莫桑比克中部有症状和无症状学童肠道寄生虫的风险关联

Risk associations for intestinal parasites in symptomatic and asymptomatic schoolchildren in central Mozambique.

作者信息

Muadica A S, Balasegaram S, Beebeejaun K, Köster P C, Bailo B, Hernández-de-Mingo M, Dashti A, Dacal E, Saugar J M, Fuentes I, Carmena D

机构信息

Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain; Departamento de Ciências e Tecnologia, Universidade Licungo, Quelimane, Zambézia, Mozambique.

Field Epidemiology Services, National Infection Service, Public Health England, London, UK.

出版信息

Clin Microbiol Infect. 2021 Apr;27(4):624-629. doi: 10.1016/j.cmi.2020.05.031. Epub 2020 Jun 4.

DOI:10.1016/j.cmi.2020.05.031

PMID:32505583

Abstract

OBJECTIVES

Chronic infections by enteric parasites including protist and helminthic species produce long-term sequelae on the health status of infected children. This study assesses potential associations linked with enteric parasite infections in symptomatic and asymptomatic children in Zambézia province, Mozambique.

METHODS

In this prospective cross-sectional study, stool samples and epidemiological questionnaires on demographics and risk associations were collected from symptomatic children (n = 286) from clinical settings and asymptomatic (n = 807) children from 17 schools and creches aged 3‒14 years. We detected enteric parasites using PCR-based methods. We calculated prevalence (adjusted for age, sex, house construction, drinking water, and latrine use) and odds ratios (ORs) for risk associations with logistic regression, after adjusting for district, neighbourhood and symptoms.

RESULTS

Numbers and adjusted prevalence (95% confidence intervals in parentheses) for the symptomatic and asymptomatic populations were Giardia duodenalis 120, 52% (22-82), 339, 42% (25-59); followed by Strongyloides stercoralis 52, 14% (9‒20), 180, 20% (15-25). Risk associations for G. duodenalis included drinking untreated river/spring water, OR 2.91 (1.80-4.70); contact with ducks, OR 14.96 (2.93‒76.31); dogs, OR 1.92 (1.04-3.52); cats, OR 1.73 (1.16-2.59), and a relative with diarrhoea, OR 2.59 (1.54‒4.37). Risk associations for S. stercoralis included having no latrine, OR 2.41 (1.44-4.02); drinking well water, OR 1.82 (1.02-3.25), and increasing age, OR 1.11 (1.04-1.20).

CONCLUSIONS

We found a high prevalence of intestinal parasites regardless of the children's symptoms. Drinking well or river water, domestic animals, and latrine absence were contributing factors of human infections.

摘要

目的

包括原生生物和蠕虫在内的肠道寄生虫慢性感染会对受感染儿童的健康状况产生长期影响。本研究评估了莫桑比克赞比西亚省有症状和无症状儿童肠道寄生虫感染的潜在关联因素。

方法

在这项前瞻性横断面研究中，从临床环境中的有症状儿童（n = 286）以及17所3至14岁学校和托儿所的无症状儿童（n = 807）中收集粪便样本以及关于人口统计学和风险关联的流行病学调查问卷。我们使用基于聚合酶链反应（PCR）的方法检测肠道寄生虫。在对地区、社区和症状进行调整后，我们通过逻辑回归计算患病率（根据年龄、性别、房屋结构、饮用水和厕所使用情况进行调整）以及风险关联的比值比（OR）。

结果

有症状和无症状人群中，十二指肠贾第虫的数量及调整后的患病率（括号内为95%置信区间）分别为120例，52%（22 - 82）；339例，42%（25 - 59）；其次是粪类圆线虫，分别为52例，14%（9 - 20）；180例，20%（15 - 25）。十二指肠贾第虫的风险关联因素包括饮用未经处理的河水/泉水，OR为2.91（1.80 - 4.70）；接触鸭子，OR为14.96（2.93 - 76.31）；接触狗，OR为1.92（1.04 - 3.52）；接触猫，OR为1.73（1.16 - 2.59），以及有腹泻亲属，OR为2.59（1.54 - 4.37）。粪类圆线虫的风险关联因素包括没有厕所，OR为2.41（1.44 - 4.02）；饮用井水，OR为1.82（1.02 - 3.25），以及年龄增长，OR为1.11（1.04 - 1.20）。