背景:网虫病,由线虫引起的类圆线虫和类圆线虫,据估计,影响全球超过6亿人。这种疾病在东南亚流行,温暖潮湿的气候和社会经济条件维持寄生虫的生命周期和传播。然而,当前的诊断方法可能不够灵敏,这表明圆线虫病的真正患病率可能被严重低估。本研究旨在通过系统评价和荟萃分析确定东南亚圆线虫病的患病率,并讨论估计患病率对诊断方法和控制策略的影响。
方法:遵循PRISMA指南,我们在PubMed和GoogleScholar数据库中进行了系统的文献检索,以确定截至2022年12月在11个东南亚国家报告了类圆线虫患病率数据的研究.采用随机效应模型来估计地区和国家两级的赤霉病的合并患病率。
结果:在确定的3722篇文章中,224符合我们的纳入标准。特别是对于ST,我们找到了187篇文章,其中52.4%来自泰国。所有东南亚国家,除了文莱,至少有一项关于类圆线虫患病率的研究。估计地区性胸骨链球菌的合并患病率为12.7%(95%CI10.70-14.80%),在国家一级从0.4%到24.9%不等。柬埔寨的合并患病率最高(24.9%,95%CI15.65-35.38%),其次是老挝人民民主共和国(16.5%,95%CI9.50-24.95%)。此外,我们在由移民组成的群体中获得了10%的合并患病率(95%CI7.06-13.52%),工人,来自东南亚国家的退伍军人。S.stercoralis感染各种宿主类型,包括非人类灵长类动物,家养的狗和猫,啮齿动物,和运输载体,如蟑螂和蔬菜。
结论:发现东南亚的圆线虫病患病率很高,强调该地区正在进行的研究的重要性,监视,控制努力。导致线虫病传播的因素包括动物宿主的作用,全球连通性的影响,以及其他类圆线虫物种共同地方性的重要性。基于这些发现,多管齐下的单一健康方法对于可持续干预和控制至关重要。
BACKGROUND: Strongyloidiasis, caused by the nematodes Strongyloides stercoralis and Strongyloides fuelleborni, is estimated to affect over 600 million individuals worldwide. The disease is endemic in Southeast Asia, where a warm-humid climate and socio-economic conditions maintain the parasite\'s life cycle and transmission. However, the current diagnostic methods may not be sufficiently sensitive, suggesting that the true prevalence of strongyloidiasis could be seriously underestimated in this. This study aims to determine the prevalence of
strongyloidiasis in Southeast Asia through a systematic
review and meta-analysis and to discuss the implications of the estimated prevalence on diagnostic approaches and control strategies.
METHODS: Following PRISMA guidelines, we conducted a systematic literature search in PubMed and Google Scholar databases to identify studies reporting Strongyloides prevalence data in the 11 Southeast Asian countries up to December 2022. A random effects model was employed to estimate the pooled prevalence of S. stercoralis at both regional and country levels.
RESULTS: Out of 3722 articles identified, 224 met our inclusion criteria. For S. stercoralis specifically, we found 187 articles, of which 52.4% were from Thailand. All Southeast Asian countries, except Brunei, had at least one study on Strongyloides prevalence. The estimated pooled prevalence of S. stercoralis regionally was 12.7% (95% CI 10.70-14.80%), ranging from 0.4 to 24.9% at the country level. Cambodia had the highest pooled prevalence (24.9%, 95% CI 15.65-35.38%), followed by Lao PDR (16.5%, 95% CI 9.50-24.95%). Moreover, we obtained a pooled prevalence of 10% (95% CI 7.06-13.52%) in a group comprising immigrants, workers, and veterans from Southeast Asian countries. S. stercoralis infects various host types, including nonhuman primates, domestic dogs and cats, rodents, and transport carriers such as cockroaches and vegetables.
CONCLUSIONS: A high prevalence of
strongyloidiasis in Southeast Asia was revealed, highlighting the importance of the region\'s ongoing research, surveillance, and control efforts. Factors contributing to the
strongyloidiasis transmission include the role of animal hosts, the impact of global connectivity, and the significance of the co-endemicity of other Strongyloides species. Based on these findings, a multi-pronged One-Health approach is essential for sustainable intervention and control.