Risk factors and spatial distribution of Schistosoma mansoni infection among primary school children in Mbita District, Western Kenya.

Risk factors and spatial distribution of Schistosoma mansoni infection among primary school children in Mbita District, Western Kenya.
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DOI:
10.1371/journal.pntd.0002991
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发表时间:
2014-07
影响因子:
3.8
通讯作者:
Hamano S
Hamano S
中科院分区:
医学2区
文献类型:
--
作者:
Nagi S;Chadeka EA;Sunahara T;Mutungi F;Justin YK;Kaneko S;Ichinose Y;Matsumoto S;Njenga SM;Hashizume M;Shimada M;Hamano S

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自20世纪70年代以来,在肯尼亚西部的维多利亚湖周围观察到曼氏血吸虫感染的风险增加。了解血吸虫病的当地传播动态对于减少感染风险的增加至关重要。我们对来自八所小学的310名儿童进行了横断面研究。总的来说,共有238名(76.8%)儿童感染了S。mansoni,而7例(2.3%)为S.埃及血吸虫钩虫、鞭虫和蛔虫的感染率分别为6.1%、5.2%和2.3%。恶性疟原虫是唯一检测到的疟原虫(12.0%)。以房屋为中心的1 km范围内的高人口密度被确定为主要的独立危险因素。曼氏感染。在对人口密度和其他潜在风险因素进行调整后,在Mbita堤道周围发现了一个高感染风险的空间集群。人口密度被证明是一个主要因素,燃料的寄生虫感染,而个人的社会经济因素似乎不影响感染的风险。Mbita堤道周围的高风险集群可能是由于建造了一条人工通道,这可能会导致S。曼森氏蜗牛通过水道的阻塞来寄生蜗牛。因此,这一建筑可能对当地居民的健康产生重大不利影响,特别是经常接触湖水的学龄儿童。据估计,世界上超过百分之十的人口面临血吸虫传播的风险,其中超过90%的感染发生在撒哈拉以南非洲。在肯尼亚,血吸虫病仍然是一个主要的公共卫生问题,特别是在维多利亚湖周围。本研究的目的是确定与曼氏血吸虫感染的危险因素之间的海岸和邻近岛屿的维多利亚湖在姆比塔区,肯尼亚西部的学童。高的当地人口密度被确定为一个重要的危险因素,S。曼氏感染。未发现社会经济因素与感染风险显著相关。我们的研究表明,与堤道建设相关的环境变化和Mbita镇周围密集的人口可能会为S.曼索尼变速器
An increasing risk of Schistosoma mansoni infection has been observed around Lake Victoria, western Kenya since the 1970s. Understanding local transmission dynamics of schistosomiasis is crucial in curtailing increased risk of infection. We carried out a cross sectional study on a population of 310 children from eight primary schools. Overall, a total of 238 (76.8%) children were infected with S. mansoni, while seven (2.3%) had S. haematobium. The prevalence of hookworm, Trichuris trichiura and Ascaris lumbricoides were 6.1%, 5.2% and 2.3%, respectively. Plasmodium falciparum was the only malaria parasite detected (12.0%). High local population density within a 1 km radius around houses was identified as a major independent risk factor of S. mansoni infection. A spatial cluster of high infection risk was detected around the Mbita causeway following adjustment for population density and other potential risk factors. Population density was shown to be a major factor fuelling schistosome infection while individual socio-economic factors appeared not to affect the infection risk. The high-risk cluster around the Mbita causeway may be explained by the construction of an artificial pathway that may cause increased numbers of S. mansoni host snails through obstruction of the waterway. This construction may have, therefore, a significant negative impact on the health of the local population, especially school-aged children who frequently come in contact with lake water. It is estimated that more than ten percent of the world's population is at risk of schistosome transmission, with over 90% of infections occurring in sub-Saharan Africa. In Kenya, schistosomiasis remains a major public health concern particularly around Lake Victoria. The objective of this study was to identify the risk factors associated with Schistosoma mansoni infection among schoolchildren on the shores and adjacent islands of Lake Victoria in Mbita district, western Kenya. High local population density was identified as an important risk factor for S. mansoni infection. Socio-economic factors were not found to be significantly associated with infection risk. Our study suggests that environmental changes related to causeway construction and the dense human population around Mbita town may result in favourable ecological conditions for S. mansoni transmission.
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