Esfandiari A, Swartz J, Teklehaimanot S
Department of Otolaryngology, Charles Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
Cell Mol Biol (Noisy-le-grand). 1997 Nov;43(7):1077-83.
The purpose of this study was to determine the mode of the spread of the enteric parasitic infections among HIV+/AIDS patients attending the AIDS clinic of the King/Drew Medical Center in Los Angeles. Two hundred forty three patients diagnosed with HIV+/AIDS agreed to participate. The study was conducted by several interviews, questionnaires and stool sample collections over a one year period. Stool samples were processed for protozoan cysts and Helminth Ova using standard stool concentration and staining techniques. An indirect immunofluorescence monoclonal antibody technique was also used as an alternate to detect the parasites in samples. Forty three cases were positive for Giardia Lamblia (17.7%) and 10 cases were positive for Cryptosporidium (4%). No Helminth Ova were detected. The majority of the participants were African-American (72.6%) and 27.6% were Hispanic. Clustering studies were performed to determine the mechanism of spread of the parasites among the population study. The Nearest Neighbor Clustering Technique (NNT) was used to determine if there was spatial clustering of positive cases. Geocoding with the MapInfo Program was performed to determine the precise coordinates of the residence of the subjects. Application of the NNT showed a high degree of clustering for Giardia. The NNT statistic for Giardia was significant with the p value for 0.020 using the Simes multiple comparisons correction. Examination of the map plots indicated that there were two areas with high Giardia prevalence, one in Hollywood region, the other in South-Central Los Angeles. The odds ratio for sexual orientation was 14.2 (for homosexuals vs heterosexuals) with a p value of less than 0.001. These findings strongly suggest that male homosexual contact was the main mode of transmission of observed Giardia cases.
本研究的目的是确定在洛杉矶国王/德鲁医疗中心艾滋病门诊就诊的HIV阳性/AIDS患者中肠道寄生虫感染的传播方式。243名被诊断为HIV阳性/AIDS的患者同意参与研究。该研究通过在一年时间内进行多次访谈、问卷调查和粪便样本采集来开展。使用标准的粪便浓缩和染色技术对粪便样本进行原生动物囊肿和蠕虫卵检测。还使用间接免疫荧光单克隆抗体技术作为检测样本中寄生虫的替代方法。43例患者贾第虫检测呈阳性（17.7%），10例患者隐孢子虫检测呈阳性（4%）。未检测到蠕虫卵。大多数参与者是非裔美国人（72.6%），27.6%是西班牙裔。进行聚类研究以确定寄生虫在研究人群中的传播机制。使用最近邻聚类技术（NNT）来确定阳性病例是否存在空间聚类。使用MapInfo程序进行地理编码以确定受试者居住地的精确坐标。NNT的应用显示贾第虫有高度聚类。使用西姆斯多重比较校正后，贾第虫的NNT统计量具有显著性，p值为0.020。对地图绘图的检查表明，有两个贾第虫患病率高的区域，一个在好莱坞地区，另一个在洛杉矶中南部。性取向的优势比为14.2（同性恋者与异性恋者相比），p值小于0.001。这些发现强烈表明，男性同性恋接触是观察到的贾第虫病例的主要传播方式。
