Malnutrition and parasitic helminth infections
Malnutrition and parasitic helminth infections
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DOI：
10.1017/s0031182000006491
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发表时间：
2000-01-01
期刊：
影响因子：
2.4
通讯作者：
Ottesen, EA
中科院分区：
文献类型：
--
作者：
Stephenson, LS;Latham, MC;Ottesen, EA
由3种主要肠道线虫引起的全球疾病负担估计为钩虫损失2210万残疾调整生命年（DADs），蛔虫损失1050万残疾调整生命年，鞭虫损失640万残疾调整生命年，三种感染合计损失3900万残疾调整生命年（而疟疾为3 570万人）（世界银行，1993年; Chan等人，1994年）;这些数字说明了为什么必须将一些稀缺的保健资源用于控制疟疾。粪类圆线虫是第四个最重要的肠道蠕虫感染，其营养的影响进行了讨论，并强调其地理分布需要进一步研究的事实。肠道蠕虫引起的营养不良的机制进行了描述，厌食症，它可以减少摄入的所有营养物质在热带人口的边缘饮食，可能是最重要的幅度和可能的主要机制，肠道线虫抑制生长和发育。我们提出了一个修订和扩大的概念框架，寄生虫如何引起/加重营养不良和发展迟缓的流行地区。具体的负面影响，各种各样的寄生虫可能对胃肠道生理。鞭虫和弯曲杆菌之间的协同作用，肠道炎症和生长障碍，以及新的研究表明，钩虫抑制生长和促进学龄前（以及学龄）儿童贫血。最后，我们提出了理由和证据，证明应确保肠道寄生虫控制方案尽可能广泛地覆盖学龄前儿童、女童和育龄妇女，以防止发病率和死亡率，特别是帮助减少生长失败的恶性代际循环。（指出生体重不足/胎儿宫内发育迟缓和发育不良）使发展中地区的婴儿、儿童、女孩和育龄妇女陷入困境。
The Global Burden of Disease caused by the 3 major intestinal nematodes is an estimated 22.1 million disability-adjusted life-years (DALYs) lost for hookworm, 10.5 million for Ascaris lumbricoides, 6.4 million for Trichuris trichiura, and 39.0 million for the three infections combined (as compared with malaria at 35.7 million) (World Bank, 1993; Chan et al. 1994); these figures illustrate why some scarce health care resources must be used for their control. Strongyloides stercoralis is the fourth most important intestinal worm infection ; its nutritional implications are discussed, and the fact that its geographic distribution needs further study is emphasized. Mechanisms underlying the malnutrition induced by intestinal helminths are described, Anorexia, which can decrease intake of all nutrients in tropical populations on marginal diets, is likely to be the most important in terms of magnitude and the probable major mechanism by which intestinal nematodes inhibit growth and development. We present a revised and expanded conceptual framework for how parasites cause/aggravate malnutrition and retard development in endemic areas. Specific negative effects that a wide variety of parasites may have on gastrointestinal physiology are presented. The synergism between Trichuris and Campylobacter, intestinal inflammation and growth failure, and new studies showing that hookworm inhibits growth and promotes anaemia in preschool (as well as school-age) children are presented. We conclude by presenting rationales and evidence to justify ensuring the widest possible coverage for preschool-age children and girls and women of childbearing age in intestinal parasite control programmes, in order to prevent morbidity and mortality in general and specifically to help decrease the vicious intergenerational cycle of growth failure (of low-birth-weight/intrauterine growth retardation and stunting) that entraps infants, children and girls and women of reproductive age in developing areas.