Re-Visiting Trichuris trichiura Intensity Thresholds Based on Anemia during Pregnancy 英文参考文献.docVIP

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2017-05-13 发布于上海
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Re-Visiting Trichuris trichiura Intensity Thresholds Based on Anemia during Pregnancy 英文参考文献.doc

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Re-Visiting Trichuris trichiura Intensity Thresholds Based on Anemia during Pregnancy 英文参考文献

Re-VisitingTrichuristrichiuraIntensityThresholdsBased onAnemiaduringPregnancy TheresaW.Gyorkos1,2*,NicolasL.Gilbert1,Rene′eLarocque3,Mart?′nCasap?′a4,AntonioMontresor5 1ParasiteEpidemiologyResearchGroup,DivisionofClinicalEpidemiology,ResearchInstituteoftheMcGillUniversityHealthCentre,Montreal,Canada,2Departmentof Epidemiology,Biostatistics andOccupational Health,McGillUniversity,Montreal, Canada, 3International Development ResearchCentre,Ottawa, Canada, 4Asociacio′n CivilSelvaAmazo′nica,Iquitos,Peru′,5DepartmentofControlofNeglectedTropicalDiseases,WorldHealthOrganization,Geneva,Switzerland Abstract Background:Theintensitycategories,orthresholds,currentlyusedforTrichuristrichiura(ie.epgintensitiesof1–999(light); 1,000–9,999 epg (moderate), and $10,000 epg (heavy)) were developed in the 1980s, when there were little epidemiological data available on dose-response relationships. This study was undertaken to determine a threshold for T.trichiura-associatedanemiainpregnantwomenandtodescribetheimplicationsofthisthresholdintermsoftheneedfor primarypreventionandchemotherapeuticinterventions. Methodology/PrincipalFindings:InIquitos,Peru,935pregnantwomenweretestedforT.trichiurainfectionintheirsecond trimesterofpregnancy;weregivendailyironsupplementsthroughouttheirpregnancy;andhadtheirbloodhemoglobin levelsmeasuredintheirthirdtrimesterofpregnancy.WomeninthehighesttwoT.trichiuraintensityquintiles(601–1632 epgand$1633epg)hadsignificantlylowermeanhemoglobinconcentrationsthanthelowestquintile(0–24epg).They alsohadastatisticallysignificantlyhigherriskofanemia,withadjustedoddsratiosof1.67(95%CI:1.02,2.62)and1.73(95% CI:1.09,2.74),respectively. Conclusions/Significance:ThisanalysisprovidessupportforcategorizingaT.trichiurainfection$1,000epgas‘moderate’, ascurrentlydefinedbytheWorldHealthOrganization.Becausethis‘moderate’levelofT.trichiurainfectionwasfoundtobe asignificantriskfactorforanemiainpregnantwomen,theintensityofTrichurisinfectiondeemedtocauseoraggravate anemiashouldnolong