Assessing the public health importance of Schistosoma mansoni in different endemic areas: Attributable fraction estimates as an approach
Assessing the public health importance of Schistosoma mansoni in different endemic areas: Attributable fraction estimates as an approach
复制标题
DOI：
10.4269/ajtmh.1995.53.660
复制
发表时间：
1995-12-01
影响因子：
3.3
通讯作者：
Tanner, M
中科院分区：
文献类型：
--
作者：
Guyatt, H;Gryseels, B;Tanner, M
曼氏血吸虫病的许多疾病症状的非特异性阻碍了对公共卫生重要性的评估。利用布隆迪两个地区的寄生虫学、临床和记忆学数据，对人口水平和不同年龄层的不同疾病症状的可归因部分进行了估计。很大比例的个体有与曼氏血吸虫感染通常相关的症状，而这些症状不是由这种寄生虫引起的。临床指标以带血腹泻效果最佳。在人群水平上，35%的出血性腹泻病例可归因于曼氏梭菌，而无血腹泻病例中这一比例仅为9%。归因比例与年龄有关，在腹泻（带血和不带血）的情况下，儿童归因曼氏链球菌感染的比例高于成人。感染与疾病症状之间的关联也随着感染强度的增加而增加。在所有症状中，曼氏链球菌的发病率相似，儿童高于成人。归因分数的估计提供了一种量化mansoni相关发病率的简单方法，也可以推广到haematobium和japonicum。对这三种血吸虫在不同流行地区的可归因比例进行估计，将极大地有助于评估这种寄生虫的健康负担和控制规划的有效性。
Assessment of the public health importance of schistosomiasis mansoni is hampered by the nonspecificity of many of its disease symptoms. Parasitologic, clinical, and anamnestic data from two areas in Burundi were used to obtain estimates of the attributable fractions for different disease symptoms at both the population level and within different age strata. A large proportion of individuals had symptoms commonly associated with Schistosoma mansoni infection that were not attributable to this parasite. The clinical indicator with the best test efficiency was shown to be bloody diarrhea. At the population level, 35% of bloody diarrhea cases were attributable to S. mansoni, compared with only 9% of diarrhea cases without blood. The attributable fractions were age-dependent, and in the case of diarrhea (with and without blood), children had a higher proportion of cases attributable to S. mansoni infection than adults. The association between infection and disease symptoms also increased with the intensity of infection. The prevalence of morbidity attributable to S. mansoni was similar for all symptoms, and higher in children than adults. The estimation of attributable fractions provides a simple approach to quantify S. mansoni-related morbidity, which could also be extended to both S. haematobium and S. japonicum. Attributable fraction estimates for these three schistosome species in different endemic areas would greatly aid in the assessment of the health burden of this parasite and the effectiveness of control programs.