Taghipour Ali, Rostami Ali, Sepidarkish Mahdi, Ghaffarifar Fatemeh
Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Microb Pathog. 2020 Feb 23;142:104099. doi: 10.1016/j.micpath.2020.104099.
There are numerous epidemiological and experimental evidences to suggest that Ascaris lumbricoides infection is a neglected risk factor for development of asthma. For this purpose, we conducted a systematic review and meta-analysis for better understanding of this relationship. Systematic searching (PubMed, Scopus, Web of Science and Google Scholar) was done, up to September 30, 2019 to identify the relevant studies. We applied random-effects meta-analysis model to generate the overall odds ratio (OR) and 95% confidence intervals (CIs). Heterogeneity was assessed with I and τ statistic. Finally, 19 studies (totally 25 datasets), including 14 datasets with microscopic methods (1830 asthmatic patients (APs) and 3802 healthy controls (HCs)) and 11 datasets with serological methods (1543 APs and 3507 HCs) met the eligibility criteria. Considering to the serological methods, our results demonstrated that the APs had higher seroprevalence rate of A. lumbricoides (48.3% vs. 35.1%) than HCs, showing a significant association (pooled crude OR, 1.53; 95%CI, 1.07-2.18). Moreover, microscopic methods showed a higher prevalence of A. lumbricoides infection in the APs compared to the HCs (37.2% vs. 30.2%), but no significant association was found between APs and HCs (pooled crude OR, 1.19; 95%CI, 0.92-1.55). After adjustment for confounders, results showed no significant association for both serological (pooled adjusted OR, 1.43; 95%CI, 0.93-2.19) and microscopic (pooled adjusted OR, 1.05; 95%CI, 0.78-1.42) methods. Despite heterogeneous results, accurate and better quality studies are needed to determine the effect of A. lumbricoides infection on induction or exacerbation of asthma.
有大量的流行病学和实验证据表明，蛔虫感染是哮喘发病的一个被忽视的危险因素。为此，我们进行了一项系统综述和荟萃分析，以更好地理解这种关系。截至2019年9月30日，我们通过系统检索（PubMed、Scopus、科学网和谷歌学术）来识别相关研究。我们应用随机效应荟萃分析模型来生成总体比值比（OR）和95%置信区间（CI）。用I和τ统计量评估异质性。最终，19项研究（共25个数据集）符合纳入标准，其中包括14个采用显微镜检查方法的数据集（1830例哮喘患者（AP）和3802例健康对照（HC））以及11个采用血清学方法的数据集（1543例AP和3507例HC）。考虑血清学方法，我们的结果表明，AP的蛔虫血清阳性率（48.3%对35.1%）高于HC，显示出显著关联（合并粗OR，1.53；95%CI，1.07 - 2.18）。此外，显微镜检查方法显示AP的蛔虫感染率高于HC（37.2%对30.2%），但AP与HC之间未发现显著关联（合并粗OR，1.19；95%CI，0.92 - 1.55）。在对混杂因素进行调整后，结果显示血清学（合并调整后OR，1.43；95%CI，0.93 - 2.19）和显微镜检查方法（合并调整后OR，1.05；95%CI，0.78 - 1.42）均无显著关联。尽管结果存在异质性，但仍需要准确且质量更高的研究来确定蛔虫感染对哮喘诱发或加重的影响。
