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孟加拉国境内被迫流离失所的缅甸国民在校儿童基线期和阿苯达唑治疗后的土壤传播性蠕虫感染流行率。

Prevalence of Soil-Transmitted Helminths at Baseline and after Albendazole Treatment in the School-Age Children of Forcibly Displaced Myanmar Nationals in Bangladesh.

机构信息

Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.

Refugee Relief and Repatriation Commissioner of Bangladesh, Cox's Bazar, Bangladesh.

出版信息

Am J Trop Med Hyg. 2023 Aug 7;109(3):656-666. doi: 10.4269/ajtmh.23-0260. Print 2023 Sep 6.

Abstract

The forcibly displaced Myanmar nationals (FDMNs) known as Rohingya refugees are the largest group of stateless individuals globally. According to the emergencies humanitarian actors at the United Nations Office for the Coordination of Humanitarian Affairs, the worldwide refugee crisis involving FDMNs is intensifying at the fastest rate in history. Growing public health demands are being exacerbated by current difficulties in addressing poor access to health services, severe food shortages, and a lack of adequate housing. Infectious diseases constitute a major public health emergency in this vulnerable population. A study was carried out in FDMN children to investigate common soil-transmitted helminth (STH) infection at the time of enrollment and prospectively followed-up to 12 months after 2 doses albendazole treatment. At baseline, the prevalence of STH infection with at least one species was found to be 91.7% and 87.3% for Kato-Katz (KK) and quantitative polymerase chain reaction (qPCR) methods, respectively. Similarly, for follow-up children, the overall infection rate was 95.3% and 91.5%, respectively. Trichuris trichiura was the most predominant STH infection by both KK (baseline 87%, follow-up 89.1%) and qPCR (baseline 77.5%, follow-up 82.9%). The overall prevalence of stunting in the children was 37.8% at baseline and rose to 51.3% at 12 months. Alpha-1 antitrypsin (r = 0.13, P = 0.01) and myeloperoxidase (r = 0.12, P = 0.01) levels showed a positive correlation with Aascaris lumbricoides egg count per gram at baseline. An in-depth investigation is urgently needed to identify the underlying protective measures and the root cause of STH infections to improve the health of FDMN children.

摘要

被迫流离失所的缅甸国民(缅甸难民)是全球最大的无国籍人群体。据联合国人道主义事务协调厅的紧急人道主义行动者称,涉及被迫流离失所的缅甸国民的全球难民危机正在以前所未有的最快速度加剧。由于目前难以获得医疗服务、严重的粮食短缺和缺乏足够的住房,不断增长的公共卫生需求正变得更加严峻。传染病是这个弱势群体的主要公共卫生紧急事件。在这项研究中,对缅甸难民儿童进行了调查,以了解在入学时常见的土壤传播性蠕虫(STH)感染,并在接受 2 剂阿苯达唑治疗后进行了 12 个月的前瞻性随访。在基线时,使用加藤厚涂片(KK)和定量聚合酶链反应(qPCR)方法,至少有一种 STH 感染的流行率分别为 91.7%和 87.3%。同样,对于随访儿童,总感染率分别为 95.3%和 91.5%。钩虫是 KK(基线 87%,随访 89.1%)和 qPCR(基线 77.5%,随访 82.9%)方法最主要的 STH 感染。儿童的整体发育迟缓患病率在基线时为 37.8%,12 个月时上升至 51.3%。α-1 抗胰蛋白酶(r = 0.13,P = 0.01)和髓过氧化物酶(r = 0.12,P = 0.01)水平与基线时每克 Ascaris lumbricoides 卵计数呈正相关。迫切需要进行深入调查,以确定 STH 感染的根本原因和潜在保护措施,以改善缅甸难民儿童的健康。

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