Blitz Jason, Riddle Mark S, Porter Chad K
Navy Environmental and Preventive Medicine Unit Six, Pearl Harbor, HI, United States.
Department of Preventive and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
Front Microbiol. 2018 Jan 23;9:17. doi: 10.3389/fmicb.2018.00017. eCollection 2018.
Infectious gastroenteritis (IGE) is caused by numerous bacterial, viral, and parasitic pathogens. A history of IGE has been shown in previous studies to increase the risk of developing chronic gastrointestinal disorders and other chronic conditions. As bacteria and viruses represent the majority of pathogen-specific causes of IGE, post-infectious studies have primarily focused on these organisms. The objective of this study was to investigate an association between a history of parasite-associated IGE and the subsequent development of chronic post-infectious gastrointestinal and non-gastrointestinal disorders in a military population. International Classification of Diseases, 9th Revision Clinical Modification (ICD-9-CM) diagnostic coding data for primary exposures and outcomes were obtained for a retrospective cohort study of active component military personnel from 1998 to 2013. Exposed subjects consisted of individuals with documented infection with one of ten parasitic pathogens. Unexposed subjects were matched to exposed subjects on demographic and operational deployment history parameters. Adjusted odds ratios (aORs) were estimated using logistic regression for several chronic disorders previously shown to be associated with a history of IGE. A total of 896 subjects with a parasitic exposure were matched to 3681 unexposed subjects for multivariate regression analysis. Individuals infected with , , , , and spp. had higher aOR for development of several chronic gastrointestinal disorders when compared with unexposed subjects after controlling for various covariates. We found that parasite-associated enteric infection increases the risk of development of post-infectious chronic gastrointestinal disorders in a military population. These results require confirmation in similar populations and in the developing world where infection with these parasites is endemic. Further understanding of disease burden and causal mechanisms should direct primary prevention and potential disease interception strategies.
感染性肠胃炎（IGE）由多种细菌、病毒和寄生虫病原体引起。既往研究表明，IGE病史会增加患慢性胃肠疾病和其他慢性病的风险。由于细菌和病毒是IGE病原体特异性病因的主要组成部分，感染后研究主要集中在这些病原体上。本研究的目的是调查寄生虫相关IGE病史与军队人群感染后慢性胃肠及非胃肠疾病后续发生之间的关联。从1998年至2013年现役军人的回顾性队列研究中获取了国际疾病分类第九版临床修订本（ICD-9-CM）主要暴露因素和结局的诊断编码数据。暴露组包括记录感染十种寄生虫病原体之一的个体。非暴露组在人口统计学和作战部署历史参数方面与暴露组进行匹配。使用逻辑回归对先前显示与IGE病史相关的几种慢性疾病估计调整后的比值比（aORs）。共有896名有寄生虫暴露史的受试者与3681名非暴露受试者进行多变量回归分析。在控制各种协变量后，与未暴露受试者相比，感染 、 、 、 和 属的个体患几种慢性胃肠疾病的aOR更高。我们发现寄生虫相关的肠道感染会增加军队人群感染后慢性胃肠疾病的发生风险。这些结果需要在类似人群以及这些寄生虫感染为地方病的发展中世界得到证实。对疾病负担和因果机制的进一步了解应指导一级预防和潜在的疾病拦截策略。
