Helminth infection and the risk of tuberculosis in children

蠕虫感染和儿童患结核病的风险

• 批准号: 7406560
• 负责人: Molly Forrest Franke
• 金额: $ 3.78万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7406560
• 关键词: Helminth; infection; risk; tuberculosis; children

DESCRIPTION (provided by applicant): In the year 2000, an estimated 884,019 children less than 15 years of age became ill with tuberculosis. Despite the existence of curative therapy, the World Health Organization (WHO) has estimated that approximately one third of TB cases among children in this age group result in death. The paucity of data describing TB risk factors in children poses a challenge to the design of interventions that could decrease TB disease progression in this group. The identification of modifiable risk factors might lead to interventions that could substantially decrease TB-related morbidity and mortality in children. Helminth infection, including round worm and hookworm infection, may be one such risk factor. Recent case-control studies in adults and adolescents demonstrate that TB disease is associated with both helminth infection and immunological responses consistent with helminth infection. To date, however, no studies have examined the association between TB endpoints and helminth infection in children, the group most vulnerable to helminth infection and about which the least is known regarding risk factors for progression to active TB disease. The general objective of this study is to examine whether helminth infection increases susceptibility to TB infection and TB disease in children. We will pursue the following specific aims: (1) To determine whether helminth infection among children is associated with an increased risk of TB infection and disease; (2) To examine whether there is a dose-response relationship between the total burden of helminths and/or the number of helminth species with which a child is infected and progression to active TB disease and infection; (3) To compare the immune response to TB disease in children with and without helminths. We will conduct two matched case-control studies in Lima, Peru. To examine whether helminth infection is a risk factor for active TB disease, we will compare the prevalence of helminth infection among children with and without TB disease. To examine whether helminth infection is a risk factor for TB infection, we will compare the prevalence of helminth infection among children with and without TB infection. In both studies we will measure parasite burden and compare serum IgE levels in these two groups. Cases will be matched to controls by age, neighborhood, and TB contact history.

描述（由申请人提供）：2000年，估计有884，019名15岁以下的儿童患结核病。尽管存在治愈性疗法，但世界卫生组织（世卫组织）估计，这一年龄组的儿童中约有三分之一的结核病病例导致死亡。描述儿童结核病风险因素的数据缺乏，这对设计可减少这一群体结核病进展的干预措施构成了挑战。确定可改变的风险因素可能会导致采取干预措施，大幅度降低儿童结核病相关的发病率和死亡率。蠕虫感染，包括蛔虫和钩虫感染，可能是一个这样的危险因素。最近在成人和青少年中进行的病例对照研究表明，结核病与蠕虫感染和与蠕虫感染一致的免疫反应有关。然而，迄今为止，还没有研究检查结核终点与儿童蠕虫感染之间的关联，儿童是最容易感染蠕虫的群体，关于进展为活动性结核病的风险因素知之甚少。 本研究的总体目标是检查蠕虫感染是否会增加儿童对结核感染和结核病的易感性。我们将追求以下具体目标：（1）确定儿童感染蠕虫是否与结核病感染和疾病风险增加有关;（2）研究儿童感染蠕虫的总负担和/或蠕虫种类数量与进展为活动性结核病和感染之间是否存在剂量-反应关系;（3）比较有蠕虫和无蠕虫儿童对结核病的免疫应答。我们将在秘鲁利马进行两项配对病例对照研究。为了检验蠕虫感染是否是活动性结核病的一个危险因素，我们将比较患有和未患有结核病的儿童的蠕虫感染率。为了研究蠕虫感染是否是结核病感染的一个危险因素，我们将比较感染和未感染结核病的儿童的蠕虫感染率。在这两项研究中，我们将测量寄生虫负荷并比较这两组的血清IgE水平。病例将根据年龄、社区和结核病接触史与对照组相匹配。