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内陆丛林中的土着尼格利陀人与城镇周边重新安置的土着尼格利陀人相比,单次剂量阿苯达唑的疗效更高,不同土壤传播的蠕虫再感染情况也不同。

Higher efficacy of a single dosage albendazole and different soil-transmitted helminths re-infection profiles amongst indigenous Negritos from inland jungle versus those in resettlement at town peripheries.

机构信息

Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), 47000, Selangor, Malaysia.

Institute for Medical Molecular Biotechnology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), 47000, Selangor, Malaysia.

出版信息

Trop Biomed. 2022 Sep 1;39(3):402-411. doi: 10.47665/tb.39.3.010.

Abstract

Demarginalization through initiation of resettlement program since 1978 is an inevitable progress faced by the indigenous Orang Asli (OA) population in Peninsular Malaysia. As Malaysian huntergatherers, the Negrito has been exposed to various environmental-cultural variations. These changes may influence the pattern of soil-transmitted helminth (STH) infections, the common malady amongst OA. This study evaluated the deworming effects of single-dosage albendazole (400 mg) and STH-reinfection rate between Negritos who are still living in the inland jungle versus those living in resettlements at town peripheries (RPS). Stool samples from the consented participants were first examined using the direct faecal smear, formalin-ether sedimentation and Kato Katz techniques. Subsequently, stool collections were carried out in three time points following treatment (i.e., 21 days, 3 months and 6 months). In brief, a total number of 54 Negritos (inland: 24; RPS: 30) with a complete set of stool collection was included in this longitudinal study. This study revealed 72.2% cure rate against T. trichiura in the inland but only 15.0% in the RPS. Although the efficacy of albendazole against T. trichiura was ultimately low in the RPS, 62.6% egg reduction rate (ERR) (arithmetic mean) was noted (p = 0.001). For A. lumbricoides and hookworm, high cure rates were found in both communities (85.7-100.0%). Reinfection for T. trichiura was seen in less than 1 month with higher rate in the RPS (90.0%) as opposed to the inland (44.4%) at 21 days following treatment. This study found that the inland OA had better tolerability to single-dosage albendazole and experienced slower STH reinfection rates versus the RPS. Hence, the selection of albendazole dosage should be targeted and the use of single- dosage albendazole (biannually) would be more suitable for the inland OA. Conversely, we propose the use of 3-days albendazole regimens in the resettled RPS population.

摘要

自 1978 年以来,通过启动重新安置计划实现去边缘化是马来西亚半岛本土原始居民(Orang Asli,简称 OA)面临的必然进步。作为马来西亚的狩猎采集者,Negrito 人已经经历了各种环境文化的变化。这些变化可能会影响土壤传播性蠕虫(STH)感染的模式,这是 OA 人群中常见的疾病。本研究评估了单一剂量阿苯达唑(400mg)的驱虫效果以及仍生活在内陆丛林中的 Negrito 人与生活在城镇边缘重新安置点(RPS)中的 Negrito 人之间的 STH 再感染率。首先使用直接粪便涂片、福尔马林-乙醚沉淀和加藤厚涂片技术检查同意参与的参与者的粪便样本。随后,在治疗后(即 21 天、3 个月和 6 个月)的三个时间点进行粪便收集。简而言之,本纵向研究共纳入了 54 名 Negrito 人(内陆:24 人;RPS:30 人),他们的粪便收集完整。这项研究显示,在内陆地区,针对 Trichuris trichiura 的治愈率为 72.2%,而在 RPS 地区仅为 15.0%。尽管阿苯达唑对 RPS 地区的 Trichuris trichiura 的疗效最终较低,但观察到 62.6%的虫卵减少率(算术平均值)(p=0.001)。对于 Ascaris lumbricoides 和钩虫,两个社区的治愈率都很高(85.7-100.0%)。在治疗后不到 1 个月就发现了 Trichuris trichiura 的再感染,RPS 地区的再感染率更高(90.0%),而内陆地区的再感染率(44.4%)。本研究发现,内陆 OA 对单一剂量阿苯达唑的耐受性更好,与 RPS 相比,其 STH 再感染率较慢。因此,阿苯达唑剂量的选择应该具有针对性,并且对内陆 OA 而言,每年使用一次(双年度)的单一剂量阿苯达唑可能更为合适。相反,我们建议在重新安置的 RPS 人群中使用 3 天的阿苯达唑疗程。

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