Evaluation of the health-related quality of life of children in Schistosoma haematobium-endemic communities in Kenya: a cross-sectional study.
Evaluation of the health-related quality of life of children in Schistosoma haematobium-endemic communities in Kenya: a cross-sectional study.
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DOI：
10.1371/journal.pntd.0002106
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发表时间：
2013
影响因子：
3.8
通讯作者：
Mutuku FM
中科院分区：
文献类型：
--
作者：
Terer CC;Bustinduy AL;Magtanong RV;Muhoho N;Mungai PL;Muchiri EM;Kitron U;King CH;Mutuku FM
血吸虫病仍然是一个全球公共卫生挑战，∼2.37亿感染者中有93%发生在撒哈拉以南非洲。虽然很少致命，但其反复发作的性质使其成为一种终生疾病，具有重大的慢性健康负担。它对健康的负面影响很大程度上是由于非特定情况，如贫血、营养不良、疼痛、运动不耐受、学习成绩差和工作能力下降。这使得很难使用标准的DALY度量来估计特定于血吸虫病的疾病负担。在我们的研究中，我们使用了儿科生活质量问卷(PedsQL)，这是一种适用于2-18岁的模块化工具，以评估生活在肯尼亚沿海血吸虫流行区的儿童的健康相关生活质量(HRQOL)。PedsQL问卷通过访谈的方式对分布在三个区的五个村庄的5-18岁儿童(及其父母)进行。血吸虫高流行村(−4.0%，p<；0.001)和社会经济四分位数较低的村(−2.0%，p<；0.05)的生活质量(总分)显著降低。与生理功能量表相比，心理社会量表的影响更大。在中度流行的村庄，在尿液中检测到任何寄生虫卵与总分显著降低2.1%(p<；0.05)相关。PedsQL信度总体较高(Cronbach Alpas≥为0.70)，地板效应可接受，对低社会经济地位儿童的识别是有效的。我们得出结论，接触泌尿生殖系统血吸虫病与HRQOL下降2-4%有关。有必要进行进一步的研究，以确定血吸虫病患者生存质量检测的重复性和响应性。我们预计，基于更敏感的儿童寄生虫学诊断的病例定义将更好地定义血吸虫感染对HRQOL的直接和长期影响。由于泌尿生殖系统血吸虫病是一种始于儿童早期的数十年慢性疾病，而且由于它是一种可能影响流行社区中几乎每个人的疾病，其对个人健康相关生活质量(HRQOL)的影响一直难以准确衡量。为了更准确地估计血吸虫病对整体健康状况的影响，我们使用了标准化问卷PedsQL SF15问卷，采访了5-18岁的儿童及其父母，以量化他们报告的身体、社交、情感和学业表现状况。与血吸虫病中度流行的村庄相比，血吸虫病高流行村庄的得分显著降低。在调整了年龄、性别、社会经济地位、营养不良、贫血和钩虫寄生虫后，我们发现相对贫困、发育迟缓、消瘦和血吸虫感染是HRQOL得分的显著相关因素，在高流行和中等流行社区有不同的影响。最大的差异是在心理社会领域的表现。我们得出的结论是，接触泌尿生殖系统血吸虫病对HRQOL的总体有害影响程度为2-4%。对儿童更好的诊断的新实施预计将完善我们对这种相关性的估计，以及在有效的个人和社区驱虫后对HRQOL的后续研究。
Schistosomiasis remains a global public health challenge, with 93% of the ∼237 million infections occurring in sub-Saharan Africa. Though rarely fatal, its recurring nature makes it a lifetime disorder with significant chronic health burdens. Much of its negative health impact is due to non-specific conditions such as anemia, undernutrition, pain, exercise intolerance, poor school performance, and decreased work capacity. This makes it difficult to estimate the disease burden specific to schistosomiasis using the standard DALY metric. In our study, we used Pediatric Quality of Life Inventory (PedsQL), a modular instrument available for ages 2–18 years, to assess health-related quality of life (HrQoL) among children living in a Schistosoma haematobium-endemic area in coastal Kenya. The PedsQL questionnaires were administered by interview to children aged 5–18 years (and their parents) in five villages spread across three districts. HrQoL (total score) was significantly lower in villages with high prevalence of S. haematobium (−4.0%, p<0.001) and among the lower socioeconomic quartiles (−2.0%, p<0.05). A greater effect was seen in the psychosocial scales as compared to the physical function scale. In moderate prevalence villages, detection of any parasite eggs in the urine was associated with a significant 2.1% (p<0.05) reduction in total score. The PedsQL reliabilities were generally high (Cronbach alphas ≥0.70), floor effects were acceptable, and identification of children from low socioeconomic standing was valid. We conclude that exposure to urogenital schistosomiasis is associated with a 2–4% reduction in HrQoL. Further research is warranted to determine the reproducibility and responsiveness properties of QoL testing in relation to schistosomiasis. We anticipate that a case definition based on more sensitive parasitological diagnosis among younger children will better define the immediate and long-term HrQoL impact of Schistosoma infection. Because urogenital schistosomiasis is a multi-decadal chronic disease that begins in early childhood, and because it is a disease that may affect nearly everyone in endemic communities, its impact on personal health-related quality of life (HrQoL) has been difficult to gauge accurately. In order to provide a more precise estimate of schistosomiasis' impact on overall health status, we used a standardized questionnaire, the PedsQL SF15 Inventory, to interview children, aged 5–18 years, and their parents, to quantify their reported physical, social, emotional, and scholastic performance status. Scores were significantly lower in villages having high Schistosoma prevalence, as compared those having moderate prevalence. In adjusting for age, sex, socioeconomic standing, undernutrition, anemia, and hookworm parasites, we found that relative poverty, stunting, wasting, and S. haematobium infection were significant correlates of HrQoL scores, with differential effects in high- and moderate-prevalence communities. The greatest differences were noted in the psychosocial domains of performance. We conclude that exposure to urogenital schistosomiasis has an overall detrimental effect on HrQoL at a level of 2–4% impairment. New implementation of better diagnostics for children is expected to refine our estimates of this association, as will follow-up studies of HrQoL following effective individual and community deworming.
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影响因子：
3
作者：
Chan, KS;Mangione-Smith, R;Varni, JW
通讯作者：
Varni, JW
DOI：
10.2471/blt.06.033035
发表时间：
2007-06-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Jia, Tie-Wu;Zhou, Xiao-Nong;Wu, Xiao-Hua
通讯作者：
Wu, Xiao-Hua
影响因子：
3
作者：
KAZIS, LE;ANDERSON, JJ;MEENAN, RF
通讯作者：
MEENAN, RF
影响因子：
168.9
作者：
King, CH;Dickman, K;Tisch, DJ
通讯作者：
Tisch, DJ
影响因子：
2.7
作者：
King, Charles H.
通讯作者：
King, Charles H.