确定土壤传播的蠕虫感染状况和体质的学龄儿童
Summary
用土壤传播的的蠕虫（STHs）的慢性感染引起吸收不良，发育迟缓，浪费在成长中的孩子。因此，它是合理的，这些感染也可以减少儿童的体能。在这里，我们可视化技术的诊断STHs和20米折返跑测试，以评估儿童的身体健康。
Abstract
土壤传播的蠕虫（STH）感染是常见的。事实上，超过1亿人受到影响，主要是在发展中世界，那里的贫困盛行，卫生行为，供水和卫生设施往往缺乏1,2， 蛔虫 ， 鞭虫和钩虫种类， 十二指肠钩虫 ， 钩虫美洲 ，是最普遍的STHs 3。由于钩虫病，蛔虫病和鞭虫病的全球疾病负担的估计是22.1，10.5，和640万伤残调整寿命年（DALY），分别为4。此外，估计有30-100亿人感染粪类圆线虫 ，最被忽视的STH种具有全球意义，可以说是也造成相当大的公众健康的影响5,6。多物种感染（即不同的STHs窝藏在一个单一的个体）是常见的，已经感染林糟透了降低生产率，从而促进经济的发展中国家的前景1,3。
的诊断的常见STHs的，世界卫生组织（WHO）建议的改良加藤技术7.8，这是一个相对简单的方法来确定这类感染的发生率和强度。它促进了检测，感染者通过在其粪便中的寄生虫卵。
随着的诊断S.stercoralis方面，目前还没有简单而准确的工具。的的贝尔曼技术是应用最广泛的方法，其诊断。的贝尔曼技术背后的原理是，积极S.stercoralis幼虫迁移出照明的新鲜粪便样品的幼虫趋光9。它需要不太复杂的实验材料和消耗更少的时间比文化和免疫学方法5。
T“发病率与运输及房屋局局长感染范围从急性，但共同的症状，如腹痛，腹泻，皮肤瘙痒，慢性症状，如贫血，不足和营养不良，和认知功能障碍10。一般都是非特异性的症状，微妙的，他们经常被忽视，被认为是一个正常的条件下受影响的个体，或者被处理作为可能会对多见于一个给定的设定的其他疾病的症状，因此，可以想象的是，真正的负担被低估了评估的STH感染工具依靠自我宣称的症状和体征通常情况下人口为基础的调查。在20世纪80年代末和90年代初，Stephenson和他的同事们强调STH感染的可能性降低了体能的男孩6-12岁11,12。最近13,14,15这条线的科学调查获得了新的动力。 20米（m）折返跑测试开发ð验证莱热等。，是全球通用的衡量有氧健身的儿童17。测试是简单的规范和可以执行的地方有20米长，平坦的运行过程和音频源，使得它的使用有吸引力的资源限制设置13。为方便和规范的尝试，在评估是否STH感染有效果的适龄儿童的体能，我们提出的方法，诊断STH感染或措施的体能是简单的执行，提供精确和可重复的结果。这将有助于产生新的证据，STH感染对健康的影响。
Protocol
1。改良加藤技术将一个标准的改良加藤模板为41.7毫克（mg），大便显微镜载片上有一个洞。 炒到2-3克（g）的新鲜粪便样品放在一张报纸或铝箔，然后按顶部的金属丝或塑料网筛它一块。 使用一个小的塑料小铲，刮离网筛分的材料，并完全填充改良加藤模板的孔中。以除去过量的粪便物，平与刮刀的孔的含量。 垂直删除，而不会干扰现在坚持粪便的显微镜幻灯片模板…
Discussion
本文中所描述的三个协议已经过测试，并执行在西南部云南省的一部分，中华人民共和国各成员之间的布朗族少数民族21在不同地区的非洲6,13,14。
有几个模板，可用于改良加藤技术。每一个不同的孔尺寸将提供一个独特的粪便量。对于计算的EPG，因此，有必要知道单元的模板，以乘以鸡蛋的计数量的修正因子，以到达的EPG估计。此外，当在社区钩虫是本调查?…
Disclosures
The authors have nothing to disclose.
Acknowledgements
作者感谢云南，中华人民共和国和阿博维尔，科特迪瓦，他们参与上述研究的社区。我们非常感激的测试和执行的协议，协助当地的野队。我们特别感谢下列同事从瑞士热带和公共健康研究所：Endriss伊薇特提供在视频拍摄过程中的显微图像，Hanspeter实验室的支持和孙燕姿克劳思·马蒂和他的团队对她的帮助。最后，我们感谢两位匿名审稿进行了一系列有益的意见。
Materials
Note: Materials in this list are generic and can be obtained from different sources.
| Name of the reagent | Company | Catalogue number | Comments |
| Kato-Katz kit [400 plastic templates with a hole of 6 millimeter (mm) (diameter) in a 1.5 mm thick template; 400 plastic spatula; a 20-m role of nylon screen of 80 mesh size; a 20-m role of hydrophilic cellophane, 34 μm thick.] |
Vestergaard Frandsen | Please note that the glycerin-malachite green solution is not included in this kit but can be bought from any chemical supplier. | |
| Glass funnel [about 8 centimeter (cm) wide and 6 cm deep] | The glass funnel for the Baermann technique should be able to hold about 60 mL of water. The size of the rubber hose and gauze is dependent on the type of glass funnel used. | ||
| Biological microscope | Olympus | CX21LED/CX21 | |
| Centrifuge | Shanghai Medical Instruments Group | 80 – 2T | |
| Pre-recorded signals | Bitworks Design | Team Bleep Test Version 1.3.1 | iPhone application |
| Heart rate monitor | POLAR | FT1 | Watch and transmitter |
References
- Steinmann, P., Utzinger, J., Du, Z. W., Zhou, X. N. Multiparasitism: a neglected reality on global, regional and local scale. Advances in Parasitology. 73, 21-50 (2010).
- Bethony, J., Brooker, S., Albonico, M., Geiger, S., Loukas, A., Diemert, D., Hotez, P. J. The soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 367, 1521-1532 (2006).
- Hotez, P. J., Molyneux, D. H., Fenwick, A., Kumaresan, J., Ehrlich Sachs, S., Sachs, J. D., Savioli, L. Control of neglected tropical diseases. New England Journal of Medicine. 357, 1018-1027 (2007).
- Chan, M. S. The global burden of intestinal nematode infections-fifty years on. Parasitology Today. 13, 438-443 (1997).
- Olsen, A., van Lieshout, L., Marti, H., Polderman, T., Polman, K., Steinmann, P., Stothard, R., Thybo, S., Verweij, J. J., Magnussen, P. Strongyloidiases – the most neglected of the neglected tropical diseases. Transactions of the Royal Society of Tropical Medicine and Hygiene. 103, 967-972 (2009).
- Becker, S. L., Sieto, B., Silue, K. D., Adjossan, L., Kone, S., Hatz, C., Kern, W. V., N’Goran, E. K., Utzinger, J. Diagnosis, clinical features, and self-reported morbidity of Strongyloides stercoralis and hookworm infection in a co-endemic setting. PLoS Neglected Tropical Diseases. 5, e1292 (2011).
- World Health Organization. Action against worms. WHO Newsletter. (11), (2008).
- Montresor, A., Crompton, D. W. T., Hall, A., Bundy, D. A. P., Savioli, L. Guidelines for the evaluation of soil-transmitted helminthiasis and schistosomiasis at community level. World Health Organization. , (1998).
- García, L. S., Bruckner, D. A. . Diagnostic medical parasitology. , (2001).
- Brooker, S. Estimating the global distribution and disease burden of intestinal nematode infection: adding up the numbers – a review. International Journal for Parasitology. 40, 1137-1144 (2010).
- Stephenson, L. S., Latham, M. C., Kinoti, S. N., Kurz, K. M., Brigham, H. Improvements in physical fitness of Kenyan schoolboys infected with hookworm, Trichuris trichiura and Ascaris lumbricoides following a single dose of albendazole. Transactions of the Royal Society of Tropical Medicine and Hygiene. 84, 277-282 (1990).
- Stephenson, L. S., Latham, M. C., Adams, E. J., Kinoti, S. N., Pertet, A. Physical fitness, growth and appetite of Kenyan school boys with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of albendazole. Journal of Nutrition. 123, 1036-1046 (1993).
- Bustinduy, A. L., Thomas, C. L., Fiutem, J. J., Parraga, I. M., Mungai, P. L., Muchiri, E. M., Mutuku, F., Kitron, U., King, C. H. Measuring fitness of Kenyan children with polyparasitic infections using the 20-meter shuttle run test as a morbidity metric. PLoS Neglected Tropical Diseases. 5, e1213 (2011).
- Müller, I., Coulibaly, J. T., Fürst, T., Knopp, S., Hattendorf, J., Krauth, S. J., Stete, K., Righetti, A. A., Glinz, D., Yao, A. K., Pühse, U., N’Goran, E. K., Utzinger, J. Effect of schistosomiasis and soil-transmitted helminth infections on physical fitness of school children in Côte d’Ivoire. PLoS Neglected Tropical Diseases. 5, e1239 (2011).
- Yap, P., Du, Z. W., Chen, R., Zhang, L. P., Wu, F. W., Wang, J., Wang, X. Z., Zhou, H., Zhou, X. N., Utzinger, J., Steinmann, P. Soil-transmitted helminth infections and physical fitness in school-aged Bulang children of southwest China: results from a cross-sectional survey. Parasites and Vectors. 5, 50 (2012).
- Léger, L. A., Mercier, D., Gadoury, C., Lambert, J. The multistage 20 metre shuttle run test for aerobic fitness. Journal of Sports Sciences. 6, 93-101 (1988).
- Tomkinson, G. R., Léger, L. A., Olds, T. S., Cazorla, G. Secular trends in the performance of children and adolescents (1980-2000): an analysis of 55 studies of the 20 m shuttle run test in 11 countries. Sports Medicine. 33, 285-300 (2003).
- Mahon, A. D., Marjerrison, A. D., Lee, J. D., Woodruff, M. E., Hanna, L. E. Evaluating the prediction of maximal heart rate in children and adolescents. Research Quarterly for Exercise and Sport. 81, 466-471 (2010).
- Bogitsh, B. J., Carter, C. E., Oeltmann, T. N. . Human Parasitology. , (2011).
- Steinmann, P., Zhou, X. N., Du, Z. W., Jiang, J. Y., Wang, L. B., Wang, X. Z., Li, L. H., Marti, H., Utzinger, J. Occurence of Strongyloides stercoralis in Yunnan province, China, and comparison of diagnostic methods. PLoS Neglected Tropical Diseases. 1, e75 (2007).
- Martin, L. K., Beaver, P. C. Evaluation of Kato thick-smear technique for quantitative diagnosis of helminth infections. American Journal of Tropical Medicine and Hygiene. 17, 382-391 (1968).
- Dacombe, R. J., Crampin, A. C., Floyd, S., Randall, A., Ndhlovu, R., Bickle, Q., Fine, P. E. Time delays between patient and laboratory selectively affect accuracy of helminth diagnosis. Transactions of the Royal Society of Tropical Medicine and Hygiene. 101, 140-145 (2007).
- Knopp, S., Mgeni, A. F., Khamis, I. S., Steinmann, P., Stothard, J. R., Rollinson, D., Marti, H., Utzinger, J. Diagnosis of soil-transmitted helminths in the era of preventive chemotherapy: effect of multiple stool sampling and use of different diagnostic techniques. PloS Neglected Tropical Diseases. 2, e331 (2008).
Tags
Soil-transmitted Helminth InfectionPhysical FitnessSchool-aged ChildrenSTH InfectionsAscaris LumbricoidesTrichuris TrichiuraHookworm SpeciesAncylostoma DuodenaleNecator AmericanusGlobal BurdenDisability-adjusted Life Years (DALYs)Strongyloides StercoralisMultiple-species InfectionsKato-Katz TechniqueWorld Health Organization (WHO)Baermann Technique
Cite This Article
Yap, P., Fürst, T., Müller, I., Kriemler, S., Utzinger, J., Steinmann, P. Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children. J. Vis. Exp. (66), e3966, doi:10.3791/3966 (2012).