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刚果民主共和国基卢省学龄儿童血吸虫病和土壤传播蠕虫感染率评估以及在当地卫生服务中整合防治措施的机会

Assessment of schistosomiasis and soil-transmitted helminths prevalence in school-aged children and opportunities for integration of control in local health services in Kwilu Province, the Democratic Republic of the Congo.

作者信息

Inocencio da Luz R, Linsuke S, Lutumba P, Hasker E, Boelaert M

机构信息

Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.

Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.

出版信息

Trop Med Int Health. 2017 Nov;22(11):1442-1450. doi: 10.1111/tmi.12965. Epub 2017 Sep 14.

Abstract

OBJECTIVE

To determine the prevalence of schistosomiasis (SCH) and soil-transmitted helminths (STH) in the Democratic Republic of Congo, and to assess the capacity of the local health centres for diagnosis and treatment.

METHODS

Cross-sectional school-based survey in two health districts in the Province of Kwilu. We collected a stool and a urine sample for parasitological examination. Urine filtration and duplicate Kato-Katz thick smears were used for the diagnosis of SCH. Health centres were evaluated using a structured questionnaire.

RESULTS

In total, 526 children participated in the study and the overall prevalence of Schistosoma mansoni infection was 8.9% (95% CI: 3.5-13.2) in both districts. The prevalence was higher in Mosango (11.7%; 95% CI: 8.9-14.8) than Yasa Bonga district (6.2%; 95% CI: 1.1-11.4). Urine filtration showed that Schistosoma haematobium infection was not present. The combined STH infection prevalence was 58.1% in both districts; hookworm infection was the most common STH found in 52.9% (95% CI: 29.3-62.4) of subjects, followed by Ascaris lumbricoides 9.3% (95% CI: 5.8-15.5) and Trichuris trichiura 2.1% (95% CI: 0.9-4.9). Mixed STH infections were observed as well as SCH-STH coinfection.

CONCLUSION

Further mapping of both SCH and STH burden is needed, and coverage of preventive chemotherapy in school-aged children should be increased.

摘要

目的

确定刚果民主共和国血吸虫病(SCH)和土源性蠕虫(STH)的流行情况,并评估当地卫生中心的诊断和治疗能力。

方法

在基卢省的两个卫生区开展基于学校的横断面调查。我们收集粪便和尿液样本进行寄生虫学检查。采用尿液过滤法和重复加藤厚涂片法诊断血吸虫病。使用结构化问卷对卫生中心进行评估。

结果

共有526名儿童参与研究,两个区曼氏血吸虫感染的总体患病率为8.9%(95%置信区间:3.5 - 13.2)。莫桑戈的患病率(11.7%;95%置信区间:8.9 - 14.8)高于亚萨邦加区(6.2%;95%置信区间:1.1 - 11.4)。尿液过滤显示不存在埃及血吸虫感染。两个区土源性蠕虫混合感染患病率为58.1%;钩虫感染是最常见的土源性蠕虫,在52.9%(95%置信区间:29.3 - 62.4)的研究对象中发现,其次是蛔虫感染9.3%(95%置信区间:5.8 - 15.5)和鞭虫感染2.1%(95%置信区间:0.9 - 4.9)。观察到土源性蠕虫混合感染以及血吸虫病与土源性蠕虫混合感染。

结论

需要进一步绘制血吸虫病和土源性蠕虫负担图,并应提高学龄儿童预防性化疗的覆盖率。

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