Gender-related differences in prevalence, intensity and associated risk factors of Schistosoma infections in Africa: A systematic review and meta-analysis.
Gender-related differences in prevalence, intensity and associated risk factors of Schistosoma infections in Africa: A systematic review and meta-analysis.
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DOI：
10.1371/journal.pntd.0009083
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发表时间：
2021-11
影响因子：
3.8
通讯作者：
Hollingsworth TD
中科院分区：
文献类型：
--
作者：
Ayabina DV;Clark J;Bayley H;Lamberton PHL;Toor J;Hollingsworth TD
血吸虫病仍然是一个全球性的健康问题，90%以上的负担集中在非洲。实地研究反映了社会文化和社会经济变量在不同人群中影响血吸虫感染分布的复杂方式。本综述旨在系统地调查和量化非洲两种最流行的血吸虫物种--曼氏血吸虫和血吸虫的男性和女性感染血吸虫负担的差异。计算机检索Embase、MEDLINE、PubMed和Web of Science(从最初到2020年3月11日)与血吸虫病相关的研究。我们纳入了报告曼氏葡萄球菌和/或血瘤沙门氏菌流行率和/或强度数据的研究，这些数据分布在男性和女性之间。我们对男性与女性(男：女)的感染率进行了荟萃分析。根据研究基线患病率、样本量以及研究参与者的年龄下限和上限进行亚组分析。我们还对男性和女性之间不同的感染风险和强度进行了描述性分析。根据血吸虫种类分层，提出了男性和女性之间血吸虫病感染率差异的证据。我们确定了128项相关研究，涉及23个国家的20多万名参与者。在所有报告的男性和女性之间的感染率差异中，只有41%和34%的曼氏葡萄球菌和血瘤葡萄球菌的感染率在统计上有显著差异。报告的男性和女性之间感染强度差异的研究相似比例(血瘤链球菌和曼氏葡萄球菌分别为27%和34%)在统计学上具有显著意义。Meta分析总结出男性感染率较高；合并随机效应加权M：F感染比分别为1.20(95%可信区间1.11-1.29)和1.15(95%可信区间1.08-1.22)。然而，在一些研究中，女性被忽视了。此外，研究之间存在显著的异质性(Higgins I2统计量(P值和lt；0.001，I2Values和gt；95%))。亚组分析的结果表明，基线流行率影响血吸虫和曼氏葡萄球菌的M：F流行率，在基线感染率较低的环境中，感染比率的M：F流行率较高。在整个研究中，我们确定了与感染率有关的四个主要风险因素：职业和娱乐用水接触、知识、社会经济因素和人口因素。这些危险因素对男性和女性感染负担的影响在不同的研究中有所不同。我们发现了男性和女性感染率差异的证据，这可能反映了性别规范和水接触活动的差异，表明区域一级的政策变化可能有助于改善血吸虫病感染负担中与性别相关的差异。目前缺乏按性别分列的流行病学数据的收集、强有力的分析和报告，但对于规划有效的治疗方案和确定血吸虫病感染风险最大的人群来说，这将是非常有用的。血吸虫病是一种寄生性水传播疾病，每年影响全球2.4亿多人，特别是在撒哈拉以南非洲地区。男性和女性在血吸虫感染率、感染强度和风险方面的差异很少被量化。在这项研究中，我们的目标是定性和定量地综合已发表的研究，这些研究提供按性别分类的流行病学数据，并调查使男性或女性更容易受到感染风险的性别差异(例如，由社会和文化规范驱动的性别差异)。基于我们的荟萃分析中包含的123项研究，我们发现血吸虫(曼氏血吸虫和血吸虫)在男性中的患病率更高。
Schistosomiasis remains a global-health problem with over 90% of its burden concentrated in Africa. Field studies reflect the complex ways in which socio-cultural and socio-economic variables, affect the distribution of Schistosoma infections across different populations. This review set out to systematically investigate and quantify the differences in Schistosoma infection burdens between males and females in Africa for two of the most prevalent Schistosoma species—Schistosoma mansoni and Schistosoma haematobium. We searched (from inception to 11th March 2020) Embase, MEDLINE, PubMed, and Web of Science for relevant studies on schistosomiasis. We included studies that report S. mansoni and/or S. haematobium prevalence and/or intensity data distributed between males and females. We conducted meta-analyses on the male to female (M:F) prevalence of infection ratios. Subgroup analyses were performed according to study baseline prevalence, sample size and the lower and upper age limit of study participants. We also present a descriptive analysis of differential risk and intensity of infection across males and females. Evidence for differences in the prevalence of schistosomiasis infection between males and females is presented, stratified by Schistosoma species. We identified 128 relevant studies, with over 200,000 participants across 23 countries. Of all the reported differences in the prevalence of infection between males and females, only 41% and 34% were statistically significant for S. mansoni and S. haematobium, respectively. Similar proportions of studies (27% and 34% for for S. haematobium and S. mansoni, respectively) of the reported differences in intensity of infection between males and females were statistically significant. The meta-analyses summarized a higher prevalence of infection in males; pooled random-effects weighted M:F prevalence of infection ratios were 1.20 (95% CI 1.11–1.29) for S. haematobium and 1.15 (95% CI 1.08–1.22) for S. mansoni. However, females are underrespresented in some of the studies. Additionally, there was significant heterogeneity across studies (Higgins I2 statistic (p-values < 0.001, I2values>95%)). Results of the subgroup analysis showed that the baseline prevalence influenced the M:F prevalence ratios for S. haematobium and S. mansoni, with higher M:F prevalence of infection ratios in settings with a lower baseline prevalence of infection. Across the studies, we identified four major risk factors associated with infection rates: occupational and recreational water contact, knowledge, socio-economic factors and demographic factors. The effect of these risk factors on the burden of infection in males and females varied across studies. We find evidence of differences in prevalence of infection between males and females which may reflect differences in gender norms and water contact activities, suggesting that policy changes at the regional level may help ameliorate gender-related disparities in schistosomiasis infection burden. Collecting, robustly analysing, and reporting, sex-disaggregated epidemiological data, is currently lacking, but would be highly informative for planning effective treatment programmes and establishing those most at risk of schistosomiasis infections. Schistosomiasis is a parasitic waterborne disease affecting more than 240 million people worldwide every year, especially in sub-Saharan Africa. The difference in schistosoma infection prevalence, infection intensity and risk between males and females has rarely been quantified. In this study, we aim to qualitatively and quantitatively synthesise published studies that present sex-disaggregated epidemiological data and investigate gender differences (e.g. those driven by social and cultural norms) that predispose males or females to higher risk of infection. Based on the 123 studies included in our meta-analysis, we found a higher prevalence of Schistosoma (S. mansoni and S. haematobium) in males.
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影响因子：
2.2
作者：
Abdulkareem BO;Habeeb KO;Kazeem A;Adam AO;Samuel UU
通讯作者：
Samuel UU
DOI：
10.4269/ajtmh.2000.62.28
发表时间：
2000-02-01
影响因子：
3.3
作者：
Abdel-Wahab, MF;Esmat, G;Strickland, GT
通讯作者：
Strickland, GT
DOI：
10.4269/ajtmh.2000.62.55
发表时间：
2000-02-01
影响因子：
3.3
作者：
Abdel-Wahab, MF;Esmat, G;Strickland, GT
通讯作者：
Strickland, GT
影响因子：
3.1
作者：
Amuta, E. U.;Houmsou, R. S.
通讯作者：
Houmsou, R. S.
影响因子：
6.4
作者：
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通讯作者：
Lotter, Hanna