Ottaru Sofia, Mirambo Mariam M, Kabyemera Rogatus, Kidenya Benson R, Seugendo Mwanaisha, Msanga Delfina R, Ngoya Patrick, Morona Domenica, Mshana Stephen E
Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania.
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
Int J Pediatr. 2020 Sep 4;2020:8326348. doi: 10.1155/2020/8326348. eCollection 2020.
infection during pregnancy is associated with serious neonatal complications, including hydrocephalus. In many high-income countries, screening and treatment during the antenatal period are routinely carried out to prevent associated complications, whereas in most low-income countries, there is no routine screening of during pregnancy. Despite the parasite being common in Tanzania, there is a paucity of information on the prevalence of and cranial ultrasound patterns among children with hydrocephalus.
An analytical cross-sectional hospital-based study involving 125 infants with hydrocephalus attending the Bugando Medical Centre (BMC) was conducted between May 2017 and February 2018. Sociodemographic and other relevant information was collected using a pretested data collection tool. Venous blood samples were collected, and sera were used for the detection of specific antibodies by indirect enzyme-linked immunosorbent assay (ELISA) as per manufacturer's instructions. Data were analysed using STATA version 13 software.
The mean age of enrolled children was 4.8 ± 3.5 months. Out of 125 infants with hydrocephalus, 29 (23.2%, 95% CI: 21-36) were seropositive for -specific IgG antibodies. By multiple generalized linear model analysis, being male (aRR = 1.1, 95% CI: 0.9-1.5, = 0.049), higher birth order (aRR = 1.2, 95% CI: 1.0-1.5, = 0.023), consumption of fish meat (aRR = 1.6, 95% CI: 1.2-2.3, = 0.003), and using other methods of cooking meat than boiling (aRR = 1.7, 95% CI: 1.1-2.5, = 0.015) were independent risk factors for IgG seropositivity. Obstructive hydrocephalus was significantly more common among seronegative infants compared to IgG-seropositive infants (31.3% [30/96] vs. 13.8% [4/29]; = 0.049).
A significant proportion of infants with nonobstructive hydrocephalus are IgG seropositive, and this is predicted by male gender, increase of birth order, consuming fish, and using other methods of cooking meat than boiling. These facts highlight the importance of continuing health education for pregnant women regarding transmission and the need to follow-up their infants so that appropriate counselling and management can be provided.
孕期感染与包括脑积水在内的严重新生儿并发症相关。在许多高收入国家，孕期会常规进行筛查和治疗以预防相关并发症，而在大多数低收入国家，孕期没有常规筛查。尽管这种寄生虫在坦桑尼亚很常见，但关于脑积水患儿中该寄生虫的患病率及头颅超声模式的信息却很少。
2017年5月至2018年2月，在布甘多医疗中心（BMC）对125名脑积水婴儿进行了一项基于医院的分析性横断面研究。使用经过预测试的数据收集工具收集社会人口学和其他相关信息。采集静脉血样本，按照制造商的说明，使用血清通过间接酶联免疫吸附测定（ELISA）检测特异性抗体。使用STATA 13版软件进行数据分析。
纳入儿童的平均年龄为4.8±3.5个月。在125名脑积水婴儿中，29名（23.2%，95%可信区间：21 - 36）特异性IgG抗体血清学呈阳性。通过多因素广义线性模型分析，男性（调整相对危险度[aRR]=1.1，95%可信区间：0.9 - 1.5，P = 0.049）、较高的出生顺序（aRR = 1.2，95%可信区间：1.0 - 1.5，P = 0.023）、食用鱼肉（aRR = 1.6，95%可信区间：1.2 - 2.3，P = 0.003）以及使用除煮沸以外的其他肉类烹饪方法（aRR = 1.7，95%可信区间：1.1 - 2.5，P = 0.015）是IgG血清学阳性的独立危险因素。与IgG血清学阳性婴儿相比，梗阻性脑积水在血清学阴性婴儿中明显更常见（31.3%[30/96]对13.8%[4/29]；P = 0.049）。
相当一部分非梗阻性脑积水婴儿IgG血清学呈阳性，男性、出生顺序增加、食用鱼类以及使用除煮沸以外的其他肉类烹饪方法可预测这一情况。这些事实凸显了对孕妇持续进行关于该寄生虫传播的健康教育的重要性，以及对其婴儿进行随访以便提供适当咨询和管理的必要性。
