Soil-Transmitted Helminth Infections among Plantation Sector Schoolchildren in Sri Lanka: Prevalence after Ten Years of Preventive Chemotherapy
Soil-Transmitted Helminth Infections among Plantation Sector Schoolchildren in Sri Lanka: Prevalence after Ten Years of Preventive Chemotherapy
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DOI：
10.1371/journal.pntd.0001341
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发表时间：
2011-09-01
影响因子：
3.8
通讯作者：
de Silva, Nilanthi
中科院分区：
文献类型：
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作者：
Gunawardena, Kithsiri;Kumarendran, Balachandran;de Silva, Nilanthi
背景：斯里兰卡的种植园部门在生活条件和健康方面落后于该国其他地区。1992年，对3-12岁儿童和育龄妇女进行的全部门调查显示，土壤传播蠕虫感染率超过90%。针对3-18岁儿童的半年一次大规模驱虫始于1994年，一直持续到2005年。本研究进行了评估的感染状况四年后停止大规模de-worming.Methods/Findings：一所学校为基础的横断面调查进行。使用改良的Kato-Katz技术检查了来自五个地区114所学校的约20名儿童的粪便样本。在对学校和家庭进行视察后，记录了有关学校、儿童家庭和家庭卫生的数据。使用逻辑回归进行多变量分析，以确定感染的危险因素。从1890名儿童身上采集了粪便样本。在4/5的地区，.20%感染一种或多种蠕虫。总体合并患病率为29.0%; 11.6%的患者有中度至重度感染。最常见的感染是蛔虫，在所有五个区都有，鞭虫也是如此。在两个地区没有发现钩虫。多因素分析确定低海拔和母亲受教育程度低是所有三种感染的危险因素。家庭卫生条件差是A.蛔虫和钩虫，而T.结论/意义：结果表明，定期大规模驱虫种植园部门的儿童应恢复沿着，更强调更好的卫生和健康教育。他们表明，即使经过10年的大规模化疗，如果最初的传播力量很强，而其他长期控制措施没有同时实施，那么在停止预防性化疗后，流行率可以反弹。
Background: The plantation sector in Sri Lanka lags behind the rest of the country in terms of living conditions and health. In 1992, a sector-wide survey of children aged 3-12 years and women of reproductive age showed >90% prevalence of soil-transmitted helminth infections. Biannual mass de-worming targeting children aged 3-18 years started in 1994 and was continued until 2005. The present study was carried out to assess the status of infection four years after cessation of mass de-worming.Methods/Findings: A school-based cross-sectional survey was carried out. Faecal samples from approximately 20 children from each of 114 schools in five districts were examined using the modified Kato-Katz technique. Data regarding the school, the child's family and household sanitation were recorded after inspection of schools and households. Multivariate analysis was carried out using logistic regression, to identify risk factors for infection. Faecal samples were obtained from 1890 children. In 4/5 districts,.20% were infected with one or more helminth species. Overall combined prevalence was 29.0%; 11.6% had infections of moderate-heavy intensity. The commonest infection was Ascaris lumbricoides, present in all five districts, as was Trichuris trichiura. Hookworm was not detected in two districts. Multivariate analysis identified low altitude and maternal under-education as risk factors for all three infections. Poor household sanitation was identified as a risk factor for A. lumbricoides and hookworm, but not T. trichiura infections.Conclusions/Significance: The results indicate that regular mass de-worming of plantation sector children should be resumed along with more emphasis on better sanitation and health education. They show that even after 10 years of mass chemotherapy, prevalence can bounce back after cessation of preventive chemotherapy, if the initial force of transmission is strong and other long-term control measures are not concomitantly implemented.