Byrne Aisling, Manalo Giselle, Clarke Naomi E, Vaz Nery Susana
Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
School of Public Health, University of Sydney, Sydney, NSW, Australia.
Trop Med Int Health. 2021 Dec;26(12):1568-1592. doi: 10.1111/tmi.13681. Epub 2021 Oct 26.
To assess the impact of hookworm infection and preventive chemotherapy on haemoglobin levels in non-pregnant populations in endemic areas.
Systematic review and meta-analysis searching PubMed and Web of Science for articles published since 2010 reporting either hookworm prevalence and Hb concentration (cross-sectional studies) or Hb concentration before and after the implementation of preventive chemotherapy (before-after studies and randomised controlled trials [RCTs]). For papers published before 2010, data were extracted from a previously published systematic review. Random effects meta-analyses were conducted to examine the relationship between Hb concentration and hookworm infection intensity (from cross-sectional studies) and the effect of preventive chemotherapy on Hb concentration (from before-after studies and RCTs). Sensitivity analyses investigated the impact of malaria endemicity and combined interventions for schistosomiasis and nutrition status on Hb concentration.
Among cross-sectional studies, both light- and heavy-intensity hookworm infections were associated with lower Hb in school-aged children. School-aged children with heavy hookworm infection in settings of high malaria endemicity had lower mean Hb than those in settings of low malaria endemicity. In non-pregnant populations, deworming with albendazole was associated with an increase in Hb of 3.02 g/L (95% CI 0.1, 6.0 g/L). No additional benefit was seen with deworming using albendazole co-administered with praziquantel for schistosomiasis infection or iron supplementation for nutrition status.
Our findings confirm the benefits of preventive chemotherapy as a public health intervention.
评估钩虫感染及预防性化疗对流行地区非妊娠人群血红蛋白水平的影响。
进行系统综述和荟萃分析，检索自2010年以来发表在PubMed和科学网（Web of Science）上的文章，这些文章报告了钩虫感染率和血红蛋白浓度（横断面研究），或预防性化疗实施前后的血红蛋白浓度（前后对照研究和随机对照试验[RCT]）。对于2010年之前发表的论文，数据取自先前发表的系统综述。进行随机效应荟萃分析，以检验血红蛋白浓度与钩虫感染强度之间的关系（来自横断面研究），以及预防性化疗对血红蛋白浓度的影响（来自前后对照研究和随机对照试验）。敏感性分析调查了疟疾流行程度以及血吸虫病和营养状况联合干预对血红蛋白浓度的影响。
在横断面研究中，轻度和重度钩虫感染均与学龄儿童血红蛋白水平较低有关。在疟疾高流行地区重度钩虫感染的学龄儿童平均血红蛋白水平低于疟疾低流行地区的儿童。在非妊娠人群中，使用阿苯达唑驱虫使血红蛋白增加3.02g/L（95%CI 0.1，6.0g/L）。对于血吸虫病感染，联合使用阿苯达唑和吡喹酮驱虫或补充铁剂改善营养状况，未发现额外益处。
我们的研究结果证实了预防性化疗作为一种公共卫生干预措施的益处。
