坦桑尼亚西北部接受抗逆转录病毒疗法的儿科人群中的感染流行率和感染强度：一项横断面研究。

Prevalence and intensity of infection in pediatric populations on antiretroviral therapy in north-western Tanzania: a cross-sectional study.

机构信息

Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania

Department of Pediatricts and Child Health, Bugando Medical Centre, Mwanza, United Republic of Tanzania.

出版信息

BMJ Open. 2019 Jul 24;9(7):e029749. doi: 10.1136/bmjopen-2019-029749.

DOI:10.1136/bmjopen-2019-029749

PMID:31345980

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6661605/

Abstract

BACKGROUND

In areas where HIV and intestinal schistosomiasis are highly endemic, co-infections of the two diseases in a single human host are frequent. Evidence in adult populations indicates that HIV and intestinal schistosomiasis are associated with negative health impacts. However, the topic of HIV and schistosomiasis in paediatric populations has received little attention. The present study determined the prevalence and intensity of infection in a paediatric population on antiretroviral therapy (ART) in north-western Tanzania.

DESIGN, SETTINGS AND PARTICIPANTS: A cross-sectional study was conducted among HIV-infected children aged 1-16 years on ART attending a Care and Treatment Clinic at Ukerewe Designated District Hospital, north-western Tanzania.

MAIN OUTCOME MEASURES

Single stool and urine samples were collected and screened for eggs and circulating cathodic antigen (CCA), using the Kato-Katz (KK) technique and point-of-care CCA (POC-CCA) rapid urine test, respectively.

RESULTS

A total of 134 children with a median age of 10 years (IQR 7-12 years) participated in the study. Of these, 44.8% (60/134) and 55.2% (74/134) were female and male, respectively. The overall prevalence of based on the KK technique and POC-CCA rapid test were 10.7% (95% CI 5.9% to 18.4%) and 33.8% (95% CI 26.2% to 42.4%), respectively. The overall geometrical mean eggs per gram of faeces was 293.9 GM-epg (95% CI 123.3 to 700.9). A small proportion of the children had moderate (4.9%, 5/103) and heavy (3.8%, 4/103) intensity of infection.

CONCLUSION

Paediatric populations on ART are co-infected with infection. Screening and treatment of intestinal schistosomiasis at initiation of ART is recommended to reduce the risk of developing hepatosplenic disease, schistosomiasis-related immune reconstitution inflammatory syndrome and the possible adverse effect of schistosomiasis on outcome of ART.

摘要

背景

在艾滋病毒和肠道血吸虫病高度流行的地区，人类宿主同时感染这两种疾病的情况很常见。在成年人群中的证据表明，艾滋病毒和肠道血吸虫病与负面健康影响有关。然而，儿科人群中的艾滋病毒和血吸虫病问题尚未得到关注。本研究旨在确定坦桑尼亚西北部接受抗逆转录病毒疗法（ART）的儿科人群中感染的流行率和严重程度。

设计、地点和参与者：这是一项在坦桑尼亚西北部 Ukerewe 指定区医院的护理和治疗诊所接受 ART 的 1-16 岁艾滋病毒感染儿童中进行的横断面研究。

主要结果测量

采集单个粪便和尿液样本，分别使用加藤厚涂片（KK）技术和即时检测（POC）循环阴离子抗原（CCA）快速尿液检测筛查虫卵和循环 CCA（CCA）。

结果

共有 134 名中位年龄为 10 岁（IQR 7-12 岁）的儿童参加了这项研究。其中，44.8%（60/134）和 55.2%（74/134）为女性和男性。基于 KK 技术和 POC-CCA 快速检测，的总流行率分别为 10.7%（95%CI 5.9%至 18.4%）和 33.8%（95%CI 26.2%至 42.4%）。粪便每克虫卵的总几何平均为 293.9 GM-epg（95%CI 123.3 至 700.9）。一小部分儿童的感染程度为中度（4.9%，5/103）和重度（3.8%，4/103）。