Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa.
Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
PLoS Negl Trop Dis. 2023 Oct 13;17(10):e0011664. doi: 10.1371/journal.pntd.0011664. eCollection 2023 Oct.
BACKGROUND/AIM: School-aged children in low- and middle-income countries carry the highest burden of intestinal helminth infections, such as soil-transmitted helminths (STH). STH infections have been associated with negative consequences for child physical and cognitive development and wellbeing. With the epidemiological transition and rise in cardiovascular disease (CVD), studies have shown that helminth infections may influence glucose metabolism by preventing obesity. Thus, the aim of this study was to determine the association of STH infections in schoolchildren from Gqeberha, focusing on physical activity, physical fitness, and clustered CVD risk score.
This cross-sectional study involved 680 schoolchildren (356 girls and 324 boys; mean age 8.19 years, SD±1.4) from disadvantaged communities in Gqeberha (formerly, Port Elizabeth), South Africa. Stool samples were collected and examined for STH infections using the Kato-Katz method. Physical activity (accelerometer) and physical fitness (grip strength, 20 m shuttle run) were measured using standard procedures. Furthermore, anthropometry, blood pressure, as well as glycated haemoglobin and lipid profile from capillary blood samples were assessed. We employed one-way ANOVAs to identify the associations of STH infections in terms of species and infection intensity with physical activity, physical fitness, and clustered CVD risk score.
We found a low STH infection prevalence (7.2%) in our study, with participants infected with at least one intestinal helminth species. In comparison to their non-infected peers, children infected with STH had lower mean grip strength scores, but higher mean VO2max estimation and higher levels of MVPA (p < .001). When considering type and intensity of infection, a positive association of A. lumbricoides infection and MVPA was found. In contrast, light T. trichiura-infected children had significantly lower grip strength scores compared to non and heavily-infected children. VO2max and MVPA were positively associated with light T. trichiura infection. No significant association between the clustered CVD risk score and infection with any STH species was evident.
STH-infected children had lower grip strength scores than their non-infected peers, yet, achieved higher VO2max and MVPA scores. Our study highlights that the type and intensity of STH infection is relevant in understanding the disease burden of STH infections on children's health. The findings of our study must be interpreted cautiously due to the low infection rate, and more research is needed in samples with higher prevalence rates or case-control designs.
背景/目的：在中低收入国家，学龄儿童感染肠道蠕虫（如土壤传播的蠕虫）的负担最重。肠道蠕虫感染与儿童身体和认知发育以及健康不良的负面后果有关。随着流行病学的转变和心血管疾病（CVD）的上升，研究表明，蠕虫感染可能通过预防肥胖来影响葡萄糖代谢。因此，本研究的目的是确定在开普敦的学龄儿童中，土壤传播的蠕虫感染与身体活动、身体适应性和心血管疾病综合风险评分之间的关联。
本横断面研究涉及南非开普敦（前身为伊丽莎白港）弱势社区的 680 名学龄儿童（356 名女孩和 324 名男孩；平均年龄 8.19 岁，SD±1.4）。使用加藤厚涂片法采集粪便样本并检查土壤传播的蠕虫感染。使用标准程序测量身体活动（加速度计）和身体适应性（握力、20 米穿梭跑）。此外，还评估了毛细血管血样中的人体测量、血压以及糖化血红蛋白和血脂谱。我们采用单向方差分析来确定根据物种和感染强度，土壤传播的蠕虫感染与身体活动、身体适应性和心血管疾病综合风险评分之间的关联。
我们发现本研究中土壤传播的蠕虫感染的患病率较低（7.2%），参与者至少感染了一种肠道蠕虫物种。与未感染的同龄人相比，感染土壤传播的蠕虫的儿童的平均握力评分较低，但最大摄氧量估计值和更高水平的中高强度身体活动（p<.001）较高。当考虑感染的类型和强度时，发现 A. lumbricoides 感染与中高强度身体活动呈正相关。相比之下，轻度 T. trichiura 感染的儿童的握力评分明显低于非重度和重度感染的儿童。最大摄氧量和中高强度身体活动与轻度 T. trichiura 感染呈正相关。没有证据表明土壤传播的蠕虫感染与任何一种土壤传播的蠕虫物种与心血管疾病综合风险评分之间存在显著关联。
感染土壤传播的蠕虫的儿童的握力评分低于未感染的同龄人，但他们的最大摄氧量和中高强度身体活动得分更高。本研究强调，土壤传播的蠕虫感染的类型和强度对于理解土壤传播的蠕虫感染对儿童健康的疾病负担很重要。由于感染率较低，本研究的结果必须谨慎解释，需要在感染率较高的样本或病例对照设计中进行更多研究。
