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臺灣北部某區域醫院外籍女性人芽囊原蟲之盛行率及治療分析

Prevalence and Treatment of Blastocystis Hominis in Foreign Females in a Regional Hospital in North-Taiwan

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摘要


目的:人芽囊原蟲(Blastocystis hominis)是一種世界上常見的消化道寄生蟲,台灣尚無流行的記錄。隨著外籍配偶及勞工逐年增加,此寄生蟲在台灣也越常見。本研究係分析外籍女性糞便人芽囊原蟲之陽性狀況及比較metronidazole和trimethoprim/sulfamethoxazole(TMP/SMX)治療後複檢陰性率高低。方法:本研究回顧並分析2007年1至10月至臺北市某區域醫院接受腸道寄生蟲檢查共1,233位包含越南、菲律賓、印尼及中國女性病歷資料。糞便檢查方法為merthiolate-iodine-formaldehyde濃縮集卵法。該院針對人芽囊原蟲之治療:(1)口服TMP/SMX,一天二次,每次160mg TMP/800mg SMX(2)口服metronidazole一天三次,每次250mg(3)口服metronidazole一天三次,每次500mg。三種處方皆服用7天療程後接受複查。結果:共241位受檢者糞便檢查人芽囊原蟲為陽性(佔19.5%),越南籍共345人,72人呈陽性(20.9%),菲律賓籍共363人,64人陽性(17.6%),印尼籍共323人,77人陽性(23.8%)及中國籍共202人,28人陽性(13.9%)。以中國籍受檢者為基準,其他三國的糞便陽性率勝算比依序為印尼1.9(95%信賴區間1.2-3.1)、越南1.6(95%信賴區間1.0-2.6)及菲律賓1.3(95%信賴區間0.8-2.2)。接受TMP/SMX共44人,治療後寄生蟲複檢陰性者34人(佔77.3%)。接受metronidazole 250mg共55人,複檢為陰性者44人(佔80.0%)。接受metronidazole 500mg共97人,複檢為陰性者89人(佔91.8%)。結論:本研究顯示來台的東南亞與中國籍女性感染人芽囊原蟲的糞便陽性率約14~24%。TMP/SMX及metronidazole是有效治療人芽囊原蟲的藥物,而且metronidazole 500mg治療後複檢陰性率高於metronidazole 250mg和TMP/SMX。

關鍵字

寄生蟲 人芽囊原蟲

並列摘要


Objectives: Blastocystis hominis is a common intestinal parasite with worldwide distribution. As a rapid increase of foreign immigrants in Taiwan, the parasite is found more frequently. In this study, we investigated the prevalence of B. hominis in foreign females and the eradication rate of metronidazole and trimethoprim/sulfamethoxazole (TMP/SMX) on persons infected with B. hominis. Methods: We collected the medical records of 1,233 foreign female examinees from Vietnam, the Philippines, Indonesia and Mainland China who received stool sampling in outpatient examination from January to October in 2007 at a Taipei city hospital. All stool samples were microscopically examined after staining by merthiolate-iodine-formaldehyde method. The regimens for B. hominis treatment included (1) oral TMP/SMX, 160mg/800mg twice per day (2) oral metronidazole 250mg three times per day (3) oral metronidazole 500mg three times per day for 7 consecutive days. Results: Two hundred and forty-one individuals with B. hominis in their stool (19.5%) were enrolled. Seventy-two of 345 (20.9%) Vietnamese, 64 of 363(17.6%) Filipinos, 77 of 323(23.8%) Indonesians and 28 of 202 (13.9%) Mainland Chinese females were infected with B. hominis. Compared with Mainland Chinese females, the odds ratio (OR) of prevalence revealed Indonesians (OR, 1.9; 95% confidence interval [CI], 1.2-3.1), Vietnamese (OR, 1.6; 95% CI, 1.0-2.6) and Filipinos (OR, 1.3; 95% CI, 0.8-2.2). B. hominis was not found microscopically in 34 of 44 (77.3%) with TMP/SMX treatment, 44 of 55 (80.0%) with metronidazole 250mg and 89 of 97 with metronidazole 500mg (91.8%). Conclusions: The prevalence of B. hominis in Southeast-Asia and Mainland Chinese females was between 14 to 24%. TMP/SMX and metronidazole were effective against this organism and the efficacy of metronidazole 500mg was superior to metronidazole 250mg and TMP/SMX to eradicate B. hominis.

並列關鍵字

parasites Blastocystis hominis

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