Department of Anthropology, Dartmouth College, Hanover, New Hampshire, United States of America.
Department of Anthropology, University of Colorado, Colorado Springs, Colorado, United States of America.
PLoS One. 2020 Jul 31;15(7):e0236924. doi: 10.1371/journal.pone.0236924. eCollection 2020.
Soil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased participation in a market-based economy). Yet the direct impact of MI-related social and environmental changes on STH infection patterns is poorly understood, making it unclear which lifestyle factors should be targeted to better control disease spread. This cross-sectional study examines if household infrastructure associated with greater MI is associated with lower STH burdens among Indigenous Ecuadorian Shuar.
Kato-Katz fecal smears were used to determine STH infection status and intensity (n = 620 participants; 308 females, 312 males, aged 6 months-86 years); Ascaris lumbricoides (ascarid) and Trichuris trichiura (whipworm) were the primary infection types detected. Structured interviews assessing lifestyle patterns (e.g., measures of household infrastructure) measured participant MI. Multilevel regression analyses and zero-inflated negative binomial regression models tested associations between MI measures and STH infection status or intensity, controlling for individual and community characteristics.
Participants residing in more market-integrated households exhibited lower infection rates and intensities than those in less market integrated households. Parasite infection status and T. trichiura infection intensity were lower among participants living in houses with wood floors than those with dirt floors, while individuals using well or piped water from a spring exhibited lower A. lumbricoides infection intensities compared to those using river or stream water. Unexpectedly, latrine type was not significantly related to STH infection status or intensity. These results suggest that sources of exposure differ between the two helminth species.
This study documents associations between household measures and STH infection among an Indigenous population undergoing rapid MI. These findings can help healthcare programs better target interventions and reduce STH exposure among at-risk populations.
土壤传播性蠕虫（STH）感染会对健康造成许多负面影响（例如腹泻、营养缺乏），这些负面影响也会加剧贫困。这些感染通常在低收入人群中最为普遍，其中许多人也正在经历市场一体化（MI；更多地参与基于市场的经济）。然而，MI 相关的社会和环境变化对 STH 感染模式的直接影响还了解甚少，这使得不清楚应该针对哪些生活方式因素来更好地控制疾病传播。本横断面研究调查了与更大 MI 相关的家庭基础设施是否与厄瓜多尔土著肖拉人的 STH 负担降低有关。
使用加藤厚涂片法确定 STH 感染状况和强度（n = 620 名参与者；女性 308 名，男性 312 名，年龄 6 个月至 86 岁）；主要检测到的感染类型为蛔虫（蛔虫）和鞭虫（鞭虫）。评估生活方式模式（例如，家庭基础设施措施）的结构访谈衡量了参与者的 MI。多水平回归分析和零膨胀负二项回归模型测试了 MI 措施与 STH 感染状况或强度之间的关联，同时控制了个体和社区特征。
居住在市场一体化程度较高的家庭中的参与者的感染率和强度低于市场一体化程度较低的家庭中的参与者。与居住在泥土地板房屋中的参与者相比，居住在木地板房屋中的参与者的寄生虫感染状况和鞭虫感染强度较低，而使用井水或泉水的人比使用河流或溪流水的人感染蛔虫的强度较低。出乎意料的是，厕所类型与 STH 感染状况或强度没有显著关系。这些结果表明，两种寄生虫的暴露源不同。
本研究记录了在经历快速 MI 的土著人群中，家庭措施与 STH 感染之间的关联。这些发现可以帮助医疗保健计划更好地针对高危人群进行干预，减少 STH 的暴露。
