Department of Vaccines and Immunity, Medical Research Council Unit The Gambia at London school of Hygiene and Tropical Medicine, Atlantic Boulevard, P.O. Box 452, Fajara, Gambia.
Department of Paediatrics, Bayero University Kano, Kano, Nigeria.
BMC Infect Dis. 2019 Feb 6;19(1):121. doi: 10.1186/s12879-019-3755-3.
Soil-transmitted helminthic (STH) infections are common in Sub-Saharan Africa. One method used for control of these helminths is mass anti-helminthic administration in populations at risk of STH infections. In this regard, empiric treatment of children with Severe Acute Malnutrition (SAM) for STH infection is practiced in this region. It is however unclear if children with SAM suffer more from STH infection than healthy children. The objective of this study was to compare prevalence and intensity of STH infection between pre-school aged children with SAM and healthy children.
We approached 1114 pre-school aged children attending care in two health facilities in Kano, Nigeria to partake in this study. Of this number, we recruited 620 (55.7%) children, comprising 310 well-nourished children from well-baby clinics and 310 children with SAM from Community Management for Acute Malnutrition (CMAM) centres in these facilities. We assessed their nutritional status using World Health Organisation (WHO) growth charts and collected stool samples which we analysed using Formal-Ether Concentration technique to identify STH infection and Stoll's technique to assess intensities of STH infection. We fitted a logistic regression model to determine if there was any association between nutrition status and helminthic infection, adjusting for the confounding effects of socio-economic status and age. We compared intensity of STH infection (measured as eggs per gram of faeces) between both nutrition groups using the independent t-test.
Overall STH prevalence in our population was low (2.7%) and we found no significant association between nutritional status and presence of STH infection (OR = 1.10, 95% CI 0.38 to 3.21). Majority of our study participants had either low or moderate (94.2%) and there was no statistically significant difference between intensity of STH infection (t value = - 1.52, P value = 0.13) in children with SAM and those who were well-nourished.
The overall STH prevalence among pre-school children was low in Kano and we did not find prevalence and intensity of STH infection to differ significantly between preschool children with SAM and well-nourished children. Our findings confirm the WHO recommendation that at low levels of prevalence and intensity, interventions to control STH are unnecessary.
土壤传播的蠕虫(STH)感染在撒哈拉以南非洲很常见。控制这些蠕虫的一种方法是对有 STH 感染风险的人群进行大规模驱虫。在这方面,该地区对患有严重急性营养不良(SAM)的儿童进行经验性驱虫治疗。然而,目前尚不清楚患有 SAM 的儿童是否比健康儿童更容易受到 STH 感染。本研究的目的是比较患有 SAM 的学龄前儿童与健康儿童之间 STH 感染的患病率和感染强度。
我们接触了在尼日利亚卡诺的两家卫生机构接受护理的 1114 名学龄前儿童,邀请他们参与本研究。在这一数字中,我们招募了 620 名(55.7%)儿童,其中 310 名来自婴儿诊所的营养良好的儿童和 310 名来自这些设施的社区管理急性营养不良(CMAM)中心的患有 SAM 的儿童。我们使用世界卫生组织(WHO)生长图表评估他们的营养状况,并收集粪便样本,我们使用福尔马林乙醚浓缩技术来识别 STH 感染,并用斯托尔技术来评估 STH 感染的强度。我们拟合了一个逻辑回归模型,以确定营养状况与蠕虫感染之间是否存在关联,同时调整了社会经济地位和年龄的混杂影响。我们使用独立 t 检验比较了两组营养儿童之间 STH 感染的强度(以每克粪便中的卵数表示)。
我们人群中的 STH 总患病率较低(2.7%),我们发现营养状况与 STH 感染之间没有显著关联(OR=1.10,95%CI 0.38 至 3.21)。我们的大多数研究参与者的感染程度较低或中等(94.2%),患有 SAM 的儿童与营养良好的儿童之间的 STH 感染强度没有统计学上的显著差异(t 值=-1.52,P 值=0.13)。
在卡诺,学龄前儿童的总体 STH 患病率较低,我们没有发现患有 SAM 的学龄前儿童与营养良好的儿童之间 STH 感染的患病率和感染强度有显著差异。我们的发现证实了世界卫生组织的建议,即在低流行率和低感染强度下,控制 STH 的干预措施是不必要的。