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尼日利亚西南部奥贡州阿波约拉基于社区的土壤传播性蠕虫病和肠血吸虫病的流行率、强度及相关危险因素。

Community-based prevalence, intensity and risk factors associated with soil-transmitted helminthiases and intestinal schistosomiasis in Apojola, Ogun state, southwest Nigeria.

机构信息

Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Lagos State, Nigeria.

Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Lagos State, Nigeria.

出版信息

BMC Infect Dis. 2024 Nov 14;24(1):1302. doi: 10.1186/s12879-024-10175-9.

Abstract

BACKGROUND

Soil-transmitted helminthiases (STH) and schistosomiasis are parasitic neglected tropical diseases (NTDs) of significant public health importance globally, including Nigeria. Urogenital schistosomiasis is highly endemic in Apojola, a rural community in Ogun State, southwest Nigeria, but data on STH and intestinal schistosomiasis in the neglected community are lacking.

OBJECTIVES

To determine the prevalence and intensity of STH and intestinal schistosomiasis and the risk factors associated with the infections in Apojola.

METHODS

The study was community-based and cross-sectional. A structured questionnaire was used to obtain information on socio-demographic, personal, and household WASH characteristics of the study population. Stool samples were collected and processed for parasitological examination using the triplicate Kato-Katz (K-K) smears.

RESULTS

A total of 283 individuals (males, 50.2%; females, 49.8%) aged 3 to 65 years (mean age ± S.D.: 19.6 ± 14.8 years) participated in the study. No case of intestinal schistosomiasis was recorded in the study, while the overall prevalence of any STH was 38.2%: A. lumbricoides (24.0%) and hookworms (25.8%). Prevalence of infection was not significantly different between males and females for any STH (40.1% vs. 36.2%, χ = 0.473, p = 0.492); A. lumbricoides (23.2% vs. 22.7%, χ = 0.012, p = 0.913); or hookworms (28.2% vs. 23.4%; p = 0.360; χ = 0.839), but significantly varied with age for any STH (χ = 22.225, p = 0.002); A. lumbricoides (χ = 16.354, p = 0.022); or hookworms (χ = 20.001, p = 0.006). The intensity of infection was neither associated with gender nor age and was mostly light. Walking barefoot, toilet type (absent/bush), and irregular washing of fruits and/or vegetables before consumption were significantly associated with STH.

CONCLUSION

Our data indicate that intestinal schistosomiasis is not prevalent in Apojola and that the community is a moderate-risk area for STH. Hence, the current annual preventive chemotherapy for STH (PC STH) with albendazole or mebendazole in school-aged children (SAC) through the school-based delivery programme should be extended to non-enrolled SAC and pre-SAC using other delivery platforms. This should be complemented with regular and effective health education campaigns as well as water, sanitation, and hygiene (WASH)-related interventions.

摘要

背景

土壤传播性蠕虫病(STH)和血吸虫病是具有重大公共卫生意义的被忽视的热带病(NTD),在全球范围内普遍存在,包括尼日利亚。在尼日利亚西南部奥贡州的一个农村社区阿波约拉,泌尿生殖性血吸虫病高度流行,但该被忽视社区的 STH 和肠道血吸虫病的数据却很缺乏。

目的

确定阿波约拉社区 STH 和肠道血吸虫病的流行率和感染强度,以及与这些感染相关的危险因素。

方法

本研究是基于社区的横断面研究。采用结构化问卷获取研究人群的社会人口学、个人和家庭用水卫生(WASH)特征信息。采集粪便样本,使用三重 Kato-Katz(K-K)涂片进行寄生虫学检查。

结果

共有 283 名年龄在 3 至 65 岁之间(平均年龄±标准差:19.6±14.8 岁)的人群(男性占 50.2%,女性占 49.8%)参与了这项研究。研究中未发现肠道血吸虫病病例,而任何 STH 的总流行率为 38.2%:A. lumbricoides(24.0%)和钩虫(25.8%)。任何 STH 的感染率在男性和女性之间均无显著差异(40.1%比 36.2%,χ²=0.473,p=0.492);A. lumbricoides(23.2%比 22.7%,χ²=0.012,p=0.913);或钩虫(28.2%比 23.4%,p=0.360;χ²=0.839),但与年龄显著相关(任何 STH:χ²=22.225,p=0.002;A. lumbricoides:χ²=16.354,p=0.022;或钩虫:χ²=20.001,p=0.006)。感染强度既不与性别相关,也不与年龄相关,且多为轻度。赤脚行走、厕所类型(缺失/丛林)以及食用水果和/或蔬菜前不规则清洗与 STH 显著相关。

结论

我们的数据表明,阿波约拉社区不存在肠道血吸虫病,且该社区是 STH 的中度风险地区。因此,目前针对在校儿童(SAC)的年度寄生虫预防性化疗(PC STH),采用阿苯达唑或甲苯咪唑,应该通过学校为非入学 SAC 和学前儿童(pre-SAC)提供,并利用其他的提供平台。这应辅以定期有效的健康教育运动以及水、环境卫生和个人卫生(WASH)相关干预措施。

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