1Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
2Department of Pediatrics, Hospital Nacional Adolfo Guevara Velasco ESSALUD, Cusco, Peru.
Am J Trop Med Hyg. 2021 May 3;104(6):2069-2073. doi: 10.4269/ajtmh.21-0131.
Fasciola hepatica is highly prevalent in the highlands of Peru. School-age children have the greatest risk of infection. Mass treatment of at-risk populations has been proposed to control the infection and prevent complications. However, the decreasing effectiveness of triclabendazole raises concerns regarding this strategy. Previous studies reported aggregation of Fasciola infection among family members. This study aimed to determine the risk of fascioliasis among household members living with Fasciola-infected children identified through school-based testing. We conducted a cross-sectional study including adult members of households where children with and without fascioliasis were identified. Demographic, epidemiological, and socioeconomic information was collected. One blood sample was drawn to test for Fasciola antibodies, and three stool samples were collected for microscopy for Fasciola ova. We tested 326 adults from 213 households. Of these adult subjects, chronic fascioliasis (24 of 326, 7.4%) was the most common helminth infection. Thirty-nine subjects (12.7%) tested positive for Fasciola antibodies. Combining microscopy and serum antibody tests, 13.2% (43 of 326) had evidence of Fasciola infection. One third (104 of 326, 31.9%) of the participants lived with at least one child infected with Fasciola hepatica. Adults with fascioliasis were four times more likely to live with an infected child. Poverty and diet were associated with increased risk of Fasciola infection. Adults with fascioliasis were significantly more likely to live with Fasciola-infected children.
肝片形吸虫在秘鲁高原地区高度流行。学龄儿童感染的风险最大。有人提议对高危人群进行大规模治疗，以控制感染并预防并发症。然而，三氯苯达唑的疗效下降引起了对这一策略的关注。先前的研究报告称，家庭成员之间的肝片形吸虫感染呈聚集性。本研究旨在确定与通过学校检测发现的感染肝片形吸虫的儿童同住的家庭成员感染肝片形吸虫的风险。我们进行了一项横断面研究，包括在确诊有和无肝片形吸虫病的儿童的家庭中成年成员。收集了人口统计学、流行病学和社会经济学信息。采集了一份血样以检测肝片形吸虫抗体，采集了三份粪便样本进行显微镜检查以检测肝片形吸虫卵。我们共检测了 326 名来自 213 个家庭的成年人。在这些成年受试者中，慢性肝片形吸虫病（326 例中的 24 例，7.4%）是最常见的寄生虫感染。39 例（12.7%）检测出肝片形吸虫抗体阳性。结合显微镜和血清抗体检测，43 例（326 例的 13.2%）有肝片形吸虫感染的证据。三分之一（326 例中的 104 例，31.9%）的参与者与至少一名感染肝片形吸虫的儿童同住。患有肝片形吸虫病的成年人与感染儿童同住的可能性是其四倍。贫困和饮食与肝片形吸虫感染风险增加有关。患有肝片形吸虫病的成年人与感染肝片形吸虫的儿童同住的可能性显著增加。
