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三苯双脒、青蒿琥酯、蒿甲醚和吡喹酮单剂、多剂或联合用药治疗大鼠华支睾吸虫感染的实验研究 被引量:10
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作者 肖树华 薛剑 +5 位作者 marcel tanner 张永年 Jennifer KEISER Jug UTZINGER 强慧琴 刘晓云 《中国寄生虫学与寄生虫病杂志》 CAS CSCD 北大核心 2008年第5期321-326,共6页
目的观察三苯双脒、青蒿琥酯、蒿甲醚、或吡喹酮单剂、多剂给药,及其伍用治疗感染华支睾吸虫大鼠的疗效。方法147只SD大鼠各感染50个华支睾吸虫囊蚴,于感染后42~44d分组治疗。各药物采用灌胃给药。①60只感染大鼠随机分为11组(每组4~5... 目的观察三苯双脒、青蒿琥酯、蒿甲醚、或吡喹酮单剂、多剂给药,及其伍用治疗感染华支睾吸虫大鼠的疗效。方法147只SD大鼠各感染50个华支睾吸虫囊蚴,于感染后42~44d分组治疗。各药物采用灌胃给药。①60只感染大鼠随机分为11组(每组4~5只),分别为三苯双脒150mg/kg(顿服)、75mg/(kg·d)×2d、50mg/(kg·d)×3d和25mg/kg(tid)×2d组;吡喹酮150mg/kg(顿服)、75mg/(kg·d)×2d和25mg/kg(tid)×2d;青蒿琥酯或蒿甲醚75mg/kg(顿服)和37.5mg/(kg·d)×2d组。②另87只感染大鼠随机分为15组(每组4~6只),用青蒿琥酯或蒿甲醚(30mg/kg)分别与吡喹酮(150mg/kg)、三苯双脒(50mg/kg和75mg/kg)伍用组;三苯双脒(50mg/kg)与吡喹酮(150mg/kg)伍用组;三苯双脒(75mg/kg)与吡喹酮(187.5mg/kg)伍用组,及各药的单用组。并设同批感染未治疗对照组。受治鼠于治疗后2周剖杀,收集胆管和肝组织内的残留华支睾吸虫,计算各组的平均虫数和减虫率,用非参数统计方法(Mann-Whitney秩和检验)对相应组间的平均虫数进行分析。结果感染华支睾吸虫的大鼠口服单剂三苯双脒或吡喹酮(150mg/kg)的减虫率分别为57.2%和63.8%。三苯双脒各小剂量多次给药组的减虫率稍高,达77.1%~79.4%,而吡喹酮小剂量多次给药组的减虫率则为50.6%~54.2%。但两种药物各组间的平均虫数的差异无统计学意义。青蒿琥酯和蒿甲醚各单剂给药组与小剂量多次给药组的减虫率均较高,分别为90.4%~98.5%和100%。三苯双脒小剂量(50或75mg/kg)与吡喹酮(150mg/kg或187.5mg/kg)伍用治疗,减虫率为74.9%~100%,高于其各单药组的减虫率(26.9%~79.6%)。青蒿琥酯或蒿甲醚小剂量(30mg/kg)与吡喹酮(150mg/kg)或三苯双脒(50或75mg/kg)伍用治疗,减虫率为74.9%~97.9%,亦高于其各药组的减虫率(24.8%~79.6%)。结论青蒿琥酯、蒿甲醚、吡喹酮和三苯双脒均为有效的抗华支睾吸虫药物,各药物小剂量伍用具有增效作用。 展开更多
关键词 三苯双脒 青蒿琥酯 蒿甲醚 吡喹酮 大鼠 华支睾吸虫 联合治疗
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蒿甲醚对感染小鼠体内埃及血吸虫皮层的损害(英文) 被引量:6
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作者 肖树华 marcel tanner +2 位作者 沈炳贵 Jürg UTZINGER Jacques CHOLLET 《中国寄生虫学与寄生虫病杂志》 CAS CSCD 北大核心 2006年第6期425-432,共8页
目的评价蒿甲醚对小鼠体内埃及血吸虫皮层的损害作用。方法8只小鼠于感染埃及血吸虫尾蚴后81d,用单剂蒿甲醚400mg/kg口服治疗。治疗后1、3、7和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作扫描电镜观察。从另2... 目的评价蒿甲醚对小鼠体内埃及血吸虫皮层的损害作用。方法8只小鼠于感染埃及血吸虫尾蚴后81d,用单剂蒿甲醚400mg/kg口服治疗。治疗后1、3、7和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作扫描电镜观察。从另2只未作治疗的感染小鼠取虫作对照。结果用蒿甲醚治疗后24h,雄虫的皮层结节肿大、破溃或从皮层上剥落;在雄虫和雌虫的体表可查见有局灶性或广泛的皮层肿胀、融合、空泡变化、糜烂和剥落,以及感觉结构的破坏。治疗后3d,雌、雄虫的皮层损害加重,最严重的损害为口吸盘肿胀和破溃,并查见皮层褶嵴有广泛和严重的肿胀、糜烂和剥落,以及雌虫盘状感觉结构的破坏。治疗后7至14d,有些虫仍示有中或重度皮层损害,而有些仍存活的虫则示其大部分皮层已有明显恢复。结论蒿甲醚对埃及血吸虫的皮层具有广泛和严重的损害作用。 展开更多
关键词 蒿甲醚 血吸虫病 埃及血吸虫 扫描电镜术
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蒿甲醚对曼氏血吸虫的作用 :剂量与效应的关系和虫的形态学和组织病理学的变化(英文) 被引量:2
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作者 肖树华 郭俭 +3 位作者 Jacques Chollet 吴嘉彤 marcel tanner Jurg Utzinger 《中国寄生虫学与寄生虫病杂志》 CAS CSCD 北大核心 2004年第3期148-153,i002,共7页
目的 应用感染曼氏血吸虫 (利比里亚株 )的小鼠观察蒿甲醚单剂量与效应的关系 ,虫体肝移及蒿甲醚所引起的虫的形态学和组织病理学变化。 方法 感染 2 1d童虫的小鼠一次口服蒿甲醚 12 .5mg/kg至 60 0mg/kg不同剂量 ,治后 2 8d剖检观... 目的 应用感染曼氏血吸虫 (利比里亚株 )的小鼠观察蒿甲醚单剂量与效应的关系 ,虫体肝移及蒿甲醚所引起的虫的形态学和组织病理学变化。 方法 感染 2 1d童虫的小鼠一次口服蒿甲醚 12 .5mg/kg至 60 0mg/kg不同剂量 ,治后 2 8d剖检观察各组虫数。感染 46d或 70d成虫的小鼠一次口服蒿甲醚 40 0mg/kg后 8~ 14d ,观察虫体肝移及其形态和组织病理学变化。 结果 蒿甲醚对 2 1d童虫的最低有效剂量为 2 0 0mg/kg ,减虫率为 81%。用蒿甲醚治疗后 8h成虫开始肝移 ,3~ 7d全部肝移 ,14d有 3 1%的虫返回肠系膜静脉。成虫虫体萎缩 ,咽部扩大 ,肠管膨胀及其色素减少。雌虫局部体表受损 ,白细胞附着 ,卵巢及卵黄腺变性退化 ,以及雄虫睾丸萎缩等。在肝内的虫体被嗜酸粒细胞为主的炎细胞包围和浸润。 结论 蒿甲醚对小鼠曼氏血吸虫 2 1d童虫的最低有效剂量为 2 0 0mg/kg ,可引起曼氏血吸虫成虫萎缩、退化或死亡。在肝内受损的虫体主要是被嗜酸粒细胞包围和侵袭所致。 展开更多
关键词 蒿甲醚 曼氏血吸虫 剂量 形态学 组织病理学 嗜酸粒细胞
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一种应用遥感技术快速确定鄱阳湖区有螺洲滩的方法(英文) 被引量:3
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作者 郭家钢 陈红根 +7 位作者 林丹丹 胡广汉 吴晓华 李东 刘红云 郑江 陈名刚 marcel tanner 《中国寄生虫病防治杂志》 CSCD 2002年第5期291-296,I015-I016,F003,共9页
目的 应用地理信息系统 /遥感技术 (GIS/ RS)快速确定鄱阳湖区钉螺孳生地带及血吸虫病高危区域。 方法 选择鄱阳湖区内 3个洲岛型血吸病重度流行村周围的洲滩地图进行数字化 ,在数字化地图的基础上分别对两张 L andsat5 (洪水期和沽... 目的 应用地理信息系统 /遥感技术 (GIS/ RS)快速确定鄱阳湖区钉螺孳生地带及血吸虫病高危区域。 方法 选择鄱阳湖区内 3个洲岛型血吸病重度流行村周围的洲滩地图进行数字化 ,在数字化地图的基础上分别对两张 L andsat5 (洪水期和沽水期 ) TM卫星遥感片进行校正 ,并提取出冬陆夏水洲滩部分 ,运用 ERDAS IMAGINE软件对此洲滩进行计算机非监督分类 (U nsu-pervised Classification)、校正植被指数 (Normalized Difference Vegetation Index,NDVI)和穗帽湿度变换指数 (Tasseled Cap,TC)模型计算 ;用传统方法进行螺情调查 ,卫星定位仪 (GPS)记录有钉螺点的经纬度 ,同时选择部分堤内的农田和水溏 (无螺区 )作为对照点。 结果 用计算机非监督分类共分为 10类 ,根据现场调查的钉螺分布图 ,有螺点主要分布在计算机非监督分类的 6、7和 8类中 ,进一步模型分析表明 ,有螺点主要分布在校正植被指数 NDVI>115和穗帽湿度变换指数 TC在 - 10到 3之间 ,而堤内农田和水溏等对照点中的值则主要分布此数值以外。 结论 鄱阳湖区钉螺分布和孳生与洲滩湖草的生长状况与及湿度有着密切的关系 ,本项研究提示 ,运用计算机非监督分类法可大致确定 6、7和 8类为有螺植被环境 ,然后通过校正植被指数 (NDVI>110 ) 展开更多
关键词 遥感技术 鄱阳湖区 有螺洲滩 血吸虫病
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蒿甲醚对感染小鼠体内埃及血吸虫超微结构的影响 被引量:1
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作者 肖树华 Jürg UTZINGER +2 位作者 沈炳贵 marcel tanner Jacques CHOLLET 《中国寄生虫学与寄生虫病杂志》 CAS CSCD 北大核心 2006年第5期321-328,共8页
目的观察蒿甲醚对小鼠体内埃及血吸虫成虫超微结构的损害。方法8只小鼠于感染埃及血吸虫尾蚴后81d用单剂蒿甲醚400mg/kg口服治疗。治后24h、3d、7d和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作透射电镜观察。... 目的观察蒿甲醚对小鼠体内埃及血吸虫成虫超微结构的损害。方法8只小鼠于感染埃及血吸虫尾蚴后81d用单剂蒿甲醚400mg/kg口服治疗。治后24h、3d、7d和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作透射电镜观察。从另2只未治疗的感染小鼠体内取虫作对照。结果蒿甲醚对血吸虫皮层超微结构的损害主要是皮层基质的肿胀、溶解和空泡变化,基底膜消失和部份受损皮层破裂;在感觉器和皮层结节中,常见其内部结构广泛溶解。在肌层、实质组织、合体细胞和肠管上皮细胞中,查见局灶性或广泛的溶解、粗面内质网减少及线粒体空泡变化和变性。雌虫卵黄细胞的严重变化是空泡变化、粗面内质网减少、卵黄球融合以及受损卵黄细胞破溃等。上述雌、雄虫变化于感染小鼠用蒿甲醚治疗后24h即可见到,并逐渐加重,3~7d后最重。治后14d,部分雌、雄虫仍示有超微结构的损害,但同时亦观察到受损虫组织的恢复。结论蒿甲醚对埃及血吸虫成虫的皮层和皮层下组织具有广泛和严重的超微结构损害。 展开更多
关键词 蒿甲醚 血吸虫病 埃及血吸虫 亚显微结构 透射电镜术
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蒿甲醚和青蒿琥酯对感染曼氏血吸虫小鼠治疗作用的初步研究 被引量:1
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作者 涂祖武 Juerg Utzinger +2 位作者 Jacques Chollet 肖树华 marcel tanner 《中国血吸虫病防治杂志》 CAS CSCD 2005年第5期362-364,共3页
目的了解蒿甲醚和青蒿琥酯对小鼠曼氏血吸虫作用的效果。方法将小鼠随机分成12个实验组及1个对照组,以皮下注射的方法,每鼠接种约80条尾蚴,接种尾蚴46d后,分别以蒿甲醚或青蒿琥酯灌胃治疗,第1天,分别以400、300、200mg/kg的剂量1次灌胃;... 目的了解蒿甲醚和青蒿琥酯对小鼠曼氏血吸虫作用的效果。方法将小鼠随机分成12个实验组及1个对照组,以皮下注射的方法,每鼠接种约80条尾蚴,接种尾蚴46d后,分别以蒿甲醚或青蒿琥酯灌胃治疗,第1天,分别以400、300、200mg/kg的剂量1次灌胃;第2~7天,则每天分别按以上剂量的半量灌胃,7d灌胃的总剂量分别为1600、1200、800mg/kg。总量1剂组,在第7天,分别按1600、1200、800mg/kg剂量1次灌胃。另设感染阳性对照组,不加治疗。结果蒿甲醚7日疗法1600、1200、800mg/kg剂量组减虫率分别为53.0%、49.0%和53.0%,减雌率为78.0%~82.0%,总量1剂组效果与7日疗法基本相同。青蒿琥酯7日疗法相应剂量减虫率分别为16.0%、37.0%和49.0%。结论蒿甲醚和青蒿琥酯对小鼠曼氏血吸虫具有一定的杀虫效果,蒿甲醚在疗效和毒性方面稍佳。 展开更多
关键词 曼氏血吸虫 蒿甲醚 青蒿琥酯
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应用遥感技术快速确定鄱阳湖区钉螺孳生地的研究 被引量:23
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作者 郭家钢 林丹丹 +9 位作者 胡广汉 宁安 刘红云 吕尚标 李东 吴晓华 王蓉蓉 陈名刚 郑江 marcel tanner 《中华流行病学杂志》 CAS CSCD 北大核心 2002年第2期99-101,T001,共4页
目的 应用地理信息系统和遥感技术 (GIS ,RS)快速确定鄱阳湖区钉螺孳生地带及血吸虫病高危区域。方法 在鄱阳湖区内选择三个血吸虫病重度流行村周围的洲滩 ,用传统方法进行螺情调查 ,卫星定位仪 (GPS)记录有钉螺点的经纬度。运用ERDAS... 目的 应用地理信息系统和遥感技术 (GIS ,RS)快速确定鄱阳湖区钉螺孳生地带及血吸虫病高危区域。方法 在鄱阳湖区内选择三个血吸虫病重度流行村周围的洲滩 ,用传统方法进行螺情调查 ,卫星定位仪 (GPS)记录有钉螺点的经纬度。运用ERDASIMAGINE软件对鄱阳湖区枯水期的卫星专题制图仪 (TM)遥感片进行计算机非监督分类 ,校正植被指数 (NDVI)和穗帽湿度变换指数 (TC)模型计算 ,并对有螺点相对应TM数据进行综合分析。结果 鄱阳湖区钉螺分布和孳生与洲滩湖草的生长状况及湿度有密切的关系 ,根据现场调查的钉螺分布图 ,有螺点主要分布在计算机非监督分类的 6、7和 8类中 ,进一步模型分析表明 :有螺点主要分布在NDVI >110和TC在 - 10~ 3之间 ,其准确率达 95 %以上。结论 本项研究提示 :运用计算机非监督分类法可大致确定 6、7和 8类为有螺植被环境 ,然后通过NDVI >110确定植被优质区为钉螺的孳生环境 ,最后通过TC =- 10~ 展开更多
关键词 血吸虫病 遥感技术 鄱阳湖区 钉螺孳生地 研究
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Science in One Health:A new journal with a new approach
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作者 Xiao-Nong Zhou marcel tanner 《Science in One Health》 2022年第1期1-5,共5页
One Health recognizes the close links and interdependence among human health,animal health and environmental health.With the pandemic of COVID-19 and the risk of many emerging or reemerging infectious diseases of zoo... One Health recognizes the close links and interdependence among human health,animal health and environmental health.With the pandemic of COVID-19 and the risk of many emerging or reemerging infectious diseases of zoonotic nature as well as the spreading antimicrobial resistance,One Health has become one of top concerns globally,as it entails the essential global public health challenges from antimicrobial resistance over zoonoses,to climate change,food security and societal well-being.Research priorities in One Health include the study on interactions of human-animal-plants-nature ecology interface,systems thinking,integrated surveillance and response systems,and the overall One Health governance as part of the global health and sustainability governance.The now launched journal,Science in One Health,aims to be a resource platform that disseminates scientific evidence,knowledge,and tools on the One Health approaches and respective possible socio-ecological interventions.Thus,aims at providing fruitful exchanges of information and experience among researchers,and decision makers as well as public health actors. 展开更多
关键词 One Health Human health Animal health Ecosystem health Research and implementation science
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Surveillance-response systems: the key to elimination of tropical diseases 被引量:17
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作者 Ernest Tambo Lin Ai +7 位作者 Xia Zhou Jun-Hu Chen Wei Hu Robert Bergquist Jia-Gang Guo Jürg Utzinger marcel tanner Xiao-Nong Zhou 《Infectious Diseases of Poverty》 SCIE 2014年第1期157-166,156,共11页
Tropical diseases remain a major cause of morbidity and mortality in developing countries.Although combined health efforts brought about significant improvements over the past 20 years,communities in resource-constrai... Tropical diseases remain a major cause of morbidity and mortality in developing countries.Although combined health efforts brought about significant improvements over the past 20 years,communities in resource-constrained settings lack the means of strengthening their environment in directions that would provide less favourable conditions for pathogens.Still,the impact of infectious diseases is declining worldwide along with progress made regarding responses to basic health problems and improving health services delivery to the most vulnerable populations.The London Declaration on Neglected Tropical Diseases(NTDs),initiated by the World Health Organization’s NTD roadmap,set out the path towards control and eventual elimination of several tropical diseases by 2020,providing an impetus for local and regional disease elimination programmes.Tropical diseases are often patchy and erratic,and there are differing priorities in resources-limited and endemic countries at various levels of their public health systems.In order to identify and prioritize strategic research on elimination of tropical diseases,the‘First Forum on Surveillance-Response System Leading to Tropical Diseases Elimination’was convened in Shanghai in June 2012.Current strategies and the NTD roadmap were reviewed,followed by discussions on how to identify and critically examine prevailing challenges and opportunities,including inter-sectoral collaboration and approaches for elimination of several infectious,tropical diseases.A priority research agenda within a‘One Health-One World’frame of global health was developed,including(i)the establishment of a platform for resource-sharing and effective surveillance-response systems for Asia Pacific and Africa with an initial focus on elimination of lymphatic filariasis,malaria and schistosomiasis;(ii)development of new strategies,tools and approaches,such as improved diagnostics and antimalarial therapies;(iii)rigorous validation of surveillance-response systems;and(iv)designing pilot studies to transfer Chinese experiences of successful surveillance-response systems to endemic countries with limited resources. 展开更多
关键词 Tropical diseases CONTROL ELIMINATION Surveillance-response system Global health China
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Elimination of tropical disease through surveillance and response 被引量:29
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作者 Xiao-Nong Zhou RobertBergquist marcel tanner 《Infectious Diseases of Poverty》 SCIE 2013年第1期1-5,共5页
Surveillance and response represent the final crucial steps in achieving effective control and particularly elimination of communicable diseases as recognized in the area of neglected tropical diseases(NTDs),applied i... Surveillance and response represent the final crucial steps in achieving effective control and particularly elimination of communicable diseases as recognized in the area of neglected tropical diseases(NTDs),applied in increasing numbers in endemic countries with ongoing control and elimination programmers.More and more national NTD elimination initiatives are scheduled based on the innovative and effective One world-One health perspective to detect pockets of transmission and disease reintroduction.Resource-constrained countries,which carry the heaviest NTD burdens,face various challenges how to strengthen the health system as well as developing effective and novel tools for sureillance and response tailored to local settings.Surillance-response approaches take place in two different stages oralling the basic components of the sureillance response system for NTD elimination.Six different research priorities have been identified:(1)dynamic mapping of transmission,(2)near real-time capture of population dynamics,(3)modelling based on a minimum essential database/dataset,(4)implementation of mobile health(m-health)and sensitive diagnostics,(5)design of effective response packages tailored to different transmission settings and levels,and( 6)validation of approaches and responses packages. 展开更多
关键词 ELIMINATION TROPICAL NEGLECTED
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Surveillance and response systems for elimination of tropical diseases: summary of a thematic series in Infectious Diseases of Poverty 被引量:12
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作者 Xia Zhou Peiling Yap +3 位作者 marcel tanner Robert Bergquist Jürg Utzinger Xiao-Nong Zhou 《Infectious Diseases of Poverty》 SCIE 2016年第1期417-423,共7页
The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a ... The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a thematic series on surveillance-response systems for elimination of tropical diseases.Overall,22 contributions covering a broad array of diseases are featured–i.e.clonorchiasis,dengue,hepatitis,human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS),H7N9 avian influenza,lymphatic filariasis,malaria,Middle East respiratory syndrome(MERS),rabies,schistosomiasis and tuberculosis(TB).There are five scoping reviews,a commentary,a letter to the editor,an opinion piece and an editorial pertaining to the theme“Elimination of tropical disease through surveillance and response”.The remaining 13 articles are original contributions mainly covering(i)drug resistance;(ii)innovation and validation in the field of mathematical modelling;(iii)elimination of infectious diseases;and(iv)social media reports on disease outbreak notifications released by national health authorities.Analysis of the authors’affiliations reveals that scientists from the People’s Republic of China(P.R.China)are prominently represented.Possible explanations include the fact that the 2012 and 2014 international conferences pertaining to surveillance-response mechanisms were both hosted by the National Institute of Parasitic Diseases(NIPD)in Shanghai,coupled with P.R.China’s growing importance with regard to the control of infectious diseases.Within 4 to 22 months of publication,three of the 22 contributions were viewed more than 10000 times each.With sustained efforts focusing on relevant and strategic information towards control and elimination of infectious diseases,Infectious Diseases of Poverty has become a leading journal in the field of surveillance and response systems in infectious diseases and beyond. 展开更多
关键词 Infectious diseases Tropical diseases Health systems Surveillance and response systems ELIMINATION People’s Republic of China
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Strategies supporting the prevention and control of neglected tropical diseases during and beyond the COVID-19 pandemic
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作者 John P.Ehrenberg Xiao-Nong Zhou +3 位作者 Gilberto Fontes Eliana M.M.Rocha marcel tanner Jürg Utzinger 《Infectious Diseases of Poverty》 SCIE 2020年第4期135-141,共7页
Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern.They include a large group of neglected tropical diseases(NTDs),many of which are of zoonotic nature.Coronavirus ... Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern.They include a large group of neglected tropical diseases(NTDs),many of which are of zoonotic nature.Coronavirus disease 201g(COVID-19),another emerging zoonotic disease,has just increased the stakes exponentially.Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases,including COVID-19,severe acute respiratory syndrome(SARS),bird flu and swine flu.It is conceivable that COVID-19 will exacerbate the NTDs,as it will divert much needed financial and human resources.There is considerable concern that recent progress achieved with control and elimination efforts will be reverted.Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive,well defined programme that will set the stage for an effective multi-sectorial approach.In this Commentary,we propose areas of potential synergies between the COVID-19 pandemic control efforts other health and non-health sector initiatives and NTD control and elimination programmes. 展开更多
关键词 COVID-19 EMERGING and re-emerging DISEASES Multi-sectorial approaches NEGLECTED TROPICAL DISEASES ZOONOTIC DISEASES
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Distinct clinical characteristics and helminth co-infections in adult tuberculosis patients from urban compared to rural Tanzania
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作者 George Sikalengo Jerry Hella +17 位作者 Francis Mhimbira Liliana K.Rutaihwa Farida Bani Robert Ndege Mohamed Sasamalo Lujeko Kamwela Khadija Said Grace Mhalu Yeromin Mlacha Christoph Hatz Stefanie Knopp Sebastien Gagneux Klaus Reither Jurg Utzinger marcel tanner Emilio Letang Maja Weisser Lukas Fenner 《Infectious Diseases of Poverty》 SCIE 2018年第1期243-254,共12页
Background:Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis(TB).We comparatively studied epidemiological features of TB and helminth co-infections ... Background:Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis(TB).We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania.Methods:Adult patients(≥18 years)with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam,with~4.4 million inhabitants(urban),and Ifakara in the sparsely populated Kilombero District with~400000 inhabitants(rural).Clinical data were obtained at recruitment.Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz,Baermann,urine filtration,and circulating cathodic antigen tests.Differences between groups were assessed byχ2,Fisher’s exact,and Wilcoxon rank sum tests.Logistic regression models were used to determine associations.Results:Between August 2015 and February 2017,668 patients were enrolled,460(68.9%)at the urban and 208(31.1%)at the rural site.Median patient age was 35 years(interquartile range[IQR]:27-41.5 years),and 454(68%)were males.Patients from the rural setting were older(median age 37 years vs.34 years,P=0.003),had a lower median body mass index(17.5 kg/m2 vs.18.5 kg/m2,P<0.001),a higher proportion of recurrent TB cases(9%vs.1%,P<0.001),and in HIV/TB co-infected patients a lower median CD4 cell counts(147 cells/μl vs.249 cells/μl,P=0.02)compared to those from urban Tanzania.There was no significant difference in frequencies of HIV infection,diabetes mellitus,and haemoglobin concentration levels between the two settings.The overall prevalence of helminth co-infections was 22.9%(95%confidence interval[CI]:20.4-27.0%).The significantly higher prevalence of helminth infections at the urban site(25.7%vs.17.3%,P=0.018)was predominantly driven by Strongyloides stercoralis(17.0%vs.4.8%,P<0.001)and Schistosoma mansoni infection(4.1%vs.16.4%,P<0.001).Recurrent TB was associated with living in a rural setting(adjusted odds ratio[aOR]:3.97,95%CI:1.16-13.67)and increasing age(aOR:1.06,95%CI:1.02-1.10).Conclusions:Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania.The differences underline the need for setting-specific,tailored public health interventions to improve clinical management of TB and comorbidities. 展开更多
关键词 CO-INFECTION Helminth infection Recurrent tuberculosis SCHISTOSOMIASIS Tanzania Tubercu
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