Spatial distribution and risk factors of Schistosoma haematobium and hookworm infections among schoolchildren in Kwale, Kenya.
Spatial distribution and risk factors of Schistosoma haematobium and hookworm infections among schoolchildren in Kwale, Kenya.
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DOI：
10.1371/journal.pntd.0005872
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发表时间：
2017-09
影响因子：
3.8
通讯作者：
Hamano S
中科院分区：
文献类型：
--
作者：
Chadeka EA;Nagi S;Sunahara T;Cheruiyot NB;Bahati F;Ozeki Y;Inoue M;Osada-Oka M;Okabe M;Hirayama Y;Changoma M;Adachi K;Mwende F;Kikuchi M;Nakamura R;Kalenda YDJ;Kaneko S;Hirayama K;Shimada M;Ichinose Y;Njenga SM;Matsumoto S;Hamano S
在社会和经济环境不同的地区实施大规模血吸虫病控制方案。血吸虫病的一个关键流行病学特征是其小规模异质性。当地分析疾病动态，包括与其传播相关的风险因素，对于设计适当的控制方案至关重要。为了确定血吸虫病及其驱动因素的空间分布，我们调查了肯尼亚夸莱的学龄儿童。我们进行了一项横断面研究的368名学童从六所小学。粪便中的土源性蠕虫和曼氏血吸虫卵采用Kato-Katz法进行评价。我们通过尿液过滤测量了埃及血吸虫感染的强度。S.每10毫升尿中有3.1个虫卵（学校范围，1.4 - 9.2）。钩虫几何平均强度为3.2个卵/g粪便（学校范围，0 - 17.4）。S.在研究区域内，很明显存在着埃及血吸虫和钩虫感染。为了确定与蠕虫感染强度相关的因素，我们利用负二项广义线性混合模型。S.血吸虫感染与宗教信仰、社会经济地位有关，钩虫感染与社会经济地位、性别、离河流远近、驱虫史有关。两个S。在这个夸莱社区，埃及血吸虫和钩虫感染显示出微地理异质性。为了证实和解释我们观察到的高S值。然而，由于穆斯林中存在结核病风险，因此有必要进行进一步广泛的调查。观察到的小规模集群的S。即使在更精细的规模上，为了有效利用有限的资源，对埃及血吸虫和钩虫感染的研究也可能意味着不太统一的战略。世界卫生组织正在带头对被忽视的热带疾病，包括蠕虫感染的战争，鼓励其成员国加强控制工作。这一呼吁最近在大多数蠕虫病流行地区得到了回应，各国政府正在与私人和公共伙伴合作，扩大以化疗为基础的控制计划。然而，有必要清楚地了解驱动蠕虫感染的局部传播动力学的因素，以设计有效的控制方案。在这里，我们进行了一项横断面调查的夸莱，肯尼亚的368名小学生，并确定了与埃及血吸虫和钩虫感染的强度相关的因素。负二项广义线性混合模型显示了S.在穆斯林和社会经济地位低的家庭的学童中，血吸虫感染率要高得多。钩虫感染的高强度与性别、社会经济地位、距河流的距离和驱虫治疗史有关。我们的研究结果表明，考虑NTDs的社会和文化驱动因素可能有利于设计有效的控制方案和加快NTDs的控制。
Large-scale schistosomiasis control programs are implemented in regions with diverse social and economic environments. A key epidemiological feature of schistosomiasis is its small-scale heterogeneity. Locally profiling disease dynamics including risk factors associated with its transmission is essential for designing appropriate control programs. To determine spatial distribution of schistosomiasis and its drivers, we examined schoolchildren in Kwale, Kenya. We conducted a cross-sectional study of 368 schoolchildren from six primary schools. Soil-transmitted helminths and Schistosoma mansoni eggs in stool were evaluated by the Kato-Katz method. We measured the intensity of Schistosoma haematobium infection by urine filtration. The geometrical mean intensity of S. haematobium was 3.1 eggs/10 ml urine (school range, 1.4–9.2). The hookworm geometric mean intensity was 3.2 eggs/g feces (school range, 0–17.4). Heterogeneity in the intensity of S. haematobium and hookworm infections was evident in the study area. To identify factors associated with the intensity of helminth infections, we utilized negative binomial generalized linear mixed models. The intensity of S. haematobium infection was associated with religion and socioeconomic status (SES), while that of hookworm infection was related to SES, sex, distance to river and history of anthelmintic treatment. Both S. haematobium and hookworm infections showed micro-geographical heterogeneities in this Kwale community. To confirm and explain our observation of high S. haematobium risk among Muslims, further extensive investigations are necessary. The observed small scale clustering of the S. haematobium and hookworm infections might imply less uniform strategies even at finer scale for efficient utilization of limited resources. The World Health Organization is spearheading the war on neglected tropical diseases, including helminth infections, by encouraging its member states to intensify control efforts. This call has recently been answered in most endemic regions of helminthiasis and governments are scaling up chemotherapy-based control programs in collaboration with private and public partners. However, it is necessary to clearly understand factors driving local transmission dynamics of helminth infections to design effective control programs. Here, we conducted a cross-sectional survey of 368 primary schoolchildren in Kwale, Kenya, and identified factors associated with the intensity of Schistosoma haematobium and hookworm infections. The negative binomial generalized linear mixed model showed the intensity of S. haematobium infection was much higher among Muslims and schoolchildren from low socioeconomic status households. High intensity of hookworm infection was associated with sex, SES, distance to river and history of anthelmintic treatment. Our findings demonstrate considering social and cultural drivers of NTDs could be beneficial in designing of efficient control programs and expediting NTDs control.