Scheutz F, Matee M I, Simon E, Mwinula J H, Lyamuya E F, Msengi A E, Samaranayake L P
Department of Oral Epidemiology and Public Health, Faculty of Health Sciences, Aarhus University, Denmark.
Community Dent Oral Epidemiol. 1997 Jun;25(3):193-8. doi: 10.1111/j.1600-0528.1997.tb00925.x.
The objective was to determine whether there is an association between carriage of oral yeasts, malnutrition and HIV-1 infection among Tanzanian children. A case-control study design within a cross-sectional study was used, and the outcome was carriage of oral yeasts. The exposure variables were malnutrition and HIV-1 antibody, and confounders to be adjusted for were age, sex, and breastfeeding. The study was carried out in Dar-es-Salaam, Tanzania, in two maternal and child health (MCH) clinics that offer routine medical checkups to all expectant mothers and children aged between 0 and 5 years in the catchment area. A total of 882 children aged between 18 months and 5 years participated. Smears from the tongue and buccal mucosa were examined for oral yeasts. Malnutrition was categorized according to standards on the MCH chart and World Health Organization/Centers for Disease Control (WHO/CDC) standards as weight-for-height (wasted), weight-for-age (underweight), and height-for-age (stunted). HIV-1 infection was determined by an enzyme-linked immunosorbent assay. Reactive sera were confirmed by Western Blot. About 27% of the children were slightly or severely malnourished according to standards on the MCH chart. According to WHO/CDC standards, 2.6% were wasted, 16.3% were underweight, and 29.6% were stunted. Fourteen (1.6%) were seropositive for HIV-1 antibody. Hyphal forms and blastospores were much more frequent among children infected with HIV-1 with odds ratios ranging from 3.8 (95% CI: 1.3;11.2) to 6.2 (95% CI: 2.1;18.4) depending on categorization of malnutrition. Malnutrition was a risk factor, too, albeit to a much lesser and insignificant degree. The study supports our previous findings that malnutrition may predispose to carriage of oral yeasts and subsequent infection. However, in this study population HIV infection was clearly the predominant risk factor.
目的是确定坦桑尼亚儿童口腔酵母菌携带、营养不良与HIV-1感染之间是否存在关联。采用了横断面研究中的病例对照研究设计，结果变量是口腔酵母菌携带情况。暴露变量为营养不良和HIV-1抗体，需调整的混杂因素为年龄、性别和母乳喂养情况。该研究在坦桑尼亚达累斯萨拉姆的两家母婴健康（MCH）诊所开展，这两家诊所为集水区内所有0至5岁的孕妇和儿童提供常规体检。共有882名18个月至5岁的儿童参与。检查舌部和颊黏膜涂片以检测口腔酵母菌。根据MCH图表标准和世界卫生组织/疾病控制中心（WHO/CDC）标准，将营养不良分为身高别体重（消瘦）、年龄别体重（体重不足）和年龄别身高（发育迟缓）。通过酶联免疫吸附测定法确定HIV-1感染情况。反应性血清通过免疫印迹法进行确认。根据MCH图表标准，约27%的儿童存在轻度或重度营养不良。根据WHO/CDC标准，2.6%的儿童消瘦，16.3%的儿童体重不足，29.6%的儿童发育迟缓。14名（1.6%）儿童HIV-1抗体血清学检测呈阳性。在感染HIV-1的儿童中，菌丝体形式和芽生孢子更为常见，根据营养不良的分类，优势比范围为3.8（95%置信区间：1.3；11.2）至6.2（95%置信区间：2.1；18.4）。营养不良也是一个危险因素，尽管程度要小得多且不显著。该研究支持了我们之前的发现，即营养不良可能易导致口腔酵母菌携带及后续感染。然而，在该研究人群中，HIV感染显然是主要的危险因素。
