Faculty of Medicine, Department of Parasitology, University of Malaya, Kuala Lumpur, Malaysia.
Faculty of Medicine, Department of Medical Microbiology and Parasitology, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
PLoS One. 2021 Jan 13;16(1):e0245377. doi: 10.1371/journal.pone.0245377. eCollection 2021.
This study compared the current nutritional status, hemoglobin levels and their associations with soil-transmitted helminth (STH) infections between two categories of Negritos (indigenous): (i) Inland Jungle Villages (IJV) (ii) and Resettlement Plan Scheme (RPS) near town peripheries, decades after redevelopment and demarginalization. A total of 416 Negritos (IJV: 149; RPS: 267) was included for nutritional profiling based on anthropometric analysis. However, only 196 (IJV: 64; RPS: 132) individuals consented to blood taking for the hemoglobin (Hb) measurements. Subsequently, the association of undernutrition and anemia with STH infections were determined based on univariate and multivariate logistic regression analyses. The overall prevalence of stunting, wasting, and underweight amongst children and adolescents (n = 343) were 45.8%, 42.3% and 59.1%, respectively. In adults (n = 73), the prevalence of underweight was low (6.8%) but overweight and obese was prominent (26.0%). For anemia (n = 196), an overall prevalence rate of 68.4% were observed with 80% and 70.4% of children aged 2-6 y/o and aged 7-12 y/o, respectively being anemic. Comparatively, the prevalence of underweight (WAZ) was significantly higher in the RPS versus the IJV (P = 0.03) In the IJV, children aged ≤ 6 y/o and having STH poly-parasitism were associated with underweight (P = 0.01) and moderate-severe T. trichiura infection was associated with anemia. Whilst in the RPS, underweight was highly associated with only T. trichiura infection (P = 0.04). Wasting was significantly associated with young children aged ≤10 in both IJV (P = 0.004) and RPS (P = 0.02). Despite efforts in improving provision of facilities and amenities among the indigenous, this study highlighted a high magnitude of nutritional issues among the Negritos especially those in the RPS and their likely association with STH infections and decades of demarginalization. Joint nutritional intervention strategies with mass anti-helminthic treatment are imperative and urgently needed to reduce the undernutrition problems especially among indigenous children.
本研究比较了两类尼格利陀人(原住民)的当前营养状况、血红蛋白水平及其与土壤传播性蠕虫(STH)感染的关系:(i)内陆丛林村(IJV)和(ii)城镇周边重新安置计划(RPS)。根据人体测量分析,共有 416 名尼格利陀人(IJV:149;RPS:267)参与了营养分析。然而,只有 196 人(IJV:64;RPS:132)同意抽血进行血红蛋白(Hb)测量。随后,基于单变量和多变量逻辑回归分析,确定了营养不良和贫血与 STH 感染的关系。在儿童和青少年(n = 343)中,生长迟缓、消瘦和体重不足的总患病率分别为 45.8%、42.3%和 59.1%。在成年人(n = 73)中,体重不足的患病率较低(6.8%),但超重和肥胖较为突出(26.0%)。对于贫血(n = 196),观察到总体患病率为 68.4%,其中 2-6 岁和 7-12 岁的儿童分别有 80%和 70.4%贫血。相比之下,RPS 的体重不足(WAZ)患病率明显高于 IJV(P = 0.03)。在 IJV 中,年龄≤6 岁且患有 STH 多寄生虫感染的儿童与体重不足相关(P = 0.01),中度至重度旋毛虫感染与贫血相关。而在 RPS 中,体重不足与仅旋毛虫感染高度相关(P = 0.04)。消瘦与 IJV(P = 0.004)和 RPS(P = 0.02)中≤10 岁的幼儿显著相关。尽管原住民在改善设施和设施方面做出了努力,但本研究强调了尼格利陀人尤其是 RPS 中存在严重的营养问题,以及它们与 STH 感染和数十年的边缘化的可能关联。联合营养干预策略与大规模驱虫治疗对于减少原住民儿童,尤其是营养问题至关重要。