Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a Co-endemic setting.
Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a Co-endemic setting.
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DOI：
10.1371/journal.pntd.0001292
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发表时间：
2011-08
影响因子：
3.8
通讯作者：
Utzinger J
中科院分区：
文献类型：
--
作者：
Becker SL;Sieto B;Silué KD;Adjossan L;Koné S;Hatz C;Kern WV;N'Goran EK;Utzinger J
粪类圆线虫和其他蠕虫感染是发展中国家的一个重要但经常被忽视的问题。事实上，类圆线虫病可能致命，但只有少数研究提供了有关其在非洲健康相关性的信息。此外，症状学和典型识别模式的临床数据主要来源于西方旅行诊所。在科特迪瓦中南部农村地区进行了横断面流行病学调查。使用一套诊断技术（即 Kato-Katz、贝尔曼漏斗和 Koga 琼脂平板）对 292 名随机选择的个体的粪便样本进行肠道蠕虫检查。参与者接受了预先测试的问卷调查并进行了临床检查。进行多变量逻辑回归分析，将感知的发病率和临床结果与蠕虫感染状态联系起来。钩虫和粪圆线虫的患病率分别为51.0%和12.7%。两种感染彼此密切相关（调整后的比值比，6.73；P<0.001），并且随着年龄的增长，患病率更高。粪圆线虫感染的个体比钩虫感染的个体更频繁地表达自我报告的发病情况。临床检查发现蠕虫感染者各种疾病的患病率很高，并发现健康状况恶化的趋势。多种诊断工具的使用表明，粪圆线虫和钩虫在科特迪瓦农村地区同时流行，每种感染都会引起临床症状和后遗症。我们的研究结果对于（重新）估计蠕虫感染的负担非常重要，并强调了在发展中国家整合流行病学调查、严格的诊断方法和临床评估的必要性。钩虫和蛔虫（粪类圆线虫）等寄生虫感染在发展中国家普遍存在。然而，寄生虫引起的症状不具有特异性，而且人们对流行国家的临床表现知之甚少，因此医生对这些疾病的认识通常较低。因此，许多感染在很长一段时间内未被发现和治疗。因此，寄生虫会损害感染者的健康，并造成有害的、有时甚至致命的健康结果。为了提高对寄生虫引起的临床症状和体征的了解，我们对科特迪瓦农村地区的 292 名儿童和成人进行了问卷调查，对他们进行了临床检查，并检查了他们的粪便是否有寄生虫感染。我们发现，患有寄生虫的人比没有寄生虫的人更容易出现一些症状，尤其是胃肠道疾病。我们的临床检查显示，蠕虫感染者的健康状况有恶化的趋势，尤其是粪圆线虫感染者。我们的结果对于改善患者管理和控制措施以及更好地估计寄生虫感染对健康的真正影响非常重要。
Infections with Strongyloides stercoralis and other helminths represent important, yet often neglected issues in developing countries. Indeed, strongyloidiasis can be fatal, but only a few studies provide information regarding its health relevance in Africa. Moreover, clinical data on symptomatology and typical recognition patterns mainly originate from Western travel clinics. A cross-sectional epidemiological survey was carried out in a rural part of south-central Côte d'Ivoire. Stool samples from 292 randomly selected individuals were examined for intestinal helminths, using a suite of diagnostic techniques (i.e., Kato-Katz, Baermann funnel, and Koga agar plate). Participants were interviewed with a pre-tested questionnaire and clinically examined. Multivariate logistic regression analysis was done to relate perceived morbidity and clinical findings to helminth infection status. The prevalence of hookworm and S. stercoralis was 51.0% and 12.7%, respectively. Both infections were strongly associated with each other (adjusted odds ratio, 6.73; P<0.001) and higher prevalences were observed with age. S. stercoralis-infected individuals expressed self-reported morbidity considerably more often than those with hookworm infection. Clinical examination identified high prevalences of various pathologies and detected tendencies to worse health conditions in helminth-infected subjects. The use of multiple diagnostic tools showed that S. stercoralis and hookworm are co-endemic in rural Côte d'Ivoire and that each infection causes clinical symptoms and sequelae. Our findings are important for (re-)estimating the burden of helminth infections, and highlight the need for integrating epidemiological surveys, rigorous diagnostic approaches, and clinical assessments in the developing world. Infections with parasitic worms such as hookworm and threadworm (Strongyloides stercoralis) are widespread throughout the developing world. However, the symptoms caused by parasitic worms are unspecific and little is known about clinical presentations in endemic countries, and hence doctors' awareness of these diseases is usually low. Many infections therefore remain undetected and untreated over long time periods. As a consequence, parasitic worms can impair the well-being of infected individuals and cause harmful, sometimes even fatal health outcomes. To improve the knowledge about clinical signs and symptoms caused by parasitic worms, we administered a questionnaire to 292 children and adults in rural Côte d'Ivoire, examined them clinically, and looked at their stool for parasitic worm infections. We found that people with parasitic worms reported some symptoms, especially disorders of the gastrointestinal tract, more often than those without worms. Our clinical examination showed a trend toward worse health conditions in worm-infected people, particularly in those with S. stercoralis. Our results are important to improve patient management and control measures, and to better estimate the true health impact of parasitic worm infections.
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影响因子：
3.8
作者：
King CH;Bertino AM
通讯作者：
Bertino AM
DOI：
10.4269/ajtmh.1991.45.518
发表时间：
1991-10-01
影响因子：
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影响因子：
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影响因子：
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