Impact of Fascioliasis among Children in the Peruvian Highlands

片形吸虫病对秘鲁高地儿童的影响

• 批准号: 8473350
• 负责人: MIGUEL MAURICIO CABADA
• 金额: $ 13.13万
• 依托单位: UNIVERSIDAD PERUANA CAYETANO HEREDIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-11 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8473350
• 关键词: Address; Affect; Africa; Anemia; Anemia due to Chronic Disorder; Area; Biological Markers; Body Weight decreased; Case Series; Case-Control Studies; Child; Childhood; Chronic; Cities; Clinical; Clinical Markers; Cognitive; Cohort Studies; Country; Cross-Sectional Studies; Data; Development; Disease; Disease Marker; Early Diagnosis; Early treatment; Epidemiology; Evaluation; Far East; Fasciola; Fascioliasis; Goals; Health; Helminths; Human; Infection; Inflammation; Intervention; Intestines; Iron; Lead; Life; Light; Malnutrition; Measures; Middle East; Minority; Parasites; Pathogenesis; Peru; Play; Poverty; Prevalence; Prevention; Productivity; Public Health; Quality of life; Research Personnel; Resources; Rural Population; Severity of illness; South America; Stress; Testing; Tropical Disease; Tropical Medicine; Weight; Zoonoses; burden of illness; clinical epidemiology; disorder control; energy balance; global health; hepcidin; immunopathology; inflammatory marker; neglect; neuropeptide Y; novel; nutrition; population based; programs; public health relevance; response

DESCRIPTION (provided by applicant): Fascioliasis is a neglected zoonotic human infection with global health importance, especially in the Peruvian highlands where the prevalence in children is among the highest in the world. Most infections by Fasciola are likely to be subclinical and can remain undiagnosed for many years. Case series of chronic fascioliasis have associated the infection with anemia and weight loss, which carry devastating consequences for children's cognitive development and productivity later in life. The epidemiology of these conditions associated with Fasciola is not well understood. Although, chronic inflammation has been postulated as the common underlying mechanism, the markers and clinical course of these complications have not been well described. We hypothesize that subclinical fascioliasis is the most common presentation in highly endemic areas and is responsible for complications rarely attributed to the parasite like anemia and malnutrition. We also hypothesize that chronic inflammation is responsible for these complications and that newly described markers will shed light into fascioliasis pathogenic mechanisms. To test these hypotheses we intend to perform a comprehensive evaluation of anemia and nutrition among children in the southern highlands of Peru. Through cross-sectional studies a large number of children will be screened for fascioliasis, anemia and malnutrition, and other intestinal helminths. A case-control study to define the mechanism of anemia will include iron studies and markers of inflammation (including a newly described marker called hepcidin that play a key role in anemia of chronic disease). Studies to evaluate the impact on nutrition and the mechanisms associated with weight lost will be performed (using Neuropeptide Y as a marker for negative shifts in energy balance). A one year cohort study to evaluate the severity of illnesses, response of anemia and malnutrition to treatment of fascioliasis and other helminths, and markers associated with fascioliasis will be performed. Our results will provide important epidemiologic and pathophysiologic information adding to the understanding of Fasciola associated anemia and malnutrition. The integration of this information with current disease interventions will lead to better planning and use of resources. But most importantly, will stress the need for early diagnosis and treatment of fascioliasis to avoid long term complications in children.

描述（由申请人提供）：片形吸虫病是一种被忽视的人畜共患人类感染，具有全球健康重要性，特别是在秘鲁高地，那里儿童的患病率是世界上最高的之一。大多数片形吸虫感染可能是亚临床的，并且可能多年未得到诊断。慢性片形吸虫病病例系列表明，感染与贫血和体重减轻有关，这对儿童以后的认知发展和生产力造成毁灭性后果。这些与片形吸虫相关的病症的流行病学尚不清楚。尽管慢性炎症被认为是常见的潜在机制，但这些并发症的标志物和临床过程尚未得到很好的描述。我们假设亚临床片形吸虫病是高流行地区最常见的表现，并导致很少归因于寄生虫的并发症，如贫血和营养不良。我们还假设慢性炎症是导致这些并发症的原因，并且新描述的标记物将揭示片形吸虫病的致病机制。为了检验这些假设，我们打算对秘鲁南部高地儿童的贫血和营养状况进行全面评估。通过横断面研究，将对大量儿童进行片形吸虫病、贫血和营养不良以及其他肠道蠕虫病的筛查。定义贫血机制的病例对照研究将包括铁研究和炎症标记物（包括新描述的称为铁调素的标记物，它在慢性病贫血中发挥关键作用）。将进行评估对营养的影响以及与减肥相关的机制的研究（使用神经肽 Y 作为能量平衡负向变化的标记）。将进行一项为期一年的队列研究，以评估疾病的严重程度、贫血和营养不良对片形吸虫病和其他蠕虫治疗的反应，以及与片形吸虫病相关的标志物。我们的结果将提供重要的流行病学和病理生理学信息，增加对片形吸虫相关贫血和营养不良的理解。将这些信息与当前的疾病干预措施相结合将有助于更好地规划和利用资源。但最重要的是，将强调需要早期诊断和治疗片形吸虫病，以避免儿童出现长期并发症。