坦桑尼亚北部被排除在血吸虫病控制预防性化疗之外的青少年和青年：他们是否面临感染风险及成为传染源？坦桑尼亚北部血吸虫病传播的流行情况及影响因素
Adolescents and young adults excluded from preventive chemotherapy for schistosomiasis control in Northern Tanzania: are they at risk and reservoirs of infection? Prevalence and determinants of transmission in Northern Tanzania.
作者信息
Maseke Leah S, Mushi Vivian, Tarimo Donath, Kwesigabo Gideon, Mazigo Humphrey
机构信息
Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
出版信息
IJID Reg. 2022 Jul 10;4:111-119. doi: 10.1016/j.ijregi.2022.07.008. eCollection 2022 Sep.
OBJECTIVE
To investigate the magnitude of urogenital schistosomiasis and determinants of transmission among adolescents and young adults in Itilima district, Simiyu region, Northern Tanzania.
METHODS
A quantitative cross-sectional study was carried out using probability sampling strategies to select 433 secondary school students from five schools among the five wards of Itilima district, an area endemic for urogenital schistosomiasis. A self-administered structured questionnaire was used to gather data on determinants, and urine samples were examined for macrohaematuria and the presence of using the standard urine filtration technique. Data analysis was performed using descriptive statistics, Chi-squared test and logistic regression.
RESULTS
The overall prevalence rates of infection and macrohaematuria among adolescents and young adults were 15.9% and 3%, respectively, with the majority of individuals being lightly infected (85.5%). The determinants for urogenital schistosomiasis among the adolescents and young adults in Itilima district were: being in Form I [adjusted odds ratio (aOR) 2.42, 95% confidence interval (CI) 1.16-11.8; =0.018]; being resident in Sasago ward (aOR 5.57, 95% CI 1.98-15.67; =0.001) or Budalabujiga ward (aOR 2.99, 95% CI 1.04-8.56; =0.042); having positive attitudes towards urogenital schistosomiasis (aOR 3.14, 95% CI 1.27-7.72; =0.013); swimming in rivers (aOR 1.92, 95% CI 1.06-3.50; =0.032); and urinating in water bodies (aOR 1.68, 95% CI 1.05-2.69; =0.032).
CONCLUSIONS
Urogenital schistosomiasis is prevalent among adolescents and young adults, and serves as a reservoir for transmission of . Preventive chemotherapy campaigns should be extended to adolescents and young adults, and integrated with regular screening, health education and an adequate water supply.
目的
调查坦桑尼亚北部西米尤地区伊蒂利马区青少年和青年泌尿生殖系统血吸虫病的感染程度及传播的决定因素。
方法
采用概率抽样策略进行定量横断面研究，从伊蒂利马区五个行政区的五所学校中选取433名中学生，该地区为泌尿生殖系统血吸虫病的流行区。使用自行填写的结构化问卷收集有关决定因素的数据，并采用标准尿液过滤技术对尿液样本进行肉眼血尿和血吸虫卵存在情况的检测。数据分析采用描述性统计、卡方检验和逻辑回归。
结果
青少年和青年中血吸虫感染和肉眼血尿的总体患病率分别为15.9%和3%，大多数个体为轻度感染（85.5%）。伊蒂利马区青少年和青年泌尿生殖系统血吸虫病的决定因素为：就读于一年级[调整后的优势比（aOR）2.42，95%置信区间（CI）1.16 - 11.8；P = 0.018]；居住在萨萨戈行政区（aOR 5.57，95% CI 1.98 - 15.67；P = 0.001）或布达拉布吉加行政区（aOR 2.99，95% CI 1.04 - 8.56；P = 0.042）；对泌尿生殖系统血吸虫病持积极态度（aOR 3.14，95% CI 1.27 - 7.72；P = 0.013）；在河中游泳（aOR 1.92，95% CI 1.06 - 3.50；P = 0.032）；以及在水体中排尿（aOR 1.68，95% CI 1.05 - 2.69；P = 0.032）。
结论
泌尿生殖系统血吸虫病在青少年和青年中流行，是血吸虫传播的一个宿主。预防性化疗运动应扩大到青少年和青年，并与定期筛查、健康教育和充足的供水相结合。
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