Department of Pathogen Biology and Immunology, Kunming Medical University, Kunming, China.
Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida.
Am J Trop Med Hyg. 2020 Apr;102(4):851-856. doi: 10.4269/ajtmh.19-0828.
In tropical areas of developing countries, the interactions among parasitic diseases such as soil-transmitted helminths (STHs) and malaria, and glucose-6-phosphate dehydrogenase deficiency (G6PDd), are complex. Here, we investigated their interactions and impact on anemia in school students residing in a conflict zone of northeast Myanmar. A cross-sectional survey was conducted between July and December 2015 in two schools located along the China-Myanmar border. Stool samples from the schoolchildren were analyzed for STH infections, whereas finger-prick blood samples were analyzed for G6PDd, hemoglobin concentrations, and infections. Among 988 enrolled children, , , hookworm, , and infections occurred in 3.3%, 0.8%, 31.5%, 1.2%, and 0.3%, respectively. Glucose-6-phosphate dehydrogenase deficiency was present in 16.9% of the children, and there was a very high prevalence of anemia (73%). Anthropometric measures performed on all children showed that 50% of the children were stunted and 25% wasted. Moderate to severe anemia was associated with STH infections, stunting, and wasting. In addition, children had increasing odds of anemia with increasing burden of infections. This study revealed a high prevalence of G6PDd, STHs, and anemia in schools located in a conflict zone. In areas where malnutrition and STH infections are rampant, testing for both glucose-6-phosphate dehydrogenase and anemia should be considered before treating vivax malaria with 8-aminoquinolines.
在发展中国家的热带地区，寄生虫病（如土壤传播的蠕虫（STH）和疟疾）和葡萄糖-6-磷酸脱氢酶缺乏症（G6PDd）之间的相互作用非常复杂。在这里，我们研究了它们在位于缅甸东北部冲突地区的在校学生中相互作用和对贫血的影响。我们于 2015 年 7 月至 12 月在中缅边境的两所学校进行了一项横断面调查。对学生的粪便样本进行了 STH 感染分析，而对指尖血样进行了 G6PDd、血红蛋白浓度和 感染分析。在 988 名入组儿童中，分别有 3.3%、0.8%、31.5%、1.2%和 0.3%的儿童存在钩虫、鞭虫、蛔虫、 感染。葡萄糖-6-磷酸脱氢酶缺乏症在 16.9%的儿童中存在，贫血患病率非常高（73%）。对所有儿童进行的人体测量学指标表明，50%的儿童发育迟缓，25%的儿童消瘦。中度至重度贫血与 STH 感染、发育迟缓以及消瘦有关。此外，随着感染负担的增加，儿童患贫血的几率也随之增加。这项研究揭示了位于冲突地区的学校中 G6PDd、STH 和贫血的高患病率。在营养不良和 STH 感染猖獗的地区，在使用 8-氨基喹啉类药物治疗间日疟之前，应该考虑同时检测葡萄糖-6-磷酸脱氢酶和贫血。
