坦桑尼亚西北部姆万扎地区小学生感染曼氏血吸虫对生活质量有影响，但对身体素质无影响：一项横断面研究
Infection with Schistosoma mansoni has an Effect on Quality of Life, but not on Physical Fitness in Schoolchildren in Mwanza Region, North-Western Tanzania: A Cross-Sectional Study.
作者信息
Kinung'hi Safari, Magnussen Pascal, Kaatano Godfrey, Olsen Annette
机构信息
National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
Parasitology and Aquatic Diseases, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
出版信息
PLoS Negl Trop Dis. 2016 Dec 27;10(12):e0005257. doi: 10.1371/journal.pntd.0005257. eCollection 2016 Dec.
BACKGROUND
Infection with Schistosoma mansoni negatively impact children's physical health and may influence their general well-being. The aim of this study was to investigate the effect of S. mansoni infections on a panel of morbidity indicators with emphasis on quality of life (PedsQL; measured in four different dimensions) and physical fitness (measured as VO2 max) among 572 schoolchildren aged 7-8 years.
METHODOLOGY/PRINCIPAL FINDINGS: Prevalence of S. mansoni infections was 58.7%, with an arithmetic mean (95% CI) among positives of 207.3 (169.2-245.4) eggs per gram (epg). Most infections were light (56.5%), while 16.4% had heavy infections. Girls had significantly higher arithmetic mean intensities (95% CI) than boys (247.4 (189.2-305.6) vs. 153.2 (110.6-195.8); P = 0.004). A total of 30.1% were anaemic with no sex difference. Stunting and wasting was found in less than 10% of the population. There was no association between S. mansoni prevalence or intensities and the following parameters: anthropometry, anaemia, liver or spleen pathology in neither univariable nor multivariable linear regression analyses. However, in univariable analyses children with S. mansoni infection had a significantly lower score in emotional PedsQL (95% CI) than uninfected (77.3 (74.5-80.1) vs. 82.7 (79.9-85.5); P = 0.033) and infected children had a higher VO2 max (95% CI) compared to uninfected (51.4 (51.0-51.8) vs. 50.8 (50.3-51.3); P = 0.042). In multivariable linear regression analyses, age, S. mansoni infection, haemoglobin and VO2 max were significant predictors for emotional PedsQL while significant predictors for VO2 max were physical PedsQL, height, age and haemoglobin. S. mansoni infection was thus not retained in the multivariable regression analyses on VO2 max.
CONCLUSIONS/SIGNIFICANCE: Of the measured morbidity parameters, S. mansoni infection had a significant effect on the emotional dimension of quality of life, but not on physical fitness. If PedsQL should be a useful tool to measure schistosome related morbidity, more in depth studies are needed in order to refine the tool so it focuses more on aspects of quality of life that may be affected by schistosome infections.
背景
曼氏血吸虫感染会对儿童身体健康产生负面影响，并可能影响他们的总体幸福感。本研究的目的是调查曼氏血吸虫感染对一组发病指标的影响，重点关注572名7 - 8岁学童的生活质量（儿童生活质量量表；在四个不同维度进行测量）和身体素质（以最大摄氧量衡量）。
方法/主要发现：曼氏血吸虫感染的患病率为58.7%，阳性者每克粪便虫卵算术平均值（95%置信区间）为207.3（169.2 - 245.4）个虫卵/克（epg）。大多数感染为轻度（56.5%），而16.4%为重度感染。女孩的算术平均感染强度（95%置信区间）显著高于男孩（247.4（189.2 - 305.6）对153.2（110.6 - 195.8）；P = 0.004）。共有30.1%的儿童贫血，无性别差异。发育迟缓与消瘦在不到10%的人群中被发现。在单变量和多变量线性回归分析中，曼氏血吸虫的患病率或感染强度与以下参数之间均无关联：人体测量学指标、贫血、肝脏或脾脏病理学指标。然而，在单变量分析中，感染曼氏血吸虫的儿童在儿童生活质量量表情感维度上的得分（95%置信区间）显著低于未感染者（77.3（74.5 - 80.1）对82.7（79.9 - 85.5）；P = 0.033），且感染儿童的最大摄氧量（95%置信区间）高于未感染者（51.4（51.0 - 51.8）对50.8（50.3 - 51.3）；P = 0.042）。在多变量线性回归分析中，年龄、曼氏血吸虫感染、血红蛋白和最大摄氧量是儿童生活质量量表情感维度的显著预测因素，而最大摄氧量的显著预测因素是儿童生活质量量表身体维度、身高、年龄和血红蛋白。因此，在关于最大摄氧量的多变量回归分析中，曼氏血吸虫感染未被保留。
结论/意义：在所测量的发病参数中，曼氏血吸虫感染对生活质量的情感维度有显著影响，但对身体素质没有影响。如果儿童生活质量量表要成为衡量血吸虫相关发病情况的有用工具，则需要进行更深入的研究，以完善该工具，使其更关注可能受血吸虫感染影响的生活质量方面。
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