Schistosomiasis, Soil-Transmitted Helminthiasis, and Sociodemographic Factors Influence Quality of Life of Adults in Cote d'Ivoire
Schistosomiasis, Soil-Transmitted Helminthiasis, and Sociodemographic Factors Influence Quality of Life of Adults in Cote d'Ivoire
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DOI：
10.1371/journal.pntd.0001855
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发表时间：
2012-10-01
影响因子：
3.8
通讯作者：
Utzinger, Juerg
中科院分区：
文献类型：
--
作者：
Fuerst, Thomas;Silue, Kigbafori D.;Utzinger, Juerg
背景：疾病负担估算被广泛用于公共卫生领域的重点确定，残疾调整生命年是当今强有力的“货币”。然而，残障权是这种负担计算的基础，残障权的确定仍然是一个广泛争论的问题。残障权反映了典型患者在某种情况下所造成的残疾。方法：在科特迪瓦中南部新近建立的Taabo健康人口监测系统（HDSS）中进行了一项横断面流行病学调查，以提供关于血吸虫病和土壤传播蠕虫病引起的残疾的新的基于人群的证据。将187名成人粪便、尿液和血液的寄生虫学检查结果与生活质量问卷调查结果并置。考虑到从Taabo HDSS数据库中获得的社会人口学特征，采用逐步向后消除的多变量线性回归模型来识别显著关联。主要发现：钩虫、疟原虫、毛滴虫、血血吸虫和曼氏血吸虫的患病率分别为39.0%、18.2%、2.7%、2.1%和2.1%。在0分（最差的生活质量）到100分（最好的生活质量）的范围内，任何强度的曼氏梭菌和毛螺旋体感染分别使参与者的自评生活质量降低了16分（95%置信区间（CI）： 4-29分）和13分（95% CI: 1-24分）。唯一具有统计学意义的其他影响是，计算财富指数每增加一个单位，生活质量量表就增加1点（95% CI: 0.1-2点）。结论/意义：在考虑社会人口学特征的情况下，我们发现血吸虫病和土壤传播蠕虫病对成人自评生活质量的负面影响一致且显著。我们的结果为进一步调查寄生虫感染导致的残疾和通用生活质量问卷在这方面的有效性提供了依据。
Background: Burden of disease estimates are widely used for priority setting in public health and disability-adjusted life years are a powerful "currency" nowadays. However, disability weights, which capture the disability incurred by a typical patient of a certain condition, are fundamental to such burden calculation and their determination remains a widely debated issue.Methodology: A cross-sectional epidemiological survey was conducted in the recently established Taabo health demographic surveillance system (HDSS) in south-central Cote d'Ivoire, to provide new, population-based evidence on the disability caused by schistosomiasis and soil-transmitted helminthiasis. Parasitological results from stool, urine, and blood examinations were juxtaposed to quality of life (QoL) questionnaire results from 187 adults. A multivariable linear regression model with stepwise backward elimination was used to identify significant associations, considering also sociodemographic characteristics obtained from the Taabo HDSS database.Principal Findings: Prevalences for hookworm, Plasmodium spp., Trichuris trichiura, Schistosoma haematobium and Schistosoma mansoni were 39.0%, 18.2%, 2.7%, 2.1% and 2.1%, respectively. S. mansoni and T. trichiura infections of any intensity reduced the participants' self-rated QoL by 16 points (95% confidence interval (CI): 4-29 points) and 13 points (95% CI: 1-24 points), respectively, on a scale from 0 (worst QoL) to 100 points (best QoL). The only other statistically significant effect was a 1-point (95% CI: 0.1-2 points) increase on the QoL scale per one unit increase in a calculated wealth index.Conclusions/Significance: We found consistent and significant results on the negative effects of schistosomiasis and soiltransmitted helminthiasis on adults' self-rated QoL, also when taking sociodemographic characteristics into account. Our results warrant further investigation on the disability incurred by helmintic infections and the usefulness of generic QoL questionnaires in this endeavor.