Helminthiasis

蠕虫病
  • 文章类型: Journal Article
    背景:结核病(TB)和肠道蠕虫是低收入国家对公共卫生造成双重负担的疾病。先前的研究表明,蠕虫可以影响活动性结核病患者痰中细菌的脱落或细菌负荷。然而,有蠕虫感染的结核病患者的细菌负荷信息有限.
    目的:本研究旨在比较Jimma地区选定的公共卫生设施中蠕虫感染和未感染肺结核患者的细菌负荷,奥罗米亚,埃塞俄比亚。
    方法:本研究在Jimma区进行,奥罗米亚,埃塞俄比亚。从2020年8月1日至2021年1月,进行了一项基于设施的比较横断面研究。该研究共纳入了124例(55例肠蠕虫感染和69例未感染)新诊断的涂片阳性肺结核(PTB)患者。采用了一种方便的抽样技术来招募研究参与者,半结构化问卷用于收集有关肠道蠕虫共感染的社会人口学特征和可能危险因素的数据.使用湿式安装和KatoKatz技术进行粪便检查。此外,体重和身高测量,痰,采集血样来确定体重指数,杆菌负荷,和糖尿病,分别。将数据输入Epi-Data软件版本3.1,并使用社会科学统计软件包(SPSS)版本25进行分析。统计学上的显著差异被定义为P值小于0.05。
    结果:肠蠕虫比未感染PTB的肠蠕虫减少了3倍以上的细菌负荷(AOR=3.44;95%CI;1.52,7.79;P=0.003)但是,糖尿病,艾滋病毒,饮酒和吸烟与杆菌负荷无关.肠道蠕虫合并感染TB的比率为44%。检测到的三种最普遍的寄生虫是Trichuristrichiura29(66%),钩虫19(43%),和蛔虫11(25%))。在共感染的患者中,约有36例(81.8%)患有单一寄生虫感染,19例(43.2%)有多重感染。体重指数<18.5(AOR=3.26;95%CI;1.25,8.56;P=0.016)和未修剪的指甲状态(AOR=3.63;95CI;1.32,9.93;P=0.012)与PTB-肠蠕虫共感染显着相关。
    结论:与未感染的PTB相比,蠕虫感染与较低的杆菌载量相关。肠道蠕虫合并感染TB的比率为44%。Trichuristrichiura是最普遍的蠕虫。未修剪的指甲和体重指数与PTB-肠道蠕虫共感染有关。
    BACKGROUND: Tuberculosis (TB) and intestinal helminths are diseases that pose a dual burden on public health in low-income countries. Previous studies have shown that helminths can affect the shedding of bacteria or the bacterial load in the sputum of active TB patients. However, there is limited information on bacterial load in TB patients with helminth infections.
    OBJECTIVE: This study aimed to compare bacterial load in helminths-infected and non-infected pulmonary tuberculosis patients at selected public health facilities in Jimma zone, Oromia, Ethiopia.
    METHODS: The study was conducted in Jimma Zone, Oromia, Ethiopia. A facility-based comparative cross-sectional study was employed from August 01, 2020, to January 2021. A total of 124 (55 intestinal helminths-infected and 69 non-infected) newly diagnosed smear-positive pulmonary tuberculosis (PTB) patients were included in the study. A convenience sampling technique was employed to recruit study participants, and a semi-structured questionnaire was used to collect data regarding socio-demographic characteristics and possible risk factors for intestinal helminths co-infection. Stool examination was performed using both wet mount and Kato Katz technique. Additionally, weight and height measurements, sputum, and blood samples were taken to determine body mass index, bacilli load, and diabetic mellitus, respectively. Data were entered into Epi-Data software version 3.1 and analyzed using Statistical Packages for Social Sciences (SPSS) Version 25. A statistically significant difference was defined as a P-value of less than 0.05.
    RESULTS: Intestinal helminths reduced bacilli load 3 times more than intestinal helminths non-infected PTB (AOR = 3.44; 95% CI; 1.52, 7.79; P = 0.003) However, diabetes mellitus, HIV, drinking alcohol and cigarette smoking were not associated with bacilli load. The rate of co-infection TB with intestinal helminths was 44%. The three most prevalent parasites detected were Trichuris trichiura 29 (66%), hookworm 19 (43%), and Ascaris lumbricoides 11(25%)). Among co-infected patients about 36 (81.8%) had a single parasite infection, and 19 (43.2%) had multiple infections. A body mass index < 18.5 (AOR = 3.26; 95% CI; 1.25, 8.56;P = 0.016) and untrimmed fingernail status (AOR = 3.63; 95%CI;1.32,9.93;P = 0.012) were significantly associated with PTB- intestinal helminth -co-infection.
    CONCLUSIONS: Helminth infection was associated with a lower bacilli load compared to helmenths non-infected PTB. The rate of co-infection TB with intestinal helminths was 44%. Trichuris trichiura was the most prevalent helminth. Untrimmed fingernail and a body mass index were associated with PTB-intestinal helminth co-infection.
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  • 文章类型: Journal Article
    背景:嗜酸性粒细胞增多综合征可引起心脏受累和心内膜心肌纤维化,预后不良。然而,关于与蠕虫病相关的嗜酸性粒细胞增多的拉丁美洲移民的心脏受累信息有限.
    方法:我们进行了一项初步观察性研究,对来自拉丁美洲的移民进行了超声心动图检查,诊断为嗜酸性粒细胞增多(>450细胞/μL)和蠕虫感染,以及来自拉丁美洲的移民,没有嗜酸性粒细胞增多或蠕虫感染。微生物学技术包括使用Ritchie的福尔马林-乙醚技术进行粪便显微镜检查,和一种特异性血清学方法来检测赤圆圆线虫抗体。
    结果:包括37名参与者,20伴嗜酸性粒细胞增多和17无嗜酸性粒细胞增多。20名男性(54.1%),平均年龄为41.3(SD14.3)岁。嗜酸性粒细胞增多组中诊断为蠕虫感染:17例胸骨链球菌感染,1例钩虫感染,2例胸骨链球菌与钩虫共感染。在嗜酸性粒细胞增多的参与者中,超声心动图显示右心室厚度(p=0.001)和左心房面积和容积指数(分别为p=0.003和p=0.004),同时显示左心房下部应变(p=0.006)和E波减速时间(p=0.008)。与无嗜酸性粒细胞增多的参与者相比,二尖瓣前后叶厚度均增加(分别为p=0.0014和p=0.004)。
    结论:来自拉丁美洲的与蠕虫感染相关的嗜酸性粒细胞增多的移民可能出现早期超声心动图改变,提示早期舒张功能障碍。这可能与嗜酸性粒细胞增多引起的心内膜改变有关。
    BACKGROUND: Hypereosinophilic syndrome can produce cardiac involvement and endomyocardial fibrosis, which have a poor prognosis. However, there is limited information regarding cardiac involvement among migrants from Latin America with eosinophilia related to helminthiasis.
    METHODS: We conducted a pilot observational study where an echocardiography was performed on migrants from Latin America with both eosinophilia (>450 cells/μL) and a diagnosis of helminth infection, and on migrants from Latin America without eosinophilia or helminth infection. Microbiological techniques included a stool microscopic examination using the Ritchie\'s formalin-ether technique, and a specific serology to detect Strongyloides stercoralis antibodies.
    RESULTS: 37 participants were included, 20 with eosinophilia and 17 without eosinophilia. Twenty (54.1%) were men with a mean age of 41.3 (SD 14.3) years. Helminthic infections diagnosed in the group with eosinophilia were: 17 cases of S. stercoralis infection, 1 case of hookworm infection, and 2 cases of S. stercoralis and hookworm coinfection. Among participants with eosinophilia, echocardiographic findings revealed a greater right ventricle thickness (p = 0.001) and left atrial area and volume index (p = 0.003 and p = 0.004, respectively), while showing a lower left atrial strain (p = 0.006) and E-wave deceleration time (p = 0.008). An increase was shown in both posterior and anterior mitral leaflet thickness (p = 0.0014 and p = 0.004, respectively) when compared with participants without eosinophilia.
    CONCLUSIONS: Migrants from Latin America with eosinophilia related to helminthic infections might present incipient echocardiographic alterations suggestive of early diastolic dysfunction, that could be related to eosinophilia-induced changes in the endomyocardium.
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  • 文章类型: Journal Article
    背景:土壤传播的蠕虫(STH)感染控制仍然是流行地区的优先事项,在这些地区,需要当地流行病学数据来实现可持续控制策略,特别是关于人口知识,态度,和实践(KAP)。我们的工作评估了Bata区居民对STH感染的KAP及其相关因素,赤道几内亚。
    方法:在Bata地区的14个随机选择的社区中进行了基于社区的横断面研究。使用标准化问卷对符合条件的参与者进行了面对面的采访。18岁以下的参与者在父母或法定监护人在场的情况下接受了采访。对于10岁以下的参与者,主要问卷的简化版本是针对儿童对STH的做法而制定的,并向其父母或法定监护人发放.
    结果:本分析共纳入399名参与者。其中,58%的人回答了主要问卷。10岁及以上参与者的平均(±SD)年龄为37.5(±22.2)岁,其中60%是女性,10岁以下人群的平均(±SD)年龄为5.0(±2.5)岁。受访者的总体知识,态度,对STH的做法被评为不良(33%),很好(77%)良好(55%),分别。知识与教育水平显着相关(p=0.04),未受过正规教育的参与者的知识水平低于受过中等/大学教育的参与者(β=-0.56,95%CI:-1.00--0.12,p=0.01);适当的态度水平与职业(p=0.02)和教育水平(p=0.049)显着相关,学生的适当态度水平低于农民/渔民(P=0.68-中等教育水平,P=0.01-1.职业(p=0.01),和教育(p=0.02),适当的实践水平随着年龄的增长而增加(β=0.03,95%CI:0.005-0.05,p=0.01),没有正规教育的参与者低于中等/大学教育的参与者(β=-1.19,-2.05--0.32,p=0.007)。
    结论:本研究表明,研究人群缺乏关于STH的知识,特别是关于疾病的原因和传播途径,强调实施综合健康教育战略的必要性,在社区和学校层面。
    BACKGROUND: Soil-transmitted helminth (STH) infection control remains a priority in endemic regions where local epidemiological data are needed for sustainable control strategies, particularly regarding population knowledge, attitudes, and practices (KAP). Our work assessed KAP toward STH infection and associated factors among residents of Bata district, Equatorial Guinea.
    METHODS: A community-based cross-sectional study was conducted among 14 randomly selected communities in the Bata district. Eligible participants were interviewed face-to-face using a standardized questionnaire. Participants aged under 18 years were interviewed in the presence of their parents or legal guardians. For participants aged less than ten, a simplified version of the main questionnaire was developed focusing on children\'s practices toward STH and was administered to their parents or legal guardians.
    RESULTS: A total of 399 participants were included in the present analysis. Among them, 58% responded to the main questionnaire. The mean (± SD) age of participants aged 10 and over was 37.5 (± 22.2) years, and 60% of them were females, while the mean (± SD) age of those aged less than ten was 5.0 (± 2.5) years. The respondents\' overall knowledge, attitudes, and practices to STH were rated as bad (33%), very good (77%), and good (55%), respectively. Knowledge was significantly associated with education level (p = 0.04) with the knowledge level lower for participants with no formal education than for those with secondary/university education (β = -0.56, 95% CI: -1.00 - -0.12, p = 0.01); Appropriate attitudes level was significantly associated with occupation (p = 0.02) and education levels (p = 0.049) with the appropriate attitude level lower for students than for farmers/fishers (β = -1.24, 95% CI: -2.17--0.32, p = 0.01) and for primary-level participants than for those with secondary/university education (β = -0.68, 95% CI: -1.23--0.13, p = 0.02); while appropriate practice level were significantly associated with age (p = 0.01), occupation (p = 0.01), and education (p = 0.02), with the appropriate practices level increasing with age (β = 0.03, 95% CI: 0.005 - 0.05, p = 0.01) and lower in participants with no formal education than in those with secondary/university education (β = -1.19, -2.05 - -0.32, p = 0.007).
    CONCLUSIONS: The present study revealed a lack of knowledge about STH in the study population, particularly regarding disease causes and transmission ways, highlighting the need for the implementation of integrated health education strategies, both at the community and school levels.
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  • 文章类型: Journal Article
    背景:土壤传播的蠕虫酶(STHs)在热带和亚热带地区很常见。泰国南部经历了一个延长的雨季,导致土壤持续湿润。此条件支持STHs的生命周期,由于再感染和药物疗效低下,阻碍了有效控制。我们在旱季实施了一项新的STH控制策略,旨在降低再感染率,而不加强环境卫生或卫生习惯。然而,有意想不到的,从2014年到2016年,与厄尔尼诺事件有关的长期干旱。此外,我们评估了这些干旱条件对不使用驱虫药的进一步控制措施的影响。
    结果:2012年至2016年进行了一项纵向研究。使用Kato-Katz和琼脂平板培养方法分析了从299名参与者收集的粪便样品。对STHs测试呈阳性的参与者接受了单次400mg剂量的阿苯达唑。三周后评估治疗的疗效。为了确认在旱季实施了控制措施,我们监测了阿苯达唑治疗52天后的雨天数,其中38个没有下雨。在2013年和2016年进行了粪便随访检查,没有额外剂量的阿苯达唑给药。降雨量和雨天数据,作为厄尔尼诺导致的意外干旱的指标,是从最近的当地气象站收集的。在干旱之前,2013年,除毛虫病以外,STH患病率有所下降,这归因于旱季的控制努力.尽管做出了这些努力,STH患病率仍然很高。值得注意的是,2016年,在干旱时期之后,毛虫病的患病率,以前没有改变,与2013年相比,在未进一步接受阿苯达唑治疗的情况下自发下降.此外,由于对干旱条件的敏感性较低,圆线虫病的患病率可能保持不变,因为它可以在主机内复制。相反,其他sths的患病率持续下降。干旱以及环境卫生和个人卫生做法的可能改善,通过降低再感染率和新感染率以及提高自然治愈率,促成了这一下降。此外,一些未被阿苯达唑治愈的感染钩虫或鞭虫的参与者经历了自然缓解。
    结论:在旱季实施的控制措施,加上2014-2016年厄尔尼诺事件引发的长达14个月的干旱,以及环境卫生和卫生习惯的一些改善,有助于降低STHs的患病率和强度,除了S.stercoralis.随着时间的推移,S.stercoralis可能成为STHs中的主要物种。
    BACKGROUND: Soil-transmitted helminthiases (STHs) are common in tropical and subtropical regions. Southern Thailand experiences an extended rainy season, leading to persistently moist soil. This condition supports the life cycle of STHs, hindering effective control due to reinfection and low drug efficacy. We implemented a novel STH control strategy during the dry season aimed at decreasing reinfection rates without enhancing sanitation or hygiene practices. However, there were unexpected, prolonged droughts linked to El Niño events from 2014 to 2016. Additionally, we assessed the effects of these drought conditions on further control measures without the use of anthelmintics.
    RESULTS: A longitudinal study was conducted from 2012 to 2016. Stool samples collected from 299 participants were analyzed using the Kato-Katz and agar plate culture methods. Participants who tested positive for STHs received a single 400 mg dose of albendazole. The efficacy of the treatment was evaluated three weeks later. To confirm the control measures were implemented during the dry season, we monitored the number of rainy days following albendazole treatment for 52 days, of which 38 were without rain. Follow-up stool examinations were carried out in 2013 and 2016, with no additional doses of albendazole administered. Rainfall and rainy day data, which served as indicators of unexpected droughts due to El Niño, were collected from the nearest local meteorological stations. Before the drought, there was a decrease in STH prevalence in 2013-except for trichuriasis-attributable to the dry season control efforts. Despite these efforts, STH prevalence remained high. Remarkably, in 2016, following the drought period, the prevalence of trichuriasis, which had not changed previously, spontaneously declined without further albendazole treatment compared to 2013. Furthermore, the prevalence of strongyloidiasis remained unchanged likely due to its low susceptibility to drought conditions, as it can reproduce within hosts. Conversely, the prevalence of other STHs consistently declined. The drought and possible improvements in sanitation and hygiene practices contributed to this decrease by reducing rates of reinfection and new infection and by increasing the natural cure rate. Additionally, some participants infected with hookworms or Trichuris who were not cured by albendazole experienced natural remission.
    CONCLUSIONS: Control measures implemented during the dry season, combined with a 14-month-long drought induced by the El Niño event of 2014-2016, and some improvements in sanitation and hygiene practices, contributed to a decrease in both the prevalence and intensity of STHs, except for S. stercoralis. Over time, S. stercoralis is likely to become the predominant species among the STHs.
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  • 文章类型: Journal Article
    背景:土壤传播的蠕虫病(STH)是撒哈拉以南非洲的主要公共卫生问题。在肯尼亚,国家学校驱虫计划(NSBDP)于2012年启动,目标是将学龄儿童的STH患病率(SAC)降低到<1%,然而,监测和评估结果一致显示,纳罗克县的患病率>20%。我们进行了一项研究,以调查纳罗克县SAC中与STH感染相关的因素。
    方法:在跨马拉西部县的五所学校的514个SAC中进行了一项横断面研究,纳罗克县。之所以选择该县,是因为它在NSBDP中有参与的学校,并且STH感染率很高。采用系统随机抽样方法选择参与者。使用Kato-Katz技术检查从参与者收集的粪便样品的STH卵。一个开放的数据套件问卷被用来收集社会人口统计数据,家庭,和来自514个SAC中的139个的STH知识信息。描述性统计数据被用来总结数据,计算感染的患病率和平均强度,和逻辑回归用于确定与STH感染相关的因素。
    结果:任何STH感染的总患病率为24.6%(95CI:21.1-28.6)。Trichuristrichiura14.4%(95CI:11.7-17.8),蛔虫12.5%(95CI:9.9-15.7),钩虫0%。从多变量分析,与STH感染风险增加显著相关的唯一因素是,在Karda和Nkarano学校上学的儿童的aOR=5.29(95CI:1.45-19.24);p=0.011和aOR=4.53(95CI:1.29-15.97);p=0.019。对于A.lumbricoides,就读于Nkarano学校的儿童与感染的显著风险相关,aOR=7.81(95CI:1.81-33.63);p=0.006.
    结论:尽管NSBDP正在进行工作,跨马拉西县纳罗克县的STH患病率仍≥20%,在SAC中。这突出表明需要持续的年度MDA。此外,如果可能,药物组合可以有效地管理T.trichiura,该地区最常见的蠕虫。研究发现,在特定学校上学的儿童与STH感染风险之间存在相关性,表明健康教育和改善水的重要性,卫生,学校和相关集水区的卫生习惯和卫生习惯,这些措施可以充当STH水库,以减轻STH的负担。
    BACKGROUND: Soil-transmitted helminthiasis (STH) are a major public health problem in Sub-Saharan Africa. In Kenya, the National School Based Deworming Program (NSBDP) was launched in 2012 with a goal of reducing STH prevalence in school-aged children (SAC) to <1%, however monitoring and evaluation results have consistently showed > 20% prevalence in Narok County. We conducted a study to investigate factors associated with STH infections among SAC in Narok County.
    METHODS: A cross-sectional study was conducted among 514 SAC from five schools in Trans Mara West sub-county, Narok County. The sub-county was selected because it had participating schools within the NSBDP with a high prevalence of STH infection. Participants were selected using systematic random sampling. Stool samples collected from participants were examined for STH eggs using Kato-Katz technique. An open data kit questionnaire was used to collect socio-demographics, household, and STH knowledge information from 139 of the 514 SAC. Descriptive statistics was used to summarize the data, prevalence and mean intensity of infections were calculated, and logistic regression used to determine factors associated with STH infections.
    RESULTS: The overall prevalence of any STH infection was 24.6% (95%CI: 21.1-28.6). Trichuris trichiura 14.4% (95%CI: 11.7-17.8), Ascaris lumbricoides 12.5% (95%CI: 9.9-15.7) and hookworm 0%. From multivariable analysis the only factors significantly associated with increased risk of STH infection were, children attending Karda and Nkarano schools with aOR = 5.29 (95%CI: 1.45-19.24); p = 0.011 and aOR = 4.53 (95%CI: 1.29-15.97); p = 0.019 respectively. For A. lumbricoides, children attending Nkarano School were associated with a significant risk of infection with aOR = 7.81 (95%CI: 1.81-33.63); p = 0.006.
    CONCLUSIONS: Despite the ongoing work of NSBDP, the STH prevalence is still ≥ 20% in Trans Mara West sub-county Narok County, among SAC. This underscores the need for continued annual MDA. Additionally, if possible, drug combinations may effectively manage T. trichiura, the region\'s most common helminth. The study found a correlation between children attending specific schools and STH infection risk, suggesting the importance of health education and improved water, sanitation, and hygiene practices holistically both in schools and associated catchment areas that can act as STH reservoirs to alleviate the burden of STH.
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  • 文章类型: Journal Article
    背景:微量营养素缺乏在印度普遍存在。土壤传播的蠕虫(STH)感染是通过与被人类粪便污染的土壤和水相互作用而获得的,并导致血液流失和微量营养素吸收不良。目前控制性病相关发病率的建议是有针对性的驱虫,然而,在不同的卫生条件下,驱虫对微量营养素状况的有效性知之甚少。印度各州的患病率在1%到40%之间,尽管印度投资于通过促进全社区的卫生设施来消除排便,但露天排便(OD)仍然很高。这种变化为研究驱虫之间的关系提供了机会,微量营养素状况,和OD在规模。
    结果:在2016年至2018年的国家综合营养调查中获得了具有印度代表性的横截面数据集(n=105,060名1至19岁的个体)。驱虫药物的消费按年龄和社区OD水平描述。使用Logistic回归模型来检验驱虫,簇OD,以及它们的相互作用,贫血和微量营养素缺乏(铁,锌,维生素A,叶酸,和维生素B12),控制年龄,性别,财富,饮食,和季节性。这些回归模型进一步使我们能够确定最小OD率,之后驱虫变得无效。在敏感性分析中,驱虫和缺陷之间的关联在社区的子样本中进行了测试,这些子样本基于统计三分位数分为3个OD水平:无OD(社区中有0%的家庭使用OD),中度OD(>0%和<30%),或高OD(至少30%)。样本中的平均驱虫覆盖率和OD患病率分别为43.4%[IQR26.0,59.0]和19.1%[IQR0,28.5],分别。控制营养状况的其他决定因素,生活在OD水平较高的社区的青少年驱虫覆盖率较低,贫血患病率较高,锌,维生素A,B12缺陷。与那些没有被驱虫的人相比,驱虫儿童和青少年贫血的几率较低(调整后的优势比0.72,(95%CI[0.67,0.78],p<0.001)和铁缺乏0.78,(95%CI[0.74,0.82],p<0.001)和叶酸0.69(95%CI[0.64,0.74],p<0.001))在无OD社区中。这些保护作用对贫血仍然显着,但对中等或高OD社区的其他微量营养素缺乏症却有所减弱。对社区OD的分析表明阈值范围为30%至60%,在这之上,有针对性的驱虫不再与较低的贫血显著相关,铁,叶酸缺乏。该研究的主要局限性包括遗漏变量偏差的可能性和无法捕获纵向效应。
    结论:中等至高的OD率显着改变了印度驱虫与微量营养素状态之间的关联。公共卫生政策可能涉及排序干预,重点是提高已达到OD最低阈值的社区的驱虫覆盖率,并在驱虫天数之前重新触发高OD社区的卫生干预措施,确保两者的高覆盖率。在这个年龄组中,补充微量营养素作为改善营养结果以及驱虫和消除OD的补充策略的有效性需要进一步研究。
    BACKGROUND: Micronutrient deficiencies are widespread in India. Soil-transmitted helminth (STH) infections are acquired by interaction with soil and water contaminated by human feces and lead to blood loss and poor micronutrient absorption. The current recommendation for control of STH-related morbidity is targeted deworming, yet little is known about the effectiveness of deworming on micronutrient status in varying sanitation contexts. Ranging between 1% and 40% prevalence across Indian states, open defecation (OD) remains high despite India\'s investments at elimination by promoting community-wide sanitation. This variation provides an opportunity to study the relationship between deworming, micronutrient status, and OD at-scale.
    RESULTS: Cross-sectional datasets that were representative for India were obtained the Comprehensive National Nutrition Survey in 2016 to 2018 (n = 105,060 individuals aged 1 to 19 years). Consumption of deworming medication was described by age and community OD level. Logistic regression models were used to examine the relationship between deworming, cluster OD, and their interactions, with anemia and micronutrient deficiencies (iron, zinc, vitamin A, folate, and vitamin B12), controlling for age, sex, wealth, diet, and seasonality. These regression models further allowed us to identify a minimum OD rate after which deworming becomes ineffective. In sensitivity analyses, the association between deworming and deficiencies were tested in subsamples of communities classified into 3 OD levels based on statistical tertiles: OD free (0% of households in the community practicing OD), moderate OD (>0% and <30%), or high OD (at least 30%). Average deworming coverage and OD prevalence in the sample were 43.4% [IQR 26.0, 59.0] and 19.1% [IQR 0, 28.5], respectively. Controlling for other determinants of nutritional status, adolescents living in communities with higher OD levels had lower coverage of deworming and higher prevalence of anemia, zinc, vitamin A, and B12 deficiencies. Compared to those who were not dewormed, dewormed children and adolescents had lower odds of anemia (adjusted odds ratio 0.72, (95% CI [0.67, 0.78], p < 0.001) and deficiencies of iron 0.78, (95% CI [0.74, 0.82], p < 0.001) and folate 0.69, (95% CI [0.64,0.74], p<0.001)) in OD free communities. These protective effects remained significant for anemia but diminished for other micronutrient deficiencies in communities with moderate or high OD. Analysis of community OD indicated a threshold range of 30% to 60%, above which targeted deworming was no longer significantly associated with lower anemia, iron, and folate deficiency. The primary limitations of the study included potential for omitted variables bias and inability to capture longitudinal effects.
    CONCLUSIONS: Moderate to high rates of OD significantly modify the association between deworming and micronutrient status in India. Public health policy could involve sequencing interventions, with focus on improving deworming coverage in communities that have achieved minimum thresholds of OD and re- triggering sanitation interventions in high OD communities prior to deworming days, ensuring high coverage for both. The efficacy of micronutrient supplementation as a complementary strategy to improve nutritional outcomes alongside deworming and OD elimination in this age group needs further study.
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  • 文章类型: Journal Article
    背景:土壤传播的蠕虫病(STH)是指由线虫引起的一系列寄生虫病,并通过粪便污染的土壤传播给人们。由于缺乏环境卫生和个人卫生,这种疾病在低收入和中等收入国家非常普遍。孕妇是由土壤传播的蠕虫感染的危险群体之一。以前对埃塞俄比亚孕妇疾病负担的研究没有表明寄生虫感染的强度。这项研究的目的是评估孕妇中土壤传播的蠕虫的患病率和相关因素。
    方法:对随机选择的416名孕妇进行了一项基于机构的横断面研究。数据是使用结构化访谈管理的问卷和实验室测试收集的。Kato-Katz技术用于诊断土壤传播的蠕虫病并确定感染强度。将收集的数据输入到Epi-Data版本4.6中,并导出到SPSS版本25中进行分析。多变量逻辑回归分析用于确定p值<0.05的土壤传播蠕虫的独立预测因子。
    结果:孕妇中土壤传播蠕虫的总体患病率为30%。(95%,CI:26-34%)。生活在农村地区(AOR=3.35;95%CI=1.83-6.13),从不受保护的水源饮用(AOR=2.52;95%CI=1.45-4.37),上厕所后不洗手(AOR=2.75;95%CI=1.55-4.88),缺乏健康信息(AOR=1.70;95%CI=1.01-2.85),作为日工工作(AOR=2.88;95%CI=1.01-8.20),赤脚行走(AOR=4.00;95%CI=2.29-7.00)与孕妇中土壤传播的蠕虫的存在显着相关。
    结论:研究区域的STH患病率明显适中,在那里,孕妇主要受到as虫病和钩虫的影响。生活在农村地区,作为一名日常劳动者,赤脚走路,厕所后不洗手,从不受保护的水源饮用,缺乏健康信息是决定因素。包括健康教育在内的干预措施,纯饮用水水源的扩大,促进个人卫生,建议穿鞋以减轻研究区域土壤传播的蠕虫的负担。
    BACKGROUND: Soil-transmitted helminthiasis (STH) refers to a set of parasitic illnesses caused by nematode worms and spread to people through faeces-contaminated soil. It is highly prevalent in low- and middle-income countries due to a lack of environmental sanitation and personal hygiene. Pregnant women are among the risk groups for infection by soil-transmitted helminths. Former studies of the disease burden among pregnant women in Ethiopia didn\'t indicate the intensity of parasitic infection. The aim of this study was to assess the prevalence and associated factors of soil-transmitted helminths among pregnant women.
    METHODS: An institution-based cross-sectional study was conducted among 416 randomly selected pregnant women. The data were collected using a structured interview-administered questionnaire and a laboratory test. The Kato-Katz technique was used to diagnose soil-transmitted helminthiasis and determine the intensity of the infection. The collected data were entered into Epi-Data version 4.6 and exported to SPSS version 25 for analysis. Multivariate logistic regression analysis was used to identify independent predictors of soil-transmitted helminths at a p-value < 0.05.
    RESULTS: The overall prevalence of soil-transmitted helminths among pregnant women was 30%. (95%, CI: 26-34%). Living in a rural area (AOR = 3.35; 95% CI = 1.83-6.13), drinking from an unprotected water source (AOR = 2.52; 95% CI = 1.45-4.37), not washing one\'s hand after the toilet (AOR = 2.75; 95% CI = 1.55-4.88), lacking health information (AOR = 1.70; 95% CI = 1.01-2.85), working as a daily labourer (AOR = 2.88; 95% CI = 1.01-8.20), and walking barefoot (AOR = 4.00; 95% CI = 2.29-7.00) were significantly associated with the presence of soil-transmitted helminths among pregnant women.
    CONCLUSIONS: The prevalence of STH was significantly moderate in the study area, where pregnant women were mostly affected by ascariasis and hookworms. Living in a rural area, being a daily labourer, walking barefoot, not washing hands after the toilet, drinking from an unprotected water source, and lacking health information were the determining factors. Interventions including health education, the expansion of pure drinking water sources, the promotion of personal hygiene, and the wearing of shoes are recommended to reduce the burden of soil-transmitted helminths in the study area.
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  • 文章类型: Journal Article
    目的:土壤传播蠕虫的驱虫计划通常通过在地区一级汇总药物覆盖率和感染水平来监测和评估。然而,在更精细的空间尺度上,药物覆盖率的异质性意味着指标可能保持在消除作为公共卫生问题或在某些地区传播的阈值之上。本文旨在强调在更大的空间尺度上汇总数据可以用于计划决策的误导性信息。
    方法:参考世界卫生组织的目标,在两个空间尺度上比较了Geshiyaro项目的药物覆盖率数据。比较了地区(woreda)和村庄(kebele)的水平。通过将加权最小二乘函数拟合到针对药物覆盖率的平均感染强度(每克粪便的鸡蛋)来分析感染水平与药物覆盖率之间的关联。
    结果:数据清楚地表明,当覆盖率的评估汇总到地区级别时,在更精细的空间尺度上失去了关于异质性的信息。随着药物覆盖率的增加,感染强度显着降低(p=0.0023)。
    结论:在大空间尺度上聚合数据会导致驱虫过早停止,促使感染迅速反弹。迫切需要为监测和评估干预方案定义特定环境的空间尺度。
    OBJECTIVE: Deworming programmes of soil-transmitted helminths are generally monitored and evaluated by aggregating drug coverage and infection levels at a district level. However, heterogeneity in drug coverage at finer spatial scales means indicators may remain above thresholds for elimination as a public health problem or of transmission in some areas. This paper aims to highlight the misleading information that aggregating data at larger spatial scales can have for programme decision making.
    METHODS: Drug coverage data from the Geshiyaro project were compared at two spatial scales with reference to the World Health Organisation\'s targets. District (woreda) and village (kebele) level were compared. The association between infection levels and drug coverage was analysed by fitting a weighted least-squares function to the mean intensity of infection (eggs per gram of faeces) against drug coverage.
    RESULTS: The data show clearly that when the evaluation of coverage is aggregated to the district level, information on heterogeneity at a finer spatial scale is lost. Infection intensity decreases significantly (p = 0.0023) with increasing drug coverage.
    CONCLUSIONS: Aggregating data at large spatial scales can result in prematurely ceasing deworming, prompting rapid infection bounce-back. There is a strong need to define context-specific spatial scales for monitoring and evaluating intervention programmes.
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  • 文章类型: Journal Article
    背景:任何生物体的所有器官都可能受到蠕虫的影响。它们可以在广谱中看到,从简单的侵扰到广泛的侵扰,危及生命的参与。症状学通常是慢性潜伏过程。然而,有时是急性的,需要紧急手术治疗。
    方法:我们对2000年1月至2019年12月在大学医院接受蠕虫感染急诊手术的患者进行了回顾性观察性前瞻性招募研究。社会人口统计学和分析变量,与临床过程相关的变量,并对诊断测试进行了分析。还分析了与手术程序和术后并发症相关的变量。
    结果:共有36例患者因蠕虫感染需要急诊手术,占紧急腹部手术的0.26%。平均年龄34.91±21.5岁,以男性为主(69.4%)。大多数患者出现右髂窝疼痛(69.4%),其次是与肠梗阻相符的症状(19.4%)。最常见的手术干预措施是阑尾切除术(38.9%),其次是肠切除术(33.3%)和回盲部切除术(11.1%)。植物性蛭虫和单纯性异尖虫合计占样本的75%。年龄差异具有统计学意义(p<0.001),进行诊断测试(p=0.032),术中临床诊断(p=0.005)和手术治疗(p<0.001)。
    结论:肠道蠕虫寄生虫的紧急手术频率正在减少。然而,其中大多数是蛭虫和单异语,有明显不同的临床表现。医生的识别和认可对于进一步的术后管理和可能的并发症仍然是必要的。
    BACKGROUND: All organs of any organism can be affected by helminths. They can be seen in a broad spectrum, from simple infestations to extensive, life-threatening involvement. Symptomatology is usually of chronic latent course. However, sometimes the presentation is acute and requires urgent surgical intervention.
    METHODS: We conducted a retrospective observational prospective recruitment study of patients undergoing emergency surgery for helminth infection from January 2000 to December 2019 at a university hospital. Sociodemographic and analytical variables, variables related to the clinical process, and the diagnostic test were analysed. Variables related to the surgical procedure and postoperative complications were also analysed.
    RESULTS: A total of 36 patients required emergency surgery for their helminth infection, which represented 0.26% of emergency abdominal surgeries. The mean age was 34.91 ± 21.5 years, with a predominance of men (69.4%). Most patients presented with pain in the right iliac fossa (69.4%), followed by symptoms compatible with intestinal obstruction (19.4%). The most frequent surgical interventions were appendectomy (38.9%) followed bowel resection (33.3%) and ileocecal resection (11.1%). Enterobious vermicularis and Anisakis simplex both together accounted for 75% of the sample. Statistically significant differences were identified in age (p < 0.001), diagnostic test performed (p = 0.032), intraoperative clinical diagnosis (p = 0.005) and surgical treatment received (p < 0.001).
    CONCLUSIONS: The frequency of emergency surgeries for intestinal helminth parasitism is decreasing. However, the majority of these are E. vermicularis and Anisakis simplex, which have distinctly different clinical presentations. Identification and recognition by physicians continue to be necessary for further postoperative management and possible complications.
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  • 文章类型: Journal Article
    实施了以学校为基础的大规模驱虫计划,以减少学龄儿童中土壤传播的蠕虫(STH)感染的患病率和强度。然而,以前的研究争论驱虫除了去除蠕虫之外的影响。因此,本研究旨在研究大规模驱虫对埃塞俄比亚学童营养指标的影响.2020年4月至5月,在Jimma镇的1,036名参与者中进行了一项基于学校的横断面研究,埃塞俄比亚。对儿童进行了基于面试官的问卷调查,以收集有关社会人口统计学的数据,生活方式变量,和驱虫状态。对儿童的身高和体重进行人体测量。收集粪便样品并使用直接湿式安装显微镜和Kato-Katz技术分析STH感染。在多变量逻辑回归分析中,在过去的6个月或1年内驱虫与体重不足没有显着相关,发育迟缓,和变薄。然而,过去一年内的驱虫与年龄体重z评分降低显著相关(校正平均差=-0.245;95%CI:-0.413~-0.076;P=0.004).在过去的6个月中,驱虫表明发育迟缓的趋势不明显(调整后比值比=1.258;95%CI:0.923-1.714;P=0.145)。这项研究提供的证据表明,在过去的6个月或1年内驱虫与体重不足没有显着相关,发育迟缓,和变薄。然而,在调整混杂变量后,Jimma镇年轻的埃塞俄比亚学童在过去一年内驱虫与年龄体重z评分显著降低相关.
    School-based mass deworming programs are implemented to reduce soil-transmitted helminth (STH) infection prevalence and intensity among school-aged children. However, previous studies debate the impact of deworming beyond the removal of worms. Hence, this study aimed to examine the effect of mass deworming on nutritional indicators in young Ethiopian schoolchildren. A school-based cross-sectional study was conducted among 1,036 participants from April to May 2020 in Jimma Town, Ethiopia. An interviewer-based questionnaire was administered to the children to gather data on sociodemographic, lifestyle variables, and deworming status. Anthropometric measurements were taken for the height and weight of the children. Stool samples were collected and analyzed for STH infection using direct wet mount microscopy and the Kato-Katz technique. In multivariate logistic regression analysis, deworming within the past 6 months or 1 year was not significantly associated with underweight, stunting, and thinning. However, deworming within the past year was significantly associated with decreased weight-for-age z-score (adjusted mean difference = -0.245; 95% CI: -0.413 to -0.076; P = 0.004). Deworming in the past 6 months demonstrated a nonsignificant trend toward increased stunting (adjusted odds ratio = 1.258; 95% CI: 0.923-1.714; P = 0.145). This study provides evidence that deworming in the past 6 months or 1 year was not significantly associated with underweight, stunting, and thinning. However, deworming within the past year was associated with a significantly decreased weight-for-age z-score in young Ethiopian schoolchildren of Jimma Town after adjustment for confounding variables.
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