驱虫药治疗对刚果民主共和国金沙萨比耶拉卫生区小学生寄生虫感染负担的影响

L. S., M. J., Doua Jy, L. P., V. J.P.
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摘要

背景:该研究评估了在一项疟疾临床试验背景下,作为非研究药物给予的抗虫肼治疗对蠕虫感染、贫血和血红蛋白(Hb)水平的影响,在该试验中,磺胺多辛乙胺嘧啶(SP)和SP+哌喹(PQ)也被评估为刚果民主共和国(DRC)学童的间歇性预防性治疗策略。方法:采用巢式队列研究方法,于2012年11月至2013年11月对比耶拉卫生区小学616名无疟疾症状儿童进行随访。巢式研究的对照组为寄生虫感染阴性。他们在基线时接受一剂PZQ和ALB,然后每隔4个月接受2剂ALB。在12个月的随访中,收集粪便和尿液样本进行蠕虫感染和手指刺血Hb水平。采用配对检验分析比较治疗前后的情况,采用多元线性回归分析检测Hb水平的混杂变量。结果:基线时,寄生虫感染和贫血的患病率分别为39.2% (95% CI: 34.7-43.7)和41.8% (95% CI: 37.3-46.3)。平均Hb水平为11.6g/dl (SD±1.3)。驱虫治疗12个月后,寄生虫感染率降至7.2% (p<0.001)。干预后12个月,仅服用驱虫药的对照组(p=1.00和p=0.26)的Hb水平和贫血情况与服用活性抗疟SP (p=0.02和p=0.09)和PQ (p=0.01和p<0.001)的对照组相比无变化。同样,在驱虫治疗12个月后,感染和未感染的学童的Hb水平也没有差异。结论:驱虫治疗可显著降低寄生虫感染的发生率。使用驱虫药对贫血和Hb水平没有影响。
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Impact of Anthelmintic Treatment on the Burden of Helminth Infections in Primary Schoolchildren in Biyela Health Zone in Kinshasa, Democratic Republic of the Congo
Background: The study evaluated the impact of anthilminthic treatment, given as non-investigational drugs, on helminth infections, anaemia, and hemoglobin (Hb) level in the context of a malaria clinical trial in which Sulfadoxine Pyrimethamine (SP) and SP+Piperaquine (PQ) were also evaluated as an intermittent preventive treatment strategy in schoolchildren in the Democratic Republic of Congo (DRC). Methods: In a nested cohort study, 616 malaria asymptomatic children attending primary schools of Biyela health area were enrolled and follow-up from November 2012 to November 2013. The control group for the nested study was the negative on helminth infections. They received one dose of PZQ and ALB at baseline and then 2 doses of ALB at 4 months intervals. During the 12-months of follow-up, stool and urine samples were collected for helminth infections and finger prick blood for Hb level. Paired test analyses were used to compare the status before and after treatment, and confounding variables for Hb level were tested by multiple linear regression analysis. Results: At baseline, the prevalence of helminth infections and anaemia were 39.2% (95% CI: 34.7-43.7), and 41.8% (95% CI: 37.3-46.3), respectively. Mean Hb level was 11.6g/dl (SD±1.3). After 12-months post-anthelminthic treatment, the prevalence of helminth infections reduced to 7.2% (p<0.001). There was no change in Hb level and anaemia in the control which received only the anthelminthic drug (p=1.00 and p=0.26, respectively) at 12-months postintervention, compared to those who received active antimalarial SP (p=0.02 and p=0.09, respectively) and PQ (p=0.01 and p<0.001, respectively). Similarly, no difference in Hb level was observed among the infected and uninfected schoolchildren with helminths at 12-months after anthelminthic treatment. Conclusion: These findings suggest that anthelminthic treatment reduces significantly the prevalence of helminth infections. There was no impact on anaemia and Hb level due to the use of anthelmintic drugs.
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