马达加斯加四个地区盘尾丝虫和其他蠕虫的流行情况。

IF 3.6 Q1 TROPICAL MEDICINE Tropical Medicine and Health Pub Date : 2024-07-29 DOI:10.1186/s41182-024-00619-y
Salvatore Scarso, Rivo Andry Rakotoarivelo, Jana Christina Hey, Tahinamandranto Rasamoelina, Anjarasoa Ravo Razafindrakoto, Zaraniaina Tahiry Rasolojaona, Nantenaina Mathieu Razafindralava, Aaron Remkes, Njary Rakotozandrindrainy, Clara Fabienne Rasoamanamihaja, Norbert Georg Schwarz, Jürgen May, Raphael Rakotozandrindrainy, Valentina Marchese, Fabio Formenti, Francesca Perandin, Francesca Tamarozzi, Cristina Mazzi, Daniela Fusco, Dora Buonfrate
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引用次数: 0

摘要

背景:需要对流行地区的盘尾丝虫病感染率进行估计,以确定需要实施控制计划的地区。马达加斯加的盘尾丝虫病感染率数据很少。这项工作的目的是估计马达加斯加四个地区的盘尾丝虫病流行率:方法:对之前血吸虫病研究中采集的粪便和血清样本分别进行了盘尾丝虫实时 PCR 检测和血清学检测。在强直性脊柱炎发病率较高的地区采集的粪便样本进行了蛔虫、十二指肠锚疽、美洲奈卡特氏虫和毛滴虫的多重实时 PCR 检测。比例之间的比较采用费舍尔精确检验,事后比较采用假发现率校正。采用多变量费思逻辑回归模型评估感染斯特氏虫的潜在风险因素:结果:共检测了 1775 份血清样本,其中马罗沃伊区和瓦托曼德里区(均为沿海地区)的血清阳性样本分别为 487 份中的 102 份(20.9%)和 296 份中的 104 份(35.2%),而齐罗亚诺曼德里区和安博西特拉区(均为高原地区)的血清阳性样本分别为 496 份中的 28 份(5.6%)和 496 份中的 30 份(6.1%)(adj.p):与高地相比,沿海地区的盘尾丝虫病流行率更高。不同的气候条件可能是造成这种分布的原因,另外,前几轮在该国发放的驱虫药可能减少了寄生虫在人口中的数量。鉴于苯并咪唑在防治活动中的良好覆盖率,瓦托曼德里其他土壤传播蠕虫(STH)的高发病率出乎意料。为了与世界卫生组织的建议保持一致,有必要开展进一步研究,探讨马达加斯加感染 STH 和盘尾丝虫的风险因素。
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Prevalence of Strongyloides stercoralis and other helminths in four districts of Madagascar.

Background: Estimation of prevalence of Strongyloides stercoralis infection is required in endemic areas, in order to identify areas in need of control programmes. Data on prevalence of strongyloidiasis in Madagascar are scant. Aim of this work was to estimate prevalence of S. stercoralis in four districts of Madagascar.

Methods: Fecal and serum samples collected in the context of a previous study on schistosomiasis were tested with S. stercoralis real-time PCR and serology, respectively. A multiplex real-time PCR for Ascaris lumbricoides, Ancylostoma duodenalis, Necator americanus, and Trichuris trichiura was done on fecal samples collected in the areas demonstrating higher prevalence of strongyloidiasis. Comparisons between proportions were made using Fisher exact test, with false discovery rate correction used for post-hoc comparisons. A multivariable Firth logistic regression model was used to assess potential risk factors for S. stercoralis infection.

Results: Overall, 1775 serum samples were tested, of which 102 of 487 (20.9%) and 104 of 296 (35.2%) were serological-positive in Marovoay and in Vatomandry districts (both coastal areas), respectively, compared to 28 of 496 (5.6%) and 30 of 496 (6.1%) in Tsiroanomandidy and in Ambositra districts (both highlands), respectively (adj. p < 0.001). PCR for S. stercoralis was positive in 15 of 210 (7.1%) and in 11 of 296 (3.7%) samples from Marovoay from Vatomandry, respectively, while was negative for all samples tested in the other two districts. High prevalence of A. lumbricoides (45.9%), hookworm (44.6%) and T. trichiura (32.1%) was found in Vatomandry. In the multivariable analysis, strongyloidiasis was associated with hookworm infection. Hookworm infection was also associated with male sex and lower education level.

Conclusions: S. stercoralis prevalence proved higher in coastal areas compared to highlands. Different climatic conditions may explain this distribution, along with previous rounds of anthelminthics distributed in the country, which may have reduced the parasite load in the population. The high prevalence of the other soil-transmitted helminths (STH) in Vatomandry was unexpected, given the good coverage with benzimidazole in control campaigns. Further studies are needed to explore the risk factors for STH and S. stercoralis infections in Madagascar, in order to align with the WHO recommendations.

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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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