越南胡志明市儿童弓形虫感染的临床和实验室特征

Thieu V Ha, Hong K Tang, Bach V Ngo, Truc P T Le, Duc H Le, Y M L Tran, Duy K H Dang, Tien T N Vo
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摘要

背景 本研究确定了犬弓形虫感染儿童的临床和辅助临床特征,以及在出现瘙痒、荨麻疹和红斑症状的群体中预测弓形虫病的血清嗜酸性粒细胞临界值。结果 在 986 名参与者中,共有 140 人(14.2%)有抗犬蛔虫抗体。这组儿童最常出现的症状是瘙痒(10.1%)、腹痛(8.2%)和荨麻疹(3.3%)。IgE 增高率(37%)、轻度和高度嗜酸性粒细胞增多率分别为 38% 和 2.2%。IgE 浓度和嗜酸性粒细胞计数有明显差异,有毒血症和无毒血症两组之间的 IgE 浓度和嗜酸性粒细胞计数也有明显差异。嗜酸性粒细胞预测弓形虫病的最佳阈值为 0.38 K/µL,瘙痒、荨麻疹和红斑的灵敏度为 61.5%,特异度为 82.1%,接收器操作特征曲线(曲线下面积)为 0.71。结论 本研究证实了 IgE 浓度、嗜酸性粒细胞计数和犬细小病毒血清学阳性之间存在正相关。包括嗜酸性粒细胞在内的全血细胞计数是一种可在医院进行的简单检测。当儿童出现瘙痒、荨麻疹、红斑和嗜酸性粒细胞增多等临床症状时,临床医生应针对并筛查犬细小病毒感染。临床试验注册号:NCT05208333
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Clinical and laboratory characteristics of Toxocara canis infection among children in Ho Chi Minh City, Vietnam
Background This study determines the clinical and paraclinical characteristics of children with Toxocara canis infection and serum eosinophil cut-off values for predicting toxocariasis in the group displaying symptoms of itching, urticaria and erythema. Methods A cross-sectional study was conducted during March and April 2023 with a sample size of 986 children aged 3–15 y. Results In total, 140 (14.2%) of the 986 participants had anti-T canis antibodies. The most frequently experienced symptoms in this group were itching (10.1%), abdominal pain (8.2%) and urticaria (3.3%). The rate of IgE increased (37%), and the rates of mild and high eosinophilia were 38% and 2.2%, respectively. There were significant differences in IgE concentration and eosinophil count, and for both IgE concentration and eosinophil count between the two groups with and without toxocariasis. The optimal threshold for eosinophil to predict toxocariasis was 0.38 K/µL, with itching, urticaria and erythema resulting in a sensitivity of 61.5%, a specificity of 82.1% and a receiver operating characteristic curve (area under the curve) of 0.71. Conclusions This study confirmed a positive association between IgE concentration, eosinophil count and positive serology for T. canis. A general blood count, including eosinophils, is a simple test that can be performed in hospitals. Clinicians should target and screen for T.oxocara canis infection when children display clinical symptoms of itching, urticaria, erythema and eosinophilia. Clinical trial registration number NCT05208333
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