PDF(Pubmed)
Abstract：
The WHO aims to eliminate schistosomiasis as a public health problem by 2030. However, standard morbidity measures poorly correlate to infection intensities, hindering disease monitoring and evaluation. This is exacerbated by insufficient evidence on Schistosoma\'s impact on health-related quality of life (HRQoL). We conducted community-based cross-sectional surveys and parasitological examinations in moderate-to-high Schistosoma mansoni endemic communities in Uganda. We calculated parasitic infections and used EQ-5D instruments to estimate and compare HRQoL utilities in these populations. We further employed Tobit/linear regression models to predict HRQoL determinants. Two-thirds of the 560 participants were diagnosed with parasitic infection(s), 49% having S. mansoni. No significant negative association was observed between HRQoL and S. mansoni infection status/intensity. However, severity of pain urinating (β = -0.106; s.e. = 0.043) and body swelling (β = -0.326; s.e. = 0.005), increasing age (β = -0.016; s.e. = 0.033), reduced socio-economic status (β = 0.128; s.e. = 0.032), and being unemployed predicted lower HRQoL. Symptom severity and socio-economic status were better predictors of short-term HRQoL than current S. mansoni infection status/intensity. This is key to disentangling the link between infection(s) and short-term health outcomes, and highlights the complexity of correlating current infection(s) with long-term morbidity. Further evidence is needed on long-term schistosomiasis-associated HRQoL, health and economic outcomes to inform the case for upfront investments in schistosomiasis interventions.
摘要：
世卫组织的目标是到2030年消除血吸虫病这一公共卫生问题。然而,标准发病率指标与感染强度相关性差，阻碍疾病监测和评估。血吸虫对健康相关生活质量（HRQoL）影响的证据不足加剧了这种情况。我们在乌干达的中度至高度曼氏血吸虫流行社区进行了基于社区的横断面调查和寄生虫学检查。我们计算了寄生虫感染，并使用EQ-5D仪器来估计和比较这些人群中的HRQoL效用。我们进一步采用Tobit/线性回归模型来预测HRQoL决定因素。560名参与者中有三分之二被诊断为寄生虫感染，49%有S.Mansoni。在HRQoL和曼氏链球菌感染状态/强度之间没有观察到显着的负相关。然而,疼痛排尿的严重程度（β=-0.106;s.e.=0.043）和身体肿胀（β=-0.326;s.e.=0.005），年龄增加(β=-0.016；s.e.=0.033)，社会经济地位降低(β=0.128；s.e.=0.032)，失业和预测较低的HRQoL。与目前的曼氏链球菌感染状况/强度相比，症状严重程度和社会经济状况是短期HRQoL的更好预测因子。这是解开感染与短期健康结果之间联系的关键，并强调了将当前感染与长期发病率相关联的复杂性。需要关于长期血吸虫病相关HRQoL的进一步证据，健康和经济成果，为血吸虫病干预措施的前期投资提供信息。
