de Lima e Costa M F, Leite M L, Rocha R S, de Almeida Magalhães M H, Katz N
Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Int J Epidemiol. 1988 Dec;17(4):880-6. doi: 10.1093/ije/17.4.880.
A cross-sectional study of anthropometric measures and their association with socioeconomic variables, infection by Schistosoma mansoni, intensity of infection and splenomegaly was carried out in an endemic area for schistosomiasis in Brazil (Comercinho), using multiple logistic regression methods. Eighty-seven per cent of all 1.5-14.4 year-old children in the area participated in the study. Children below the 5th percentile (USA Ten State Survey) for height-for-age, weight-for-age and arm muscle area-for-age were compared to those greater than the 5th percentile. There was no association between low anthropometric measures and schistosomiasis or socioeconomic variables in children under five years of age. For the 4.4-14.4 year-old children, poor condition of the heads of family and poorer housing were independently associated with low height and arm muscle area. Heavy excretion of S. mansoni eggs (greater than or equal to 500 epg) was related to low height, and splenomegaly was the variable which showed the strongest association with low height, weight and arm muscle area (odds ratios adjusted for socioeconomic variables were 6.4, 3.5 and 3.7 respectively). This indicates that there is a biological component for low anthropometric measures in the severe form of schistosomiasis and this reinforces the need for public health measures to prevent the development of splenomegalies in endemic areas.
在巴西一个血吸虫病流行地区(科梅林霍),采用多元逻辑回归方法,对人体测量指标及其与社会经济变量、曼氏血吸虫感染、感染强度和脾肿大的关联进行了一项横断面研究。该地区所有1.5至14.4岁儿童中有87%参与了这项研究。将年龄别身高、年龄别体重和年龄别上臂肌肉面积处于第5百分位数以下(美国十州调查标准)的儿童与高于第5百分位数的儿童进行比较。五岁以下儿童的低人体测量指标与血吸虫病或社会经济变量之间没有关联。对于4.4至14.4岁的儿童,户主状况不佳和住房条件较差与身高较低和上臂肌肉面积较小独立相关。曼氏血吸虫卵大量排泄(大于或等于500个虫卵/克粪便)与身高较低有关,脾肿大是与身高较低、体重较轻和上臂肌肉面积较小关联最强的变量(经社会经济变量调整后的优势比分别为6.4、3.5和3.7)。这表明,在严重血吸虫病形式下,低人体测量指标存在生物学因素,这强化了在流行地区采取公共卫生措施预防脾肿大发生的必要性。