Nutritional status improves after treatment of Schistosoma japonicum -: Infected children and adolescents
Nutritional status improves after treatment of Schistosoma japonicum -: Infected children and adolescents
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DOI：
10.1093/jn/136.1.183
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发表时间：
2006-01-01
影响因子：
4.2
通讯作者：
Friedman, JF
中科院分区：
文献类型：
--
作者：
Coutinho, HM;Acosta, LP;Friedman, JF
关于慢性血吸虫病与营养状况关系的研究有限。我们在菲律宾的莱特对477名7-20岁的日本血吸虫感染者进行了一项纵向治疗-再感染研究，以评估吡喹酮治疗后营养状况的变化。在基线、治疗后4 wk和每3 mo评价大便、坦纳分期、人体测量学指标和血红蛋白（Hb），持续18 mo。计算年龄别身高Z评分（HAZ）和BMI Z评分（BMIZ）。为所有结局指标创建相对于基线的变化评分。多水平重复测量分析用于调整社会经济地位，性别，青春期状态或年龄，以及家庭水平的聚类。Z评分随着时间的推移略有改善，但有显著性。基线消瘦儿童的BMIZ改善最多[0.41（0.26-0.56）Z评分单位]，HAZ仅在基线发育迟缓儿童中改善[0.17（0.12-0.21）Z评分单位]。Hb改善在15个月时达到峰值，仅发生在基线贫血受试者[改善峰值：8.3（6.0-10.6）g/L]和男性[改善峰值：4.7（2.9-6.6）g/L]中。再感染，评估随着时间的推移和鸡蛋计数3个月前评估延迟效应，与血红蛋白的改善呈负相关（P = 0.06和0.004，分别）。与低强度和无再感染相比，18个月时高强度再感染与基线绝对生长显著减少相关。根据治疗后15个月时Hb改善峰值，建议每年治疗一次，以减少与染色体相关的营养性发病率。
Studies addressing the relation between chronic schistosomiasis japonica and nutritional status are limited. We conducted a longitudinal treatment-reinfection study in Leyte, the Philippines, among 477 Schistosoma japonicum-infected subjects aged 7-20 y, to evaluate changes in nutritional status after treatment with praziquantel. Stool, Tanner stage, anthropometric indices, and hemoglobin (Hb) were evaluated at baseline, 4 wk post-treatment, and every 3 mo for 18 mo. Height-for-age Z-score (HAZ) and BMI Z-score (BMIZ) were calculated. Change scores relative to baseline were created for all outcome measures. Multilevel repeated-measures analyses were used to adjust for socioeconomic status, sex, either pubertal status or age, and household-level clustering. Z-scores improved modestly but significantly over time. BMIZ in children wasted at baseline improved the most [0.41 (0.26-0.56) Z-score unit] and HAZ improved only in children stunted at baseline [0.17 (0.12-0.21) Z-score unit]. Hb improvement peaked at 15 mo and occurred only in subjects that were anemic at baseline [peak improvement: 8.3 (6.0-10.6) g/L] and in males [peak improvement 4.7 (2.9-6.6) g/L]. Reinfection, evaluated as egg count over time and egg count 3 mo earlier to assess a delay in effect, was inversely associated with improvement in Hb (P = 0.06 and 0.004, respectively). High-intensity reinfection at 18 mo was associated with significantly less absolute growth from baseline compared with lower-intensity and no reinfection. Based on the peak Hb improvement at 15 mo post-treatment, annual treatment intervals are recommended to reduce schistosomiasis-associated nutritional morbidity.