Department of Infectious Disease and Microbiology, Royal Free Hospital, Pond Street, London, NW3 2QG, UK.
Clinical Research Department, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
BMC Infect Dis. 2019 Oct 11;19(1):838. doi: 10.1186/s12879-019-4439-8.
Helminthic and protozoan infections are common, particularly in low- or middle-income countries. Although an association between parasite carriage and markers of poor growth have been shown in some studies, systematic reviews have suggested only a modest impact of clearing carriage. The prevalence of these pathogens and the effect that they have on growth in preschool children has never been investigated in Malawi.
One hundred ninety-three children aged 0-72 months were randomly recruited from rural villages in the Mangochi district of Malawi. Formol-ether concentration was performed on stool and the samples examined with a light microscope. Anthropometric data was taken for each child and the haemoglobin measured with a point of care test.
The mean age of the children was 2 years 4 months. Overall prevalence of intestinal parasite infection was 37.3%. Protozoa were found in 28.5% of children, while helminths were found in 8.8%. The most commonly found organisms were Giardia lambia (12.4%), Entamoeba coli (10.4%) and Hookworm species (3.6%). Stunting was seen in 47.8% of children, 12.9% were underweight and 5.0% were wasted. No significant association was found between markers of poor growth and infection with any intestinal parasite.
We found that prevalence of helminth infection was low in preschool children living in the Mangochi district compared to international standards. However a significant proportion of the preschool population are infected with protozoa, particularly Giardia lambia. In this cohort, despite a significant prevalence of stunting, helminth infection was not significantly associated with any markers of poor growth. The significance of protozoal carriage and contribution to growth restriction in this context creates further avenues for future research.
蠕虫和原生动物感染很常见，尤其是在低收入和中等收入国家。尽管一些研究表明寄生虫携带与生长不良标志物之间存在关联，但系统评价表明清除携带的影响仅适度。这些病原体的流行率及其对学龄前儿童生长的影响在马拉维从未被调查过。
从马拉维曼戈奇区的农村村庄随机招募了 193 名 0-72 个月大的儿童。对粪便进行福尔马林乙醚浓缩，并用显微镜检查样本。对每个孩子进行了人体测量数据测量，并使用即时检测测试测量了血红蛋白。
儿童的平均年龄为 2 岁 4 个月。肠道寄生虫感染的总体患病率为 37.3%。原虫在 28.5%的儿童中发现，而蠕虫在 8.8%的儿童中发现。最常见的生物体是兰比亚贾第虫（12.4%）、结肠内阿米巴（10.4%）和钩虫属（3.6%）。 47.8%的儿童出现发育迟缓，12.9%的儿童体重不足，5.0%的儿童消瘦。感染任何肠道寄生虫与生长不良标志物之间均未发现显著相关性。
我们发现，与国际标准相比，生活在曼戈奇区的学龄前儿童的寄生虫感染率较低。然而，相当一部分学龄前儿童感染了原虫，特别是兰比亚贾第虫。在这个队列中，尽管发育迟缓的患病率很高，但寄生虫感染与任何生长不良标志物均无显著相关性。在这种情况下，原虫携带的重要性及其对生长受限的贡献为进一步的研究提供了途径。
