Human Intestinal Parasite Burden and Poor Sanitation in Rural Alabama
Human Intestinal Parasite Burden and Poor Sanitation in Rural Alabama
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DOI：
10.4269/ajtmh.17-0396
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发表时间：
2017-01-01
影响因子：
3.3
通讯作者：
Mejia, Rojelio
中科院分区：
文献类型：
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作者：
McKenna, Megan L.;McAtee, Shannon;Mejia, Rojelio
钩虫感染影响全球4.3亿人，导致缺铁、认知发育受损和儿童发育迟缓。由于钩虫生命周期所需的环境条件，这种寄生虫在资源有限的国家是地方性的。在污水处理系统改善和根除计划之前，美洲Necator是美国南部的地方病。在美国南部的一些地区，由于持续的贫困、恶劣的卫生条件和适合钩虫生命周期的环境，目前有必要使用现代分子诊断技术进行流行病学研究。阿拉巴马州朗兹县之所以被选为研究地点，是因为该地区以前钩虫数量多、贫困程度高，而且使用了开放式污水处理系统。对参与者进行访谈，并使用多重平行定量实时pcr （qPCR）和酶联免疫吸附试验对粪便、血清和土壤样本进行9种肠道寄生虫检测。我们发现，在24个家庭中，有42.4%的人报告在家中接触过未经处理的污水，从55个粪便样本中，19个（34.5%）检测出美洲蜱虫阳性，4个（7.3%）检测出粪类圆线虫阳性，1个（1.8%）检测出溶组织内阿米巴阳性。粪便美洲蠊检测呈阳性，含有低水平的寄生虫DNA（几何平均0.0302 fg/ μ L）。土壤检测隐孢子虫1种（2.9%），弓形虫血清学检测弓形虫1种（5.2%）。生活在美国这种高风险环境中的个人，粪便样本中仍有美洲乳杆菌阳性。已知发展中国家特有的胃肠道寄生虫在美国贫困地区可以识别，而疾病负担较低的地区更有可能通过qPCR识别。
Hookworm infection affects 430 million people worldwide, causing iron deficiency, impaired cognitive development, and stunting in children. Because of the environmental conditions needed for the hookworm life-cycle, this parasite is endemic to resource-limited countries. Necator americanus was endemic in the southern United States before improvement of sewage disposal systems and eradication programs. With continued poverty, poor sanitation, and an environment suitable for the hookworm life-cycle in some regions of the southern United States, a current prevalence study using modern molecular diagnostics is warranted. Lowndes County, Alabama, was chosen as the study site given previous high hookworm burdens, degree of poverty, and use of open-sewage systems. Participants were interviewed, and stool, serum, and soil samples were tested for nine intestinal parasites using a multiparallel quantitative real-timePCR (qPCR) and enzyme-linked immunosorbent assays. We found that, among 24 households, 42.4% reported exposure to raw sewage within their home, and from 55 stool samples, 19 (34.5%) tested positive for N. americanus, four (7.3%) for Strongyloides stercoralis, and one (1.8%) for Entamoeba histolytica. Stool tested positive for N. americanus contained low levels of parasite DNA (geometric mean 0.0302 fg/mu L). Soil studies detected one (2.9%) Cryptosporidium species, and Toxocara serology assay detected one (5.2%) positive in this population. Individuals living in this high-risk environment within the United States continue to have stool samples positive for N. americanus. Gastrointestinal parasites known to be endemic to developing countries are identifiable in American poverty regions, and areas with lower disease burden are more likely to be identified by using qPCR.