Rivero M R, De Angelo C, Nuñez P, Salas M, Liang S
Instituto Nacional de Medicina Tropical, INMeT, Ministerio de Salud de la Nación, Puerto Iguazú, Misiones, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, Argentina.
Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, Argentina; Instituto de Biología Subtropical (IBS, UNaM-CONICET), Puerto Iguazú, Misiones, Argentina; Assoc. Civil Centro de Investigaciones del Bosque Atlántico (CeIBA), Puerto Iguazú, Misiones, Argentina.
Acta Trop. 2018 Nov;187:248-256. doi: 10.1016/j.actatropica.2018.08.015. Epub 2018 Aug 17.
Intestinal parasitoses, especially in the less favored populations of tropical and subtropical areas, are a scourge of high impact in public health. We conducted a cross-sectional survey to investigate the prevalence of helminths and protozoa pathogens, malnutrition, and their determinants in children from indigenous Mbyá Guaraní villages of Iguazú, in the subtropical Atlantic Forest of Argentina.
Parasitological assessment was performed using a combination of flotation, sedimentation, and centrifugation techniques, as well as temporal and permanent stains. Nutritional assessment was based on nutritional indicators derived from anthropometric measurements. Statistical analysis of socio-demographic determinants was assessed by Generalized Linear Mixed Models at individual, household, and village levels.
A total of 303 children from 140 families from Fortin Mbororé and Yriapú Jungle villages participated, and 87.8% of them resulted positive to at least one parasite. Multiparasitism reached 70% and children with up to six different parasites were detected. Thirteen genera were identified, of which eight were pathogenic. The most frequent soil-transmitted helminths were hookworms and Strongyloides stercoralis with 60.7 and 41.9%, respectively. Enterobius vermicularis was detected in 28.4% of children. Giardia duodenalis was the main protozoan and reached the 33.3%. The prevalence of stunting and underweight were 38.9% and 6.9%, whereas for overweight and obesity were 28.1% and 12.9%, respectively. An association was observed between stunting in older children and the presence of parasites, multiparasitism, and giardiasis. Individual conditions and habits were important determinants for most of the parasitoses.
We evidenced that the community is affected by the double burden of malnutrition and parasitoses. To face this alarming situation, public policies are needed to improve sanitation, hygiene education access, community deworming programs, and quality nutrition on a regular basis of intercultural approaches.
肠道寄生虫病，尤其是在热带和亚热带地区条件较差的人群中，是对公共卫生有重大影响的一大祸害。我们开展了一项横断面调查，以调查阿根廷亚热带大西洋森林伊瓜苏地区姆比亚瓜拉尼原住民村庄儿童中蠕虫和原生动物病原体的流行情况、营养不良状况及其决定因素。
采用漂浮法、沉淀法和离心法相结合的技术以及临时染色和永久染色进行寄生虫学评估。营养评估基于人体测量得出的营养指标。通过广义线性混合模型在个体、家庭和村庄层面评估社会人口学决定因素的统计分析。
来自福尔廷姆博雷和伊里亚普丛林村140个家庭的303名儿童参与了调查，其中87.8%的儿童至少对一种寄生虫检测呈阳性。多重寄生虫感染率达70%，检测到有多达六种不同寄生虫的儿童。鉴定出13个属，其中8个属具有致病性。最常见的土源性蠕虫是钩虫和粪类圆线虫，分别占60.7%和41.9%。28.4%的儿童检测到蛲虫。十二指肠贾第鞭毛虫是主要的原生动物，占33.3%。发育迟缓率和体重不足率分别为38.9%和6.9%，而超重和肥胖率分别为28.1%和12.9%。观察到年龄较大儿童的发育迟缓与寄生虫感染、多重寄生虫感染和贾第虫病之间存在关联。个体状况和习惯是大多数寄生虫病重要的决定因素。
我们证明该社区受到营养不良和寄生虫病双重负担的影响。为应对这一令人担忧的情况，需要制定公共政策，通过跨文化方法定期改善环境卫生、提供卫生教育、开展社区驱虫计划并提供优质营养。
