Effects of soil-transmitted nematode infection on wheezing, asthma, and skin prick test positivities in rural preschool children

doi:10.12140/j.issn.1000-7423.2023.03.012

Abstract

Abstract:

Objective To investigate the effects of soil-transmitted nematode infection of mother and child on wheezing, asthma, and skin prick test (SPT) positive in rural preschool children. Methods Preschool children and their mohers in rural area were enrolled respectively, who underwent physical examination in the Yuncheng Central Hospital outpatient sector from April 2020 to March 2021. Basic information of mothers and children and children’s wheezing/asthma condition were collected through questionnaires. Fecal samples were collected from participants, and examined for soil-transmitted nematode eggs by the Kato-Katz thick smaear method, The SPT test was performed for children to collect allergic and atopic data. Multivariate unconditional logistic regression analysis was used to explore the relevant factors affecting asthma, wheezing, and SPT positivity in children. Results In this study, there were 2 014 children and their mothers each. The infection rate of soil-transmitted nematodes among the mothers was 14.40% (290/2 014), and among the preschool children was 7.99% (161/2 014). There were 117 children had wheezing symptoms, with an occurrence rate of 5.81% (117/2 014); 149 cases had asthma, with an occurrence rate of 7.40% (149/2 014) and 304 cases were positive for SPT, with a positive rate of 15.09% (304/2 014). Premature infants, mothers with a history of allergies, and family members smoking are risk factors for wheezing in children (P < 0.05, OR > 1); female gender and complete breastfeeding are protective factors for wheezing in children (P < 0.05, OR < 1). Mothers with a history of allergies, having someone smoking at home, and planting flowers and plants at home are risk factors for childhood asthma (P < 0.05, OR > 1); female and complete breastfeeding are protective factors for childhood asthma (P < 0.05, OR < 1). Mothers with a history of allergies is a risk factor for SPT positivity in children (P < 0.05, OR > 1), while the gender of the child, presence of soil-transmitted nematode infection in the child, and presence of soil-transmitted nematode infection in the mother are protective factors for SPT positivity in children (P < 0.05, OR < 1). Conclusion Mothers and children infected with soil-transmitted nematode may reduce the occurrence of allergic diseases in children.

Key words: Worm, Children, Wheezing, Asthma, SPT positive

CLC Number:

R383.1

LI Fang, WANG Shufang, HE Pengfei, XU Shuhui. Effects of soil-transmitted nematode infection on wheezing, asthma, and skin prick test positivities in rural preschool children[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2023, 41(3): 336-343.

Figures/Tables 6

Table 1

Table 2

Table 3

Univariate analysis of influencing factors on wheezing, asthma, and SPT in children among survey subjects

特征 Feature	全部（构成比/%） Total (constituent ratio/%)	喘息史（构成比/%） Wheezing history (constituent ratio/%)	哮喘（构成比/%） Asthma history (constituent ratio/%)	SPT阳性（构成比/%） SPT Positive (constituent ratio/%)	χ²（F）	P
母亲 Mothers
分娩年龄/岁 Delivery age/year	25.14 ± 3.82	26.74 ± 3.26	25.99 ± 3.65	26.01 ± 3.74	-2.282	> 0.05
教育年限/年 Education years/year	11.38 ± 3.02	11.25 ± 3.17	11.49 ± 2.98	11.67 ± 2.95	-0.870	> 0.05
过敏史 Allergy history
否 No	1 137（56.45）	54（46.15）	60（40.27）	115（37.83）	2.437	> 0.05
是 Yes	877（43.55）	63（53.85）	89（59.73）	189（62.17）
儿童 Children
性别 Gender
男 Male	1 083（53.77）	84（71.79）	103（69.13）	197（64.80）	2.163	> 0.05
女 Female	931（46.23）	33（28.21）	46（30.87）	107（35.20）
剖宫产 Cesarean section
否 No	1 341（66.58）	85（72.65）	102（68.46）	203（66.78）	1.349	> 0.05
是 Yes	673（33.42）	32（27.35）	47（31.54）	101（33.22）
早产 Premature birth
否 No	1 805（89.62）	86（73.50）	134（89.93）	272（89.47）	20.475	< 0.05
是 Yes	209（10.38）	31（26.50）	15（10.07）	32（10.53）
出生顺序 Birth order	1.94 ± 0.57	2.01 ± 0.32	1.86 ± 0.62	1.99 ± 0.45
出生后母乳喂养 Postnatal breastfeeding
否 No	143（7.10）	0（0.00）	17（11.41）	31（10.20）	34.154	< 0.05
不完全 Incompletely	1 204（59.78）	66（56.41）	56（37.58）	181（59.54）
完全 Completely	667（33.12）	51（43.59）	76（51.01）	92（30.26）
家庭居住面积/m² Household living area/m²	87.24 ± 23.25	90.25 ± 24.16	82.37 ± 28.94	85.19 ± 30.26	-2.267	> 0.05
共同居住人口数/人 No. co residents/person	4.06 ± 1.37	4.84 ± 1.52	4.66 ± 1.28	4.93 ± 1.14	-1.663	> 0.05
家庭宠物数/只 No. family pets/piece	1.06 ± 0.33	1.21 ± 0.40	1.38 ± 0.29	1.25 ± 0.17	-14.500	< 0.05
家中种植花草 Planting flowers and plants at home
否 No	1 197（50.43）	68（58.12）	61（40.94）	183（60.20）	15.647	< 0.05
是 Yes	817（40.57）	49（41.88）	88（59.06）	121（39.80）
饲养大型家畜 Raising large livestock
否 No	761（37.79）	50（42.74）	64（42.95）	117（38.49）	1.125	> 0.05
是 Yes	1 253（62.21）	67（57.26）	85（57.05）	187（61.51）
家中有人吸烟 Someone smoking at home
否 No	917（45.53）	31（26.50）	35（23.49）	143（47.04）	30.438	< 0.05
是 Yes	1 097（54.47）	86（73.50）	114（76.51）	161（52.96）
母亲土源性线虫感染 Mothers infected by soil borne nematodes
否 No	1 724（85.60）	96（82.05）	122（81.88）	282（92.76）	15.386	< 0.05
是 Yes	290（14.40）	21（17.95）	27（18.12）	22（7.24）
儿童土源性线虫感染 Children infected by soil borne nematodes
否 No	1 853（92.01）	106（90.60）	134（89.93）	294（96.71）	10.132	< 0.05
是 Yes	161（7.99）	11（9.40）	15（10.07）	10（3.29）

Table 3

Table 4

Table 5

Table 6

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因素 Factor	赋值 Assignment	因素 Factor	赋值 Assignment
母亲年龄/岁 Age of mothers/year	≤ 30 = 0，≥ 31 = 1	母亲文化程度 Education level of mothers	中学及以下 = 0，大专及以上 = 1 Middle school and below = 0, College and above = 1
儿童年龄/岁 Age of children/year	3~5 = 0，6~8 = 1	儿童性别 Gender of children	男 = 0，女 = 1 Male = 0, Female = 1
母亲分娩年龄/岁 Delivery age of mothers/year	< 24 = 0，≥ 24 = 1	母亲过敏史 Allergy history of mothers	否 = 0，是 = 1 No = 0, Yes = 1
剖宫产 Cesarean section	否 = 0，是 = 1 No = 0, Yes = 1	早产 Premature birth	否 = 0，是 = 1 No = 0, Yes = 1
出生顺序 Birth order	1 = 0，≥ 2 = 1	完全母乳喂养 Complete breastfeeding	否 = 0，是 = 1 No = 0, Yes = 1
家庭居住面积/m² Household living area/m²	< 50 = 0，≥ 50 = 1	家庭宠物数目/只 No. family pets/piece	≤ 2 = 0，≥ 2 = 1
家中种植花草 Planting flowers and plants at home	否 = 0，是 = 1 No = 0, Yes = 1	饲养大型家畜 Raising large livestock	否 = 0，是 = 1 No = 0, Yes = 1
母亲土源性线虫感染 Mothers infected with soil borne nematodes	否 = 0，是 = 1 No = 0, Yes = 1	儿童土源性线虫感染Children infected by soil borne nematodes	否 = 0，是 = 1 No = 0, Yes = 1
家中有人吸烟 Someone smoking at home	否 = 0，是 = 1 No = 0, Yes = 1	儿童有喘息史 Wheezing history of children	否 = 0，是 = 1 No = 0, Yes = 1
儿童有哮喘史 Asthma history of children	否 = 0，是 = 1 No = 0, Yes = 1	儿童SPT阳性 SPT positive in children	否 = 0，是 = 1 No = 0, Yes = 1

特征 Feature	检查人数 No. examined	鞭虫 Trichuris trichura		钩虫 Hookworm		蛔虫 Ascaris lumbricoides		合计 Total
特征 Feature	检查人数 No. examined	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%
母亲 Mothers
年龄/岁 Age/Year
18~29	927	10	1.08	5	0.54	57	6.15	72	7.77
30~35	648	9	1.39	7	1.08	69	10.65	85	13.12
≥ 36	439	22	5.01	11	2.51	100	22.78	133	30.3
文化程度 Education level
小学及以下 Primary school and below	1 203	27	2.24	16	1.33	150	12.47	193	16.04
中学 Middle school	655	13	1.98	7	1.07	69	10.53	89	13.59
大专及以上 College and above	156	1	0.64	0	0	7	4.45	8	5.13
儿童 Children
年龄/岁 Age/Year
3	626	7	1.12	4	0.64	37	5.91	56	8.95
4	894	9	1.01	5	0.56	65	7.27	52	5.82
5~6	494	6	1.21	5	1.01	23	4.66	53	10.73
性别 Gender
男 Male	1 193	8	0.67	6	0.5	73	6.12	87	7.29
女 Female	821	14	1.71	8	0.97	52	6.33	74	9.01

因素 Factor	回归系数 Regression coefficient	标准误差 Standard error	χ²	P	OR	OR 95%CI
常数 Constant	0.100	0.048	4.344	< 0.05	-	-
早产儿 Premature	0.691	0.192	12.907	< 0.05	1.996	1.369~2.909
儿童性别 Gender of children	-0.459	0.201	5.230	< 0.05	0.632	0.426~0.936
母亲有过敏史 Allergy history of mothers	0.768	0.204	14.132	< 0.05	2.156	1.444~3.217
完全母乳喂养 Complete breastfeeding	-0.875	0.300	8.528	< 0.05	0.417	0.232~0.750
家中有人吸烟 Someone smoking at home	0.700	0.288	5.905	< 0.05	2.014	1.145~3.542

因素 Factor	回归系数 Regression coefficient	标准误差 Standard error	χ²	P	OR	OR 95%CI
常数 Constant	-0.044	0.023	3.552	> 0.05	-	-
儿童性别 Gender of children	-0.219	0.091	5.802	< 0.05	0.803	0.672~0.960
母亲有过敏史 Allergy history of mothers	0.767	0.215	12.716	< 0.05	2.153	1.413~3.282
完全母乳喂养 Complete breastfeeding	-0.475	0.177	7.185	< 0.05	0.622	0.439~0.880
家中有人吸烟 Someone smoking at home	0.628	0.168	13.945	< 0.05	1.873	1.348~2.605
家中种植花草 Planting flowers and plants at home	0.461	0.205	5.073	< 0.05	1.585	1.062~2.368

因素 Factor	回归系数 Regression coefficient	标准误差 Standard error	χ²	P	OR	OR 95%CI
常数 Constant	-0.076	0.037	4.156	< 0.05	-	-
儿童性别 Gender of children	-0.282	0.127	4.929	< 0.05	0.754	0.588~0.967
母亲有过敏史 Allergy history of mothers	0.249	0.096	6.788	< 0.05	1.283	1.064~1.547
儿童土源性线虫感染 Children infected by soil borne nematodes	-0.337	0.139	5.873	< 0.05	0.714	0.544~0.938
母亲土源性线虫感染Mothers infected by soil borne nematodes	-0.464	0.120	14.846	< 0.05	0.629	0.497~0.796