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评估印度东北部洪灾地区学龄儿童土壤传播性蠕虫感染的流行情况及其相关危险因素。

Assessment of the Prevalence of Soil-Transmitted Helminth Infections and Associated Risk Factors among School-Aged Children in a Flood-Affected Area of Northeast India.

机构信息

1Department of Microbiology, Fakhruddin Ali Ahmed Medical College & Hospital (FAAMCH), Barpeta, Assam, India.

4Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

出版信息

Am J Trop Med Hyg. 2021 Jul 6;105(2):480-489. doi: 10.4269/ajtmh.20-1238.

DOI:10.4269/ajtmh.20-1238
PMID:34228636
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8437162/
Abstract

Soil-transmitted helminthiasis is a major disease burden in developing countries, with a considerable share borne by India. Currently, the principal strategy of the World Health Organization for the control of soil-transmitted helminths (STHs) is mass deworming in the high-risk population based on the prevalence and intensity of infection in a region. However, the disease load of STH remains unknown in many regions. A cross-sectional study was conducted in 2017 among children in the age group of 5-13 years in Barpeta, Assam, to ascertain the prevalence of STH infection in school-aged children and its probable risk factors. Socio-demographic and epidemiologic data were gathered using a piloted questionnaire. Geohelminths were identified by the Kato-Katz method. Association with probable risk-factors was analyzed by binomial logistic regression. Overall, 16.3% [95% confidence interval (CI) = 12.9-19.8] of children were found to be infected with one or more of the three STHs. Ascaris, hookworm, and Trichuris infections were observed in 9.4%, 7.4%, and 5.3%, respectively. The strongest predictors for the presence of any STH with multivariable analysis were open defecation (habitual or occasional), lack of proper handwashing, living in homes affected by flood, and age group of 8-10 years. The availability of proper handwashing stations in schools was found to be protective against Trichuris. Awareness among the people regarding sanitation and personal hygiene, particularly in the post-flood scenario, is imperative for sustainable control of STH infections. Preventive deworming should be continued; however, the time and frequency must be adjusted according to the prevailing climatic conditions in the region under study.

摘要

土壤传播性蠕虫病是发展中国家的一个主要疾病负担,印度承担了相当大的份额。目前,世界卫生组织控制土壤传播性蠕虫病(STH)的主要策略是根据该地区的感染流行率和强度,对高危人群进行大规模驱虫。然而,许多地区仍然不知道 STH 的疾病负担。2017 年,在印度阿萨姆邦的巴雷塔地区对 5-13 岁的儿童进行了横断面研究,以确定学龄儿童中 STH 感染的流行率及其可能的危险因素。使用试点问卷收集社会人口统计学和流行病学数据。采用加藤厚涂片法鉴定土源性蠕虫。采用二项逻辑回归分析与可能的危险因素的关联。总体而言,发现 16.3%(95%置信区间[CI]:12.9-19.8)的儿童感染了一种或多种三种 STH 中的一种。观察到蛔虫、钩虫和鞭虫感染分别为 9.4%、7.4%和 5.3%。多变量分析显示,存在任何 STH 的最强预测因素是露天排便(习惯性或偶尔)、未正确洗手、居住在受洪水影响的房屋中以及 8-10 岁年龄组。发现学校内有适当的洗手站可预防鞭虫感染。在洪灾后,人们必须提高对卫生和个人卫生的认识,这对可持续控制 STH 感染至关重要。应继续进行预防性驱虫;但是,必须根据所研究地区的当前气候条件调整时间和频率。

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