Real-time PCR Demonstrates Ancylostoma duodenale Is a Key Factor in the Etiology of Severe Anemia and Iron Deficiency in Malawian Pre-school Children 英文参考文献.docVIP

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Real-time PCR Demonstrates Ancylostoma duodenale Is a Key Factor in the Etiology of Severe Anemia and Iron Deficiency in Malawian Pre-school Children 英文参考文献.doc

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Real-time PCR Demonstrates Ancylostoma duodenale Is a Key Factor in the Etiology of Severe Anemia and Iron Deficiency in Malawian Pre-school Children 英文参考文献

Real-timePCRDemonstratesAncylostomaduodenaleIs aKeyFactorintheEtiologyofSevereAnemiaandIron DeficiencyinMalawianPre-schoolChildren FemkjeA.M.Jonker1*,JobC.J.Calis1,KamijaPhiri2,EricA.T.Brienen3,HarrietKhoffi2,BernardJ. Brabin1,JacoJ.Verweij3,MichaelBoelevanHensbroek1,LisettevanLieshout3 1GlobalChildHealthGroup,EmmaChildren’sHospital,AcademicMedicalCentre,Amsterdam,TheNetherlands,2CommunityHealthDepartment,CollegeofMedicine, Blantyre,Malawi,3DepartmentofParasitology,LeidenUniversityMedicalCenter,Leiden,TheNetherlands Abstract Background:Hookworminfectionsareanimportantcauseof(severe)anemiaandirondeficiencyinchildreninthetropics. Type of hookwormspecies (Ancylostoma duodenale or Necator americanus) andinfection loadare consideredassociated withdiseaseburden,althoughtheseparametersarerarelyassessedduetolimitationsofcurrentlyuseddiagnosticmethods. Usingmultiplexreal-timePCR,weevaluatedhookwormspecies-specificprevalence,infectionloadandtheircontribution towardssevereanemiaandirondeficiencyinpre-schoolchildreninMalawi. MethodologyandFindings:A.duodenaleandN.americanusDNAloadsweredeterminedin830fecalsamplesofpre-school children participating in a case control study investigating severe anemia. Using multiplex real-time PCR, hookworm infectionswerefoundin34.1%oftheseverelyanemiccasesandin27.0%ofthenon-severelyanemiccontrols(p,0.05) whereas a 5.6% hookworm prevalence was detected by microscopy. Prevalence of A. duodenale and N. americanus was 26.1%and4.9%respectively.ModerateandhighloadA.duodenaleinfectionswerepositivelyassociatedwithsevereanemia (adjusted odds ratio: 2.49 (95%CI1.16–5.33) and9.04 (95%CI2.52–32.47) respectively). Iron deficiency (assessed through bone marrow examination) was positively associated with intensity of A. duodenale infection (adjusted odds ratio: 3.63 (95%CI1.18–11.20);16.98(95%CI3.88–74.35)and44.91(95%CI5.23–385.77)forlow,moderateandhighloadrespectively). Conclusions/Significance: This is thefirst report assessing the association of hookworm