School of Biodiversity, One Health and Veterinary Medicine & Wellcome Centre for Integrative Parasitology, University of Glasgow , Glasgow, UK.
Vector Borne and Neglected Tropical Diseases Control Division, Ministry of Health , Kampala, Uganda.
Proc Biol Sci. 2024 Jun;291(2024):20240449. doi: 10.1098/rspb.2024.0449. Epub 2024 Jun 12.
The WHO aims to eliminate schistosomiasis as a public health problem by 2030. However, standard morbidity measures poorly correlate to infection intensities, hindering disease monitoring and evaluation. This is exacerbated by insufficient evidence on 's impact on health-related quality of life (HRQoL). We conducted community-based cross-sectional surveys and parasitological examinations in moderate-to-high endemic communities in Uganda. We calculated parasitic infections and used EQ-5D instruments to estimate and compare HRQoL utilities in these populations. We further employed Tobit/linear regression models to predict HRQoL determinants. Two-thirds of the 560 participants were diagnosed with parasitic infection(s), 49% having . No significant negative association was observed between HRQoL and infection status/intensity. However, severity of pain urinating ( = -0.106; s.e. = 0.043) and body swelling ( = -0.326; s.e. = 0.005), increasing age ( = -0.016; s.e. = 0.033), reduced socio-economic status ( = 0.128; s.e. = 0.032), and being unemployed predicted lower HRQoL. Symptom severity and socio-economic status were better predictors of short-term HRQoL than current infection status/intensity. This is key to disentangling the link between infection(s) and short-term health outcomes, and highlights the complexity of correlating current infection(s) with long-term morbidity. Further evidence is needed on long-term schistosomiasis-associated HRQoL, health and economic outcomes to inform the case for upfront investments in schistosomiasis interventions.
世界卫生组织旨在到 2030 年消除血吸虫病这一公共卫生问题。然而,标准发病率与感染强度相关性较差,阻碍了疾病监测和评估。在“对健康相关生活质量(HRQoL)的影响”方面证据不足,使情况进一步恶化。我们在乌干达中高度流行地区的社区进行了横断面调查和寄生虫学检查。我们计算了寄生虫感染,并使用 EQ-5D 工具来估计和比较这些人群的 HRQoL 效用。我们进一步采用 Tobit/线性回归模型来预测 HRQoL 的决定因素。在 560 名参与者中,有三分之二被诊断患有寄生虫感染,其中 49%患有 。HRQoL 与 感染状况/强度之间没有显著的负相关。然而,排尿时疼痛的严重程度( = -0.106;s.e. = 0.043)和身体肿胀( = -0.326;s.e. = 0.005)、年龄增长( = -0.016;s.e. = 0.033)、社会经济地位降低( = 0.128;s.e. = 0.032)和失业都预测 HRQoL 较低。症状严重程度和社会经济地位是短期 HRQoL 的更好预测因素,而不是当前的 感染状况/强度。这是理清感染与短期健康结果之间关系的关键,突出了将当前感染与长期发病率相关联的复杂性。需要进一步研究长期血吸虫病相关 HRQoL、健康和经济结果,为血吸虫病干预措施的前期投资提供依据。