Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy.
The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (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 w...
Published in: | PLoS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2012
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0001783 https://doaj.org/article/25993440a5eb491f88c6da7394eff55c |
id |
ftdoajarticles:oai:doaj.org/article:25993440a5eb491f88c6da7394eff55c |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:25993440a5eb491f88c6da7394eff55c 2023-05-15T15:13:52+02:00 Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. Theresa W Gyorkos Nicolas L Gilbert Renée Larocque Martín Casapía Antonio Montresor 2012-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001783 https://doaj.org/article/25993440a5eb491f88c6da7394eff55c EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3441397?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001783 https://doaj.org/article/25993440a5eb491f88c6da7394eff55c PLoS Neglected Tropical Diseases, Vol 6, Iss 9, p e1783 (2012) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2012 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001783 2022-12-31T00:25:31Z The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (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-associated anemia in pregnant women and to describe the implications of this threshold in terms of the need for primary prevention and chemotherapeutic interventions.In Iquitos, Peru, 935 pregnant women were tested for T. trichiura infection in their second trimester of pregnancy; were given daily iron supplements throughout their pregnancy; and had their blood hemoglobin levels measured in their third trimester of pregnancy. Women in the highest two T. trichiura intensity quintiles (601-1632 epg and ≥ 1633 epg) had significantly lower mean hemoglobin concentrations than the lowest quintile (0-24 epg). They also had a statistically significantly higher risk of anemia, with adjusted odds ratios of 1.67 (95% CI: 1.02, 2.62) and 1.73 (95% CI: 1.09, 2.74), respectively.This analysis provides support for categorizing a T. trichiura infection ≥ 1,000 epg as 'moderate', as currently defined by the World Health Organization. Because this 'moderate' level of T. trichiura infection was found to be a significant risk factor for anemia in pregnant women, the intensity of Trichuris infection deemed to cause or aggravate anemia should no longer be restricted to the 'heavy' intensity category. It should now include both 'heavy' and 'moderate' intensities of Trichuris infection. Evidence-based deworming strategies targeting pregnant women or populations where anemia is of concern should be updated accordingly. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 6 9 e1783 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Theresa W Gyorkos Nicolas L Gilbert Renée Larocque Martín Casapía Antonio Montresor Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (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-associated anemia in pregnant women and to describe the implications of this threshold in terms of the need for primary prevention and chemotherapeutic interventions.In Iquitos, Peru, 935 pregnant women were tested for T. trichiura infection in their second trimester of pregnancy; were given daily iron supplements throughout their pregnancy; and had their blood hemoglobin levels measured in their third trimester of pregnancy. Women in the highest two T. trichiura intensity quintiles (601-1632 epg and ≥ 1633 epg) had significantly lower mean hemoglobin concentrations than the lowest quintile (0-24 epg). They also had a statistically significantly higher risk of anemia, with adjusted odds ratios of 1.67 (95% CI: 1.02, 2.62) and 1.73 (95% CI: 1.09, 2.74), respectively.This analysis provides support for categorizing a T. trichiura infection ≥ 1,000 epg as 'moderate', as currently defined by the World Health Organization. Because this 'moderate' level of T. trichiura infection was found to be a significant risk factor for anemia in pregnant women, the intensity of Trichuris infection deemed to cause or aggravate anemia should no longer be restricted to the 'heavy' intensity category. It should now include both 'heavy' and 'moderate' intensities of Trichuris infection. Evidence-based deworming strategies targeting pregnant women or populations where anemia is of concern should be updated accordingly. |
format |
Article in Journal/Newspaper |
author |
Theresa W Gyorkos Nicolas L Gilbert Renée Larocque Martín Casapía Antonio Montresor |
author_facet |
Theresa W Gyorkos Nicolas L Gilbert Renée Larocque Martín Casapía Antonio Montresor |
author_sort |
Theresa W Gyorkos |
title |
Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. |
title_short |
Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. |
title_full |
Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. |
title_fullStr |
Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. |
title_full_unstemmed |
Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy. |
title_sort |
re-visiting trichuris trichiura intensity thresholds based on anemia during pregnancy. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2012 |
url |
https://doi.org/10.1371/journal.pntd.0001783 https://doaj.org/article/25993440a5eb491f88c6da7394eff55c |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 6, Iss 9, p e1783 (2012) |
op_relation |
http://europepmc.org/articles/PMC3441397?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001783 https://doaj.org/article/25993440a5eb491f88c6da7394eff55c |
op_doi |
https://doi.org/10.1371/journal.pntd.0001783 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
6 |
container_issue |
9 |
container_start_page |
e1783 |
_version_ |
1766344382078779392 |