Impact of the level of economic development on intestinal parasitism in serbia

Abstract

Investigation of intestinal parasitism in Serbia during the period 1984-1993 showed infection with 9 species (Entamoeba histoiytica, Entamoeba hartmanni Entamoeba coli, lodamoeba biitchlii, Giardia lamblia, Hymenolepis пaпa Enterobius vermicularis, Ascaris lumbricoides, Trichuris trichiura), with a high overall prevalence of 24.6%. However, significant variations (14.4-43.8%) were found among the investigated counties, which occurred as a consequence of numerous factors (environmental, economic, societal cultural). While some of these are defined, others remain to be elucidated. Given the downfall of the general living conditions in our country over the past decade, the impact of the level of economic development on the occurrence of intestinal parasitic infections was investigated. The level of public income per capita as provided by the Federal Agency of Statistics was taken as a parameter of economic development. By this criterion, of all 16 counties examined, nine were considered developed (Kragujevac, Lučani, Bor Valjevo, Pirot, Ivanjica, Užice, Kladovo, Beograd), while seven were underdeveloped (Žagubica, Sjenica, Novi Pazar, Aleksandrovac, Bosilegrad Golubac, Negotin). Our series included 4913 children, of which 2858 (58.2%) resided in developed, and 2055 (41.8%) in underdeveloped counties. The prevalence of intestinal parasitic infections was significantly higher (p lt 0.01) in residents of underdeveloped counties (27.2%) than in residents of the developed ones (22.7%). In addition, infections with clinically relevant species such as G. lamblia, A. lumbricoides i T.trichiura were more frequent in underdeveloped counties, while the infection rate with E.vermicularis was even significantly higher (p lt 0.01). In view of the continuing negative economic trends in our country during the past decade these results emphasize the urgent need for defining strategies and programmes for the control of intestinal parasite infections in Serbia.

Istraživanjem rasprostranjenosti crevnih parazitskih infekcija u Srbiji (1984-1993) dokazano je prisustvo devet vrsta parazita (Entamoeba histolytica, Entamoeba hartmanni, Entamoeba coli, lodamoeba butchlii Ciardia lamblia, Hymenolepis пaпa, Enterobius vermicularis, Ascaris lumbricoides, Trichuris trichiura), sa visokom opštom prevalencom od 24,6%. Značajna raznolikost nalaza na 16 ispitanih područja (14,4-43,8%) nastala je kao posledica uticaja brojnih epidemioloških činilaca od kojih su neki prepoznati i definisani. U ovom radu je analiziran uticaj ekonomske razvijenosti Srbije na rasprostranjenost crevnih parazitskih infekcija. Ekonomska razvijenost procenjena je prema nivou narodnog dohotka po stanovniku, po kome je devet ispitanih područja ekonomski razvijeno (Kragujevac, Lučani, Bor, Valjevo, Pirot, Ivanjica, Užice, Kladovo Beograd), a preostalih sedam nedovoljno razvijeno (Žagubica, Sjenica, Novi Pazar, Aleksandrovac, Bosilegrad, Golubac, Negotin). Od 4913 pregledane dece, 2858 (58,2%) živelo je u ekonomski razvijenim, a 2055 (41,8%) u nedovoljno razvijenim područjima. Pokazano je da su infekcije crevnim parazitima značajno učestalije (p lt 0,01) u ekonomski nedovoljno razvijenim (27,2%) u odnosu na razvijena područja (22,7%). Klinički značajne vrste G. lamblia, A.lumbricoides i T. trichiura se javljaju češće, a E, vermicularis značajno češće (p lt 0,01), u ekonomski nedovoljno razvijenim područjima. Kako je prevalenca ovih infekcija u deset naselja bila izrazito visoka ( gt 50%) podatak da se čak osam ovih naselja nalazi na ekonomski nedovoljno razvijenim područjima Srbije ukazuje na to da je životni standard stanovništva faktor rizika za crevne parazitske infekcije. S obzirom na zbivanja u našem okruženju u poslednjoj deceniji (posle 1993) koja su rezultirala negativnim ekonomskim trendovima, rezultati ove studije ukazuju na potrebu hitne izrade strategije i programa za suzbijanje crevnih parazitskih infekcija u Srbiji.