Booth M, Mayombana C, Machibya H, Masanja H, Odermatt P, Utzinger J, Kilima P
Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland.
Trans R Soc Trop Med Hyg. 1998 Sep-Oct;92(5):484-90. doi: 10.1016/s0035-9203(98)90884-7.
Parasitic infections were investigated in Morogoro Rural District, Tanzania, between October 1992 and June 1993. A total of 4589 schoolchildren (aged 7-17 years) from 30 primary schools was screened for infection with Ascaris lumbricoides, Trichuris trichiura, hookworms (3456 children only), Schistosoma mansoni and S. haematobium. The children were also asked about their recent experiences of the following: diarrhoea, abdominal pain, blood in stool, perception of suffering from schistosomiasis, and worm infection and examined for spleen and liver enlargement. Among schools, there were correlations between the prevalence of S. mansoni infection and bloody stools, spleen enlargement and liver enlargement, and between S. haematobium infection and the presence of blood in urine. To exclude ecological explanations for the correlations, logistic regression was used to estimate the adjusted odds ratio (OR) for each infection and each sign or symptom. No sign or symptom was significantly associated with any geohelminth infection. Reported blood in stool was significantly associated with S. mansoni infection (OR = 1.62, P = 0.045). Reported blood in urine was significantly associated with S. haematobium infection (OR = 7.71, P < 0.001), as was reported blood in stool (OR = 11.52, P < 0.001), indicating that presence of blood in either form of excreta was related to the local term for schistosomiasis. These results support the possibility of using reported blood in stool as a means of rapid assessment for identifying communities with a high prevalence of S. mansoni infection.
1992年10月至1993年6月期间，在坦桑尼亚的莫罗戈罗农村地区对寄生虫感染情况进行了调查。对来自30所小学的4589名学童（年龄在7至17岁之间）进行了筛查，以检测是否感染蛔虫、鞭虫、钩虫（仅对3456名儿童进行检测）、曼氏血吸虫和埃及血吸虫。还询问了这些儿童近期是否有以下经历：腹泻、腹痛、便血、是否感觉感染了血吸虫病以及蠕虫感染情况，并检查了脾脏和肝脏是否肿大。在各学校中，曼氏血吸虫感染率与便血、脾脏肿大和肝脏肿大之间存在相关性，埃及血吸虫感染与血尿之间也存在相关性。为排除这些相关性的生态学解释，采用逻辑回归来估计每种感染以及每种体征或症状的调整优势比（OR）。没有任何体征或症状与任何土源性蠕虫感染显著相关。报告的便血与曼氏血吸虫感染显著相关（OR = 1.62，P = 0.045）。报告的血尿与埃及血吸虫感染显著相关（OR = 7.71，P < 0.001），报告的便血也与之显著相关（OR = 11.52，P < 0.001），这表明排泄物中出现任何一种形式的血液都与当地对血吸虫病的称呼有关。这些结果支持了将报告的便血作为一种快速评估手段来识别曼氏血吸虫感染高流行社区的可能性。
