Abera Dessie, Wordofa Moges, Mesfin Abiyot, Tadesse Gemechu, Wolde Mistire, Desta Kassu, Tsegaye Aster, Taye Bineyam
Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Korea Hospital, Addis Ababa, Ethiopia.
Allergy Asthma Clin Immunol. 2021 Apr 23;17(1):43. doi: 10.1186/s13223-021-00545-2.
Intestinal helminths have been proposed to have a protective role against allergic sensitization and atopic diseases. However, consistent data demonstrating this are lacking in Sub-Saharan countries. We aimed to assess the association between intestinal helminths and allergic disorders among school children enrolled in mass deworming program in Sululta, Ethiopia.
A cross sectional study was conducted among 526 school children aged 5 to 14 years old from primary government schools in Sululta district, Ethiopia. An interviewer-led questionnaire administered to parents provided information on demographic and lifestyle variables. Questions on allergic disease symptoms were collected using the International Study of Asthma and Allergies in Children (ISAAC) questionnaire 6 months following deworming treatments. Atopy was defined as a positive skin prick test reaction to one or both dust mite (Dermatophagoides) and German cockroach (Blatella germanica) allergens. Fresh stool samples were collected, processed, and examined by direct wet mount, Kato-Katz technique, and formol-ether concentration technique. Multivariate logistic regressions were used to assess the association between allergic disorder and helminths infection.
Of the total 526 school children, 58.2% were females. Overall, 24% (126/526) had allergic symptoms, 5.1% (27/526) had atopy, and 16.9% (89/526) had intestinal helminths. There was no association between helminthic infection and self-reported allergic symptoms (P = 0.317), but Ascaris lumbricoides infection was positively associated with atopy (AOR = 4.307, 95% CI 1.143-16.222, P = 0.031). Atopy was related to increased allergy symptoms (AOR = 2.787, 95% CI 1.253-6.197, P = 0.012), and family history of allergy was associated with increased childhood allergy (AOR = 2.753, 95% CI 1.565-4.841, P = 0.001). Deworming in the past 6 months showed a reduced odd of self-reported allergic symptoms (AOR = 0.581, 95% CI 0.366-0.954, P = 0.034).
While no significant association between self-reported allergy and helminths was found in this study, this may have been due to the low prevalence and intensity of helminthic infection in the sample. There was a positive association between Ascaris lumbricoides and atopy. To further examine the underlying mechanism behind this positive association, a longitudinal study is needed.
肠道蠕虫被认为对过敏性致敏和特应性疾病具有保护作用。然而，撒哈拉以南国家缺乏证明这一点的一致数据。我们旨在评估埃塞俄比亚苏卢尔塔参加大规模驱虫计划的学童中肠道蠕虫与过敏性疾病之间的关联。
对埃塞俄比亚苏卢尔塔区公立小学的526名5至14岁学童进行了一项横断面研究。由访谈员主导的问卷向家长发放，提供了人口统计学和生活方式变量的信息。在驱虫治疗6个月后，使用儿童哮喘和过敏国际研究（ISAAC）问卷收集有关过敏性疾病症状的问题。特应性定义为对尘螨（屋尘螨）和德国小蠊过敏原中的一种或两种皮肤点刺试验反应呈阳性。收集新鲜粪便样本，进行处理，并通过直接湿涂片法、加藤-厚片法和甲醛-乙醚浓缩法进行检查。使用多变量逻辑回归来评估过敏性疾病与蠕虫感染之间的关联。
在总共526名学童中，58.2%为女性。总体而言，24%（126/526）有过敏症状，5.1%（27/526）有特应性，16.9%（89/526）有肠道蠕虫。蠕虫感染与自我报告的过敏症状之间无关联（P = 0.317），但蛔虫感染与特应性呈正相关（调整后比值比[AOR]=4.307，95%置信区间[CI] 1.143 - 16.222，P = 0.031）。特应性与过敏症状增加有关（AOR = 2.787，95% CI 1.253 - 6.197，P = 0.012），过敏家族史与儿童期过敏增加有关（AOR = 2.753，95% CI 1.565 - 4.84l，P = 0.001）。过去6个月内进行驱虫显示自我报告的过敏症状几率降低（AOR = 0.581，95% CI 0.366 - 0.954，P = 0.034）。
虽然本研究未发现自我报告的过敏与蠕虫之间存在显著关联，但这可能是由于样本中蠕虫感染的患病率和感染强度较低。蛔虫与特应性之间存在正相关。为了进一步研究这种正相关背后的潜在机制，需要进行一项纵向研究。
