1.7 %) infections were common. The odds of anaemia was higher among children infected with helminths (adjusted odds ratio (aOR) = 3.83, 95 % CI = 1.92, 7.62) especially in those infected with hookworm (aOR = 2.42, 95 % CI = 1.34, 4.39) or S. mansoni (aOR = 2.67, 95 % CI = 1.46, 4.88) and two or more helminth species (aOR = 7.31, 95 % CI = 3.27, 16.35) than those uninfected with intestinal helminths at baseline. Significant reduction in prevalence of helminth infection (77.0 %) and increment in mean haemoglobin level (+3.65 g/l) of children infected with helminths was observed one month after anthelminthic treatment. The increase in haemoglobin level after anthelminthic treatment was significantly positively associated with the age, but negatively associated with the haemoglobin level at baseline. The change in mean haemoglobin level was significantly higher among undernourished than normal children. Percent reduction in the prevalence of anaemia among children infected with helminths was 25.4 % after anthelminthic treatment.

CONCLUSIONS

The present study provides evidence that anthelminthic treatment of school-age children infected with intestinal helminth can improve haemoglobin level in addition to reducing the prevalence and intensity of helminth infections one month after treatment. This suggests that deworming of children may benefit the health of children in sub-Sharan Africa where hookworm and S. mansoni infections are prevalent.

摘要

背景

关于驱虫治疗后受蠕虫感染风险人群健康状况改善的信息有助于评估大规模驱虫计划的有效性。本研究的目的是评估驱虫治疗对学龄儿童肠道蠕虫感染的患病率和感染强度、血红蛋白水平及贫血患病率的影响。

方法

2011年2月至3月期间,埃塞俄比亚西北部吉加的提库尔·武哈小学共有403名儿童参与了本研究。采用甲醛-乙醚浓缩法和改良加藤厚涂片法在基线时及驱虫治疗后1个月检测粪便中的肠道蠕虫感染情况。使用血红蛋白仪在基线时及驱虫治疗后1个月测量血红蛋白水平。

结果

在接受检查的403名学童中,基线时15.4%的儿童贫血,58.3%的儿童感染肠道蠕虫。常见的感染有钩虫(46.9%)、曼氏血吸虫(24.6%)、蛔虫(4.2%)和鞭虫(1.7%)。感染蠕虫的儿童贫血几率更高(调整后的优势比(aOR)=3.83,95%置信区间(CI)=1.92,7.62),尤其是感染钩虫(aOR=2.42,95%CI=1.34,4.39)或曼氏血吸虫(aOR=2.67,95%CI=1.46,4.88)以及两种或更多蠕虫种类的儿童(aOR=7.31,95%CI=3.27,16.35),高于基线时未感染肠道蠕虫的儿童。驱虫治疗1个月后,观察到感染蠕虫儿童的蠕虫感染患病率显著降低(77.0%),平均血红蛋白水平升高(+3.65g/l)。驱虫治疗后血红蛋白水平的升高与年龄显著正相关,但与基线时的血红蛋白水平负相关。营养不良儿童的平均血红蛋白水平变化显著高于正常儿童。感染蠕虫儿童驱虫治疗后贫血患病率降低了25.4%。

结论

本研究提供了证据表明,对感染肠道蠕虫的学龄儿童进行驱虫治疗,除了在治疗1个月后降低蠕虫感染的患病率和感染强度外,还可提高血红蛋白水平。这表明在撒哈拉以南非洲地区,钩虫和曼氏血吸虫感染普遍,对儿童进行驱虫可能有益于儿童健康。

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