学龄儿童生长发育迟缓及其与土源性线虫感染的关系

Relations between stunting and soil-transmitted helminths infections in school-age pupils

【目的】了解学龄儿童生长发育迟缓现状及其相关影响因素。【方法】在广西、海南两地农村地区,对3个乡15个学校的1 031名9~12岁儿童生长发育进行现况调查,调查内容包括：填写问卷、病原学检测、体格测量以及实验室检测等。问卷涉及儿童、家长及家庭经济状况等信息。病原学粪便检测采用Kato-Katz涂片法一送三检查三种主要土源性线虫（钩虫、蛔虫和鞭虫）虫卵并感染度分级为轻、中、重度感染。测量儿童身高体重并采用WHO标准计算年龄别身高（Height-for-age,HA）的Z评分值,作为评定儿童生长发育迟缓的指标。检测血红蛋白评价儿童是否贫血。使用EpiData3.0软件建立数据库,SPSS16.0软件进行统计分析。【结果】儿童生长发育迟缓（HAZ〈2）264人,占25.6%。生长发育迟缓的危险因素：1）中重度土源性线虫感染（OR=1.927,95%CI：1.194~3.110）;2）贫血（OR=3.26,95%CI：2.02~5.27）,母亲的文化程度（OR=2.13,95%CI：1.39~3.25）。土源性线虫感染378例,感染率为36.7%;中、重度感染173例,感染率为16.8%。单纯蛔虫、钩虫和鞭虫感染的感染率为11.2%（115/1 031）、11.5%（119/1 031）和4.9%（51/1 031）,混合感染的感染率为9.1%（93/1 031）。贫血（Hb〈120 g/L）135人,患病率为13.1%。【结论】生长发育迟缓在研究地区患病率高,且土源性线虫感染,尤其是中重度感染是生长发育迟缓的重要危险因素。

【Objective】 To understand stunting status and explore the influence factor of stunting. 【Methods】 A cross-sectional method to examine 1 031 pupils aged 9 to 12 years.These pupils came from 15 schools in Guangxi Autonomous Regional and Hainan Province rural areas in China.Study contects included questionnaires survey;physical examination,based on the new WHO Child Growth Standards（WHO Anthroplus,2007）;haemoglobin detection;stool samples were examined by Kato-Katz technique to choose soil-transmitted helminthes（Hookworm,Ascaris lumbricoides and Trichuris trichiura） infections.EpiData3.0 was used to establish a database.Statistical analyses of the data were performed using statistical package for Social Sciences for Windows SPSS（version 16.0）. 【Results】 The overall prevalence of stunting（HAZ2SD） was 25.6%（264/1 031）.Risk factors for stunting that based on logistic regression analyses were： 1） Soil-transmitted helminthes moderate-to-heavy intensity infections（OR=1.927,95%CI：1.194~3.110）;2）anaemia（OR=3.26,95%CI： 2.018~5.268）;3）education level of mother（OR=2.125,95%CI：1.388~3.254）.The overall prevalence of STH infections was 36.7%（378/1 031）,moderate-to-heavy intensity STH infections was 16.8%（173/1 031）.Ascariasis,hookworm trichuriasis and co-infection were 11.2%（115/1 031）,11.5%（119/1 031）,4.9%（51/1 031）,and 9.1%（93/1 031） respectively.The anaemia（Hb120 g/L） was 13.1%. 【Conclusions】 The present study shows that stunting is highly prevalence among study population and STH infections is one of the important risk factors for stunting,especially moderate-to-heavy intensity infections is the main predictors of stunting.