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缅甸掸邦南部茵莱湖周边当地居民血吸虫抗体检测及相关因素探索。

Detection of Schistosoma Antibodies and exploration of associated factors among local residents around Inlay Lake, Southern Shan State, Myanmar.

作者信息

Soe Htin Zaw, Oo Cho Cho, Myat Tin Ohn, Maung Nay Soe

机构信息

University of Community Health, Magway, Myanmar.

University of Medicine (Mandalay), Mandalay, Myanmar.

出版信息

Infect Dis Poverty. 2017 Mar 1;6(1):3. doi: 10.1186/s40249-016-0211-0.

Abstract

BACKGROUND

Schistosomiasis is a chronic parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma. Its transmission has been reported in 78 countries affecting at least 258 million people world-wide. It was documented that S. japonicum species was prevalent in Shan State, Myanmar, but the serological study was not conducted yet. General objective of the present study was to detect schistosoma antibodies and explore associated factors among local residents living around Inlay Lake, Nyaung Shwe Township, and Southern Shan State, Myanmar.

METHODS

An exploratory and cross-sectional analytic study was conducted among local residents (n = 315) in selected rural health center (RHC) areas from December 2012 through June 2013. The participants were interviewed with pretested semi-structured questionnaires and their blood samples (serum) were tested using Schistosomiasis Serology Microwell ELISA test kits (sensitivity 100% and specificity 85%) which detected IgG antibodies but could not distinguish between a new and past infection. Data collected were analysed by SPSS software 16.0 and associations of variables were determined by Chi-squared test with a significant level set at 0.05.

RESULTS

Schistosoma seroprevalence (IgG) in study area was found to be 23.8% (95% CI: 18.8-28.8%). The present study is the first and foremost study producing serological evidence of schistosoma infection-one of the neglected tropical diseases-in local people of Myanmar. The factors significantly associated with seropositivity were being male [OR = 2.6 (95% CI: 1.5-4.49), P < 0.001], residence [OR = 3.41 (95% CI: 1.6-7.3), P < 0.05 for Khaung Daing vs. Min Chaung] and education levels [OR = 4.5 (95% CI: 1.18-17.16), P < 0.05 for illiterate/3Rs level vs. high/graduate and OR = 3.16 (95% CI: 1.26-7.93), P < 0.05 for primary/middle level vs. high/graduate] all factors classically associated with risk of schistosoma infection. None of the behavioural factors tested were significantly associated with seropositivity.

CONCLUSION

Schistosoma infection serologically detected was most probably present at some time in this location of Myanmar, and this should be further confirmed parasitologically and kept under surveillance. Proper trainings on diagnosis, treatment, prevention and control of schistosomiasis should be provided to the healthcare providers.

TRIAL REGISTRATION

ISRCTN ISRCTN73824458 . Registered 28 September 2014, retrospectively registered.

摘要

背景

血吸虫病是一种由血吸虫属(吸虫纲蠕虫)引起的慢性寄生虫病。据报道,其传播已波及78个国家,全球至少有2.58亿人受到影响。有记录表明,日本血吸虫在缅甸掸邦流行,但尚未开展血清学研究。本研究的总体目标是检测缅甸掸邦南部良瑞镇茵莱湖周边当地居民中的血吸虫抗体,并探索相关因素。

方法

2012年12月至2013年6月,在选定的农村卫生中心(RHC)地区对当地居民(n = 315)进行了一项探索性横断面分析研究。采用预先测试的半结构化问卷对参与者进行访谈,并使用血吸虫病血清学微孔ELISA检测试剂盒(灵敏度100%,特异性85%)检测他们的血样(血清),该试剂盒可检测IgG抗体,但无法区分新感染和既往感染。收集的数据通过SPSS软件16.0进行分析,变量之间的关联通过卡方检验确定,显著性水平设定为0.05。

结果

研究区域内血吸虫血清阳性率(IgG)为23.8%(95%可信区间:18.8 - 28.8%))。本研究是首个在缅甸当地居民中产生血吸虫感染血清学证据的研究,血吸虫感染是被忽视的热带病之一。与血清阳性显著相关的因素包括男性[比值比(OR)= 2.6(95%可信区间:1.5 - 4.49),P < 0.001]、居住地[OR = 3.41(95%可信区间:1.6 - 7.3),Khaung Daing与Min Chaung相比,P < 0.05]以及教育水平[OR = 4.5(95%可信区间:1.18 - 17.16),文盲/3R水平与高中/本科相比,P < 0.05;OR = 3.16(95%可信区间:1.26 - 7.93),小学/初中水平与高中/本科相比,P < 0.05],所有这些因素都是与血吸虫感染风险经典相关的因素。所测试的行为因素均与血清阳性无显著关联。

结论

血清学检测到的血吸虫感染很可能在缅甸的这个地区曾经出现过,这一点应通过寄生虫学进一步证实并持续监测。应向医疗服务提供者提供关于血吸虫病诊断、治疗、预防和控制的适当培训。

试验注册

ISRCTN ISRCTN73824458。2014年9月28日注册,追溯注册。

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