Beyene Belay, Vaz Nery Susana, Lambiyo Tariku, Shimelis Techalew
College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Arba Minch College of Health Sciences, Arba Minch, Ethiopia.
Parasit Vectors. 2024 Dec 3;17(1):498. doi: 10.1186/s13071-024-06578-x.
Schistosoma mansoni and soil-transmitted helminth (STH) infections are major public health problems in areas with poor sanitation and limited access to water. In Ethiopia, there is limited data available for monitoring the efficacy of interventions aimed at reducing helminth infections. Therefore, we assessed the prevalence of S. mansoni and STH infections, as well as factors associated with this prevalence, among schoolchildren and compared the findings with those of earlier studies. We also evaluated the diagnostic agreement between two parasitological methods.
A cross-sectional study involving 363 schoolchildren from three rural primary schools located along the shore of Lake Hawassa, Sidama Regional State, southern Ethiopia, was conducted in October and November 2023. The schoolchildren were selected using a systematic random sampling technique. Socio-demographic data were collected using pre-structured questionnaires. A single stool sample was collected from each study participant and processed using direct wet mount (DM) microscopy and the formol-ether concentration technique (FECT) to detect helminth ova.
The overall prevalence of helminths was 59.8%, with 36.6% of participating children having a single infection and 23.1% having multiple infections. Schistosoma mansoni and STHs were present in 33.9% and 38.8% of children, respectively. The STHs included Ascaris lumbricoides (28.9% of children), Trichuris trichiura (10.7%), hookworms (5.2%) and Strongyloides stercoralis (2.8%). Diagnostic agreement between the DM microscopy method and FECT was substantial [kappa (κ) = 0.710] for the detection of Hymenolepis nana and almost perfect (κ = 0.827) for the dection of A. lumbricoides, but only fair for the detection of other detected helminths. Children at Finchawa primary school had a lower prevalence of S. mansoni infection [adjusted odds ratio (AOR) 0.31; 95% confidence interval (CI) 0.13-0.76] than those at St Paul's Tullo Catholic primary school. STH infections were more common among children who sometimes (vs. always) washed their hands before meals (AOR 1.89; 95% CI 1.01-3.54) and those who regularly played with soil (AOR 2.56; 95% CI 1.47-4.46).
This study showed a reduction in STH infections from a high prevalence in 2015 to a moderate prevalence at the present time, despite a similar moderate prevalence of S. mansoni infection. Thus, it is crucial to intensify deworming interventions to reduce the burden of helminths in the study area. Additionally, there is a need to enhance the capacity of clinical laboratories to perform FECT in Ethiopian clinical settings where DM is often employed to diagnose helminths.
曼氏血吸虫感染和土壤传播的蠕虫（STH）感染是卫生条件差且用水受限地区的主要公共卫生问题。在埃塞俄比亚，用于监测旨在减少蠕虫感染的干预措施效果的数据有限。因此，我们评估了小学生中曼氏血吸虫和STH感染的患病率以及与该患病率相关的因素，并将结果与早期研究进行了比较。我们还评估了两种寄生虫学方法之间的诊断一致性。
2023年10月和11月，在埃塞俄比亚南部锡达马州哈瓦萨湖岸边的三所农村小学对363名小学生进行了一项横断面研究。使用系统随机抽样技术选择小学生。使用预先构建的问卷收集社会人口统计学数据。从每个研究参与者收集一份粪便样本，并使用直接涂片镜检法（DM）和甲醛-乙醚浓缩技术（FECT）进行处理，以检测蠕虫卵。
蠕虫感染的总体患病率为59.8%，36.6%的参与儿童为单一感染，23.1%为多重感染。曼氏血吸虫和STH分别存在于33.9%和38.8%的儿童中。STH包括蛔虫（占儿童的28.9%）、鞭虫（10.7%）、钩虫（5.2%）和粪类圆线虫（2.8%）。DM镜检法和FECT在检测微小膜壳绦虫方面的诊断一致性较高（kappa（κ）=0.710），在检测蛔虫方面几乎完美（κ=0.827），但在检测其他检测到的蠕虫方面仅为一般。芬奇瓦小学的儿童曼氏血吸虫感染患病率低于圣保罗图洛天主教小学的儿童[调整优势比（AOR）0.31；95%置信区间（CI）0.13 - 0.76]。STH感染在有时（而非总是）饭前洗手的儿童（AOR 1.89；95%CI 1.01 - 3.54）和经常玩土的儿童中更常见（AOR 2.56；95%CI 1.47 - 4.46）。
本研究表明，尽管曼氏血吸虫感染患病率处于类似的中等水平，但STH感染率已从2015年的高患病率降至目前的中等患病率。因此，加强驱虫干预以减轻研究地区的蠕虫负担至关重要。此外，在埃塞俄比亚临床环境中，当通常采用DM诊断蠕虫时，有必要提高临床实验室进行FECT的能力。
