Optics & Imaging, Doris Duke Medical Research Institute, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Department of Biochemistry, University of Zimbabwe, Harare, Zimbabwe.
Trop Med Int Health. 2020 Sep;25(9):1110-1121. doi: 10.1111/tmi.13451. Epub 2020 Jul 9.
To investigate Schistosoma haematobium morbidity in infected pre-school age children and establish their disease burden.
Pre-school age children (1-5 years) who were lifelong residents of the study area and had no other infections were included in the study. Participants underwent a physical examination with clinicians blinded to their infection status. Diagnosis of S. haematobium was by urine filtration.
The prevalence of S. haematobium was 35.1% (146/416). The clinical features observed in patients with Schistosoma haematobium were as follows: wheezes (morbidity attributable factor (AF = 93.9%), haematuria (AF = 92.6%), ascites (AF = 91.5%), atopy (AF = 76.9%), inguinal lymphadenopathy (AF = 68.4%), stunting (AF = 38.2), malnutrition (MUAC)(AF = 20%) and weight for height scales (AF = 5%). Schistosoma. haematobium infected children were at greater odds ratio of presenting with inguinal lymphadenopathy (AOR)=99.2(95% CI 24.2 to 854.5), wheezes in the chest (AOR = 35.4 95% CI 15.3 to 94.2), Distended abdomen with ascites (AOR = 23.9 95% CI 11.4 to 54), haematuria (AOR = 12.6 95% CI 11.6 to 14.1), atopy history (AOR = 5.6 95% CI 1.85 to 20.2), malnutrition (AOR = 2.3 95% CI 1.4 to 3.2) and stunting (AOR = 1.9 95% CI 1.1 to2.7).
The study is novel as it demonstrates for the first time clinical morbidity markers associated with S. haematobium infection in pre-school age children. Furthermore the study adds scientific evidence to the call for inclusion of pre-school age children in schistosomiasis control programmes. These morbidity markers highlight the need for early diagnosis and screening for S. haematobium in pre-school age children.
调查感染学龄前儿童的埃及血吸虫病发病率，并确定其疾病负担。
本研究纳入了在研究区域居住的终生居民且无其他感染的学龄前儿童。参与者接受了体格检查，检查人员对其感染状况不知情。埃及血吸虫病的诊断通过尿过滤进行。
埃及血吸虫病的患病率为 35.1%（146/416）。患有埃及血吸虫病的患者的临床特征如下：哮喘（归因发病因素（AF）=93.9%）、血尿（AF=92.6%）、腹水（AF=91.5%）、特应性（AF=76.9%）、腹股沟淋巴结病（AF=68.4%）、发育迟缓（AF=38.2%）、营养不良（MUAC）（AF=20%）和身高体重比例（AF=5%）。感染埃及血吸虫的儿童更有可能出现腹股沟淋巴结病（OR=99.2[95%CI 24.2 至 854.5]）、胸部哮喘（OR=35.4[95%CI 15.3 至 94.2]）、腹部膨隆伴腹水（OR=23.9[95%CI 11.4 至 54]）、血尿（OR=12.6[95%CI 11.6 至 14.1]）、特应性病史（OR=5.6[95%CI 1.85 至 20.2]）、营养不良（OR=2.3[95%CI 1.4 至 3.2]）和发育迟缓（OR=1.9[95%CI 1.1 至 2.7]）。
本研究是新颖的，因为它首次证明了学龄前儿童埃及血吸虫病感染相关的临床发病率标志物。此外，该研究为呼吁将学龄前儿童纳入血吸虫病控制计划提供了科学证据。这些发病率标志物突出表明需要对学龄前儿童进行早期诊断和筛查埃及血吸虫病。
