a La Trobeᄺ▇߽Ѯ㓈߽Ѯᴀ䖾ៜDŽ
b ᯚ݄म⠽佚ˈ▇߽Ѯᯚ݄Ꮧ䞠ᮃ⧁DŽ
c Menziesعᒋⷨおᄺ䰶▇߽Ѯ࣫乚ഄ䖒ᇨ᭛DŽ
d Ngalkanbuyि⫳Ёᖗ▇߽Ѯ࣫乚ഄGaliwin’kuDŽ
e ⱛᆊ䖒ᇨ᭛ए䰶ˈ▇߽Ѯ࣫乚ഄ䖒ᇨ᭛DŽ
f ᯚ݄ᄺˈ▇߽Ѯᯚ݄Ꮧ䞠ᮃ⧁DŽ
ᡩ〓᮹ᳳ˖2015ᑈ1᳜15᮹˗থ㸼᮹ᳳ˖2015ᑈ3᳜6᮹
1994-1996 ᑈ▇߽Ѯ࣫乚ഄأ䖰ೳ㨫⼒ऎܓ
ス៤Ҏ㙴䘧ᆘ⫳㰿⮙
Jennifer Shield
aˈ Kieran Aland
bˈ Thérèse Kearns
cˈ Glenda Gongdjalk
dˈ Deborah Holt
cˈ Bart Currie
ce Paul Prociv
f䗮䆃㗙˖Jennifer Shield (䚂ㆅ: [email protected])DŽ
ᆘ
⫳㰿ᛳᶧӮᇍعᒋѻ⫳ϡ߽ᕅડDŽϹ䞡ⱘᆘ⫳㰿ᛳᶧৃҹᓩথ䋿㸔ǃ㝍⋏㧹ݏϡ㡃ㄝ Ϲ䞡ⱘЈᑞ⮒⮙[1–5]DŽЁᑺ䕏ᑺᛳᶧৃҹ 䗴៤㧹ݏϡ㡃[6]ᑊৃҹ䗮䖛ࠞᔅ䅸ⶹ䖛㗠ᕅડᬭ㚆 ᬜᵰ[7]DŽ↯佪䶁ൟ㒓㰿ᛳᶧϢ⾡वҟ㢫ᇐ㟈ⱘܡ⭿
ॳᗻᏂ᳝݇[8]DŽ
䚼ߚ⾡㉏ⱘ㙴䘧ᆘ⫳㰿▇߽Ѯݰᴥأ䖰
ೳ㨫⼒ऎⱘᛳᶧ⥛䴲ᐌ催DŽ䩽㰿˄Џ㽕ᰃकѠᣛ㙴 䩽 ষ 㒓 㰿 ˅ Џ 㽕 থ ⫳ फ 㒀22°ҹ ࣫ 䖥 ⍋ ኌ 㒓 ⱘ
ഄऎ[9–12]DŽ䶁㰿˄↯佪䶁ൟ㒓㰿˅▇߽Ѯ㽓䚼[9]
↨䕗㔩㾕ˈԚᯚ݄[10]↨䕗ᐌ㾕ˈৠᯊгᄬѢ࣫
䚼乚ഄ[10,13,14]DŽ㉾㉏㒓㰿↨䕗ᐌ㾕ˈߚᏗᭈϾ
࣫䚼ˈऴ▇߽Ѯ乚ೳⱘϝߚПѠ˄Jennifer Shieldˈ ᢝㅍԃᄺˈথ㸼ⱘ᭄˅DŽⷂ㒺㰿˄ᖂᇣ㝰㒺 㰿˅कѠᣛ㙴䌒㰿▇߽Ѯ㽓䚼ǃᯚ݄Ꮂ[1]
࣫䚼乚ഄⱘೳ㨫⼒ऎ䕗Ўᐌ㾕[9,10,13]DŽ䰓㉇Ꮘሲᆘ
⫳㰿ܼ▇߽Ѯഛ᳝থ⫳[1,15,16]DŽ㙴䘧ᆘ⫳㰿᠔
᳝㟈⮙⾡ሲЁˈ⒊㒘㒛䰓㉇Ꮘ⮙ᰃܼ⧗ᓩথ⅏ѵⱘ
ѠॳˈҙѢ⭳⮒[15]ˈकѠᣛ㙴؛㰿ৃᓩ䍋᜶
ᗻ㝍⋏ǃᬊϡ㡃ԧ䞡ϟ䰡ˈ⫮㟇Ӯᇐ㟈ܓスথ㚆 䖳㓧䅸ⶹࡳ㛑䱰[17]DŽ
䖛এˈᇍᆘ⫳㰿ᛳᶧᙷ⮙⥛ⱘ䆘Ԅᰃҹऩϔᆘ⫳
㰿Ў⸔䖯㸠DŽ✊㗠ˈⳂࠡⱘ䆕ᰒ⼎ˈᔧϔϾҎᛳ ᶧњ2⾡ঞҹϞⱘᆘ⫳㰿ᯊˈ䙷Мᇍ㧹ݏ఼ᅬ⮙⧚ᄺ ⱘ䋳䴶ᕅડӮѻ⫳乱ࡴᬜᑨ[18]DŽ
▇߽Ѯ㙴䘧ᆘ⫳㰿䇗ᶹⱘⳌ݇᭛ゴথ㸼䕗ᇥDŽ ᴀ᭛ᇍ
1994
ᑈ㟇1996
ᑈ▇߽Ѯأ䖰ೳ㨫⼒ऎⱘ㙴 䘧ᆘ⫳㰿ᙷ⮙ᚙމ䖯㸠ᦣ䗄DŽℸ㉏ⷨおⱘग़᭄䴲 ᐌᇥ㾕ˈℸ᳝䕗催ӋؐDŽℸˈᴀ᭛ᓎゟњ᳝݇㙴䘧ᆘ⫳㰿ᛳᶧⱘ㒓᭄ˈ䗮䖛ᇚ݊Ϣᔧࠡᚙމ䖯 㸠↨䕗ˈৃҹᇍ偅㰿ㄪ⬹ᬜᵰ䖯㸠䆘ӋDŽ
♉ᬣᑺԄ䅵Ў93%ˈ⡍ᓖᑺԄ䅵Ў95%[21]DŽՓ⫼⢀ᓧ 佪㒓㰿ⱘᥦ⊘⠽ߚ⊠⠽Ўᡫॳᇍᓧ㲨㰿ሲ䖯㸠⌟
ᅮˈ݊♉ᬣᑺԄ䅵Ў91%ˈ⡍ᓖᑺԄ䅵Ў86%[22]DŽ 㒳䅵ߚᵤ
া᳝䞛⫼ᅮ䞣⬆䝯Э䝮⊩Ẕ⌟ߎ䰇ᗻᷛᴀˈᠡ߸ᅮЎ ᆘ⫳㰿ᛳᶧDŽখࡴ1ঞҹϞ䇗ᶹⱘখϢ㗙ᠡ㹿䅵᳔ܹ
㒜䇗ᶹ㒧ᵰˈ㗠䇗ᶹᇍ䈵ҙ䅵ܹ݊Ẕ⌟㒧ᵰDŽᛳ ᶧ㗙ⱘ㰿ॉ䅵᭄ⱘԩᑇഛ᭄Փ⫼ᇍ᭄eЎᑩ᭄䖯㸠
᭄䕀ᤶᑊՓ⫼ডᇍ᭄ডㅫॉ᭄DŽᔧकѠᣛ㙴䩽ষ㒓 㰿↯佪䶁ᔶ㒓㰿ॉ᭄䗮䖛ᇍ᭄ࠏᑺ䖯㸠ߚ㒘ᯊˈ㒬 ࠊⱘ乥⥛ਜℷᗕߚᏗˈ㸼ᯢᔧᇍॉ᭄᭄䖯㸠ᇍ᭄䕀
࣪ᯊˈ䗖⫼ѢℷᗕߚᏗⱘ㒳䅵ᮍ⊩ᰃ᳝ᬜⱘDŽᛳᶧᔎ ᑺḍϪ⬠ि⫳㒘㒛ߚ㉏䖯㸠ᔦ㉏[23]˄؛ᅮॉ᭄↿
छ㑺ㄝѢॉ᭄ܟ˅DŽ
ϸ Ͼ ⣀ ゟ ḋ ᴀ ↨ ՟ 䯈 ⱘ Ꮒ ᓖ ↨ 䕗 䞛 ⫼
Z
Ẕ 偠 ˈP
ؐ䞛⫼ঠջሒؐ˄ὖ⥛˅DŽབᵰᛳᶧ᭄䰈ᗻ᭄ᇥˈ߭䞛⫼
Fisher
⹂ߛὖ⥛⊩DŽ⣀ゟḋᴀॉ᭄ⱘ㞾✊ᇍ᭄䕀࣪ഛ᭄↨䕗䞛⫼ঠջWẔ偠DŽ乥⥛᭄ߚᵤ䞛⫼
Yates’
वᮍẔ偠DŽP
ؐ<0.05
㸼⼎Ꮒᓖ᳝ᰒ㨫ᗻᛣНDŽ ᠔᳝㒳䅵䅵ㅫഛ䞛⫼VassarStats
㔥キᦤկⱘ㒓䅵ㅫ఼䖯㸠
http://www.vassarstats.net/
ˈ⫼Excel
㒬ࠊ㸼DŽ Ӻ⧚ໄᯢ
ᴀⷨおᏆ㦋ᕫ▇߽Ѯ࣫乚ഄि⫳㕆Menziesعᒋⷨ
おᄺ䰶˄⊼ݠো˖EC00153˅Ҏ㉏ⷨおӺ⧚ྨਬӮⱘ ᥜᴗˈᡍޚোЎ94/19DŽ↣ϔԡ⦄എ⍖⠛ᆘ⫳㰿Ẕ⌟䰇 ᗻⱘ䇗ᶹᇍ䈵ഛӮࠄਞⶹˈᑊ㽕∖ࠡᕔए⭫Ёᖗ䖯 㸠⊏⭫DŽ
㒧ᵰ
㙴䘧ᆘ⫳㰿⮙˖᠔᳝䇗ᶹⱘⱘ㓐ড়㉾֓䅵᭄
314
ৡ䇗ᶹ㗙Ёˈ㙴䘧ᆘ⫳㰿Ẕ⌟䰇ᗻ᠔ऴ↨՟Ў89%
ˈϔ⾡ঞҹϞ㷩㰿ᛳᶧ䰇ᗻ᠔ऴ↨՟Ў88%
DŽ᳔ᐌ㾕ⱘᆘ⫳㰿⾡㉏Ў↯佪䶁ᔶ㒓㰿˄
86%
䰇ᗻ˅ˈ݊Ў䩽㰿˄
36%
˅ǃݙ䰓㉇Ꮘሲ>⒊㒘㒛ݙ䰓㉇Ꮘ˖㙴ᴚ㦠ㄝ@˄
29%
˅ˈ㉾㉏㒓㰿˄19%
˅ǃ㒺㰿˄
16%
˅ǃकѠᣛ㙴䌒㰿˄10%
˅ǃ㳆㰿ǃ䶁↯㰿ǃ㙴ݙⓈ㰿ǃҹঞ㢑ಞॳ㰿ሲᇥ᭄䇗ᶹ㗙ЁẔ ߎDŽ
314ৡখϢ㗙ᛳᶧ䩽㰿ⱘᔎᑺ˖䰈ᗻ˖ 64%˗
ᔅ䰇ᗻ˄1–1999ॉ᭄↿छ㉾֓˅˖35%˗Ёᑺ䰇
ᮍ⊩
ᇍ䈵⦄എ
ᴀⷨおѢ1994ᑈ7᳜㟇1996ᑈ10᳜▇߽Ѯϰ࣫䚼 䰓㒇ྚഄⱘϔϾأ䖰е䬛ᅲᮑDŽ䆹ഄऎ䚼ߚሙ⇥ሲ Ѣ▇߽Ѯೳ㨫䲡সᮣDŽ
㉾֓ᷛᴀⱘᬊ䲚
⬅ᆘ⫳㰿⮙ᡔᴃҎਬعᒋᬭ㚆ϧϮҎਬᇍ↣᠋ᆊ ᒁ 䖯 㸠 䍄 䆓 䇗 ᶹ DŽ Փ ⫼ ᔧ ഄ 䇁 㿔 ᬊ 䲚 ᳝ ݇ 䩽 㰿 ᛳ ᶧǃӴ᪁䆞ᮁⱘֵᙃˈᑊᇍ㹿䇗ᶹ㗙䞛䲚㉾֓ᷛ
ᴀDŽ↣ৡফ䇗ᶹ㗙ഛߚথϔϾᷛ䆄དⱘᏺ᳝ᨁᠷᓣ Ⲫᄤⱘ䭓ᮍᔶล᭭ᆍ఼ϔϾ⠯Ⲃ㒌㹟DŽ᮹ᮽ᰼
ᬊ䲚ᆍ఼DŽᷛᴀҹϟϾᯊ䯈↉䞛䲚˖1994ᑈ7᳜
˄
7
᳜1᮹ ࠄ 18᮹ ˅ ˈ 1994ᑈ 10᳜ ˄ 9᳜ 30
᮹ 㟇10᳜19᮹˅ˈ 1994ᑈ12᳜˄12᳜8᮹㟇19᮹˅ˈ 1995ᑈ5᳜˄5᳜5᮹㟇22᮹˅ˈ1995ᑈ8᳜˄8᳜4᮹
㟇19᮹˅ˈ1995ᑈ12᳜˄11᳜20᮹㟇12᳜19᮹˅ˈ1996ᑈ 10᳜˄⹂ߛ᮹ᳳ䆄ᔩ˅DŽ݊Ёˈ11᳜
12᳜໘Ѣ䲼ᄷˈ݊ԭḋᴀᬊ䲚ᯊ䯈ഛ໘ѢᯅᄷDŽ
㉾֓ᷛᴀẔ⌟
⦄എᅲ偠ᅸˈሑᖿᇍࡴܹⲤ∈໘⧚ⱘ㉾֓ᷛᴀ䖯 㸠ᰒᖂ䬰Ẕˈ
0.91
↿छⱘㄝӑ㉾֓ࡴܹ5–10
↿छ4%
ⱘ⬆䝯ˈПৢ䞛⫼ᅮ䞣⬆䝯Э䝮䅵᭄⊩䖯㸠Ẕ偠DŽᇍ 䩽㰿↯佪䶁ᔶ㒓㰿㰿ॉ䖯㸠䅵᭄ҹঞᇍ㉾㉏㒓 㰿ǃकѠᣛ㙴䌒㰿ǃ䰓㉇Ꮘ㰿ሲㄝ䖯㸠䆄ᔩDŽ↣↿
छ㉾֓Ёⱘ㰿ॉ᭄䗮䖛݀ᓣ䅵ㅫ˄㉾֓ ⍂⎆>㉾֓
ḋᴀⱘᆍ⿃ḋᴀⱘԧ⿃@˅DŽⅪᄤⱘᇣ
10
ࠄ42
П䯈DŽՓ⫼ᮃᠬᇨ᷵ℷᄤᇍ䅵᭄䖯㸠䇗ᭈˈҹֱᣕϡৠ㉾֓ᷛᴀⱘϔ㟈ᗻ[19]DŽ 䩽㰿⾡㉏ⱘ⹂ᅮ
ᇚ㳁ݏⱘ10ӑ㉾֓ḋᴀҹঞ䞣ⱘ㰿ॉⳈ⍖⠛
ҹ⹂ᅮѢϱ⢊㲈ᔶᗕϞⱘ䩽㰿⾡㉏[20]DŽ
䗮 䖛 ሌ Ẕ ⌕ ⌾ ⢫ ⱘ ⍜ ࣪ ㋏ 㒳 ᬊ 䲚 ៤ ᑈ 䩽 㰿 DŽ ᇍ12ӑ៤㰿ḋᴀ䖯㸠䆺㒚Ẕ⌟ҹ⹂ᅮԧ⾡㉏DŽ 㸔⏙ᄺẔ⌟˄⡍ᓖᗻ㸔⏙ܡ⭿⧗㲟ⱑ
G
˄IgG
˅ Ẕ⌟˅ᢑপ39ৡ៤Ҏܓスⱘ䴭㛝㸔䖯㸠ᐌ㾘Ẕ⌟ᑊՓ⫼䝊 㘨ܡ⭿䰘⌟ᅮ⊩Ẕ⌟㒓㰿㲨㰿ⱘIgG∈ᑇDŽՓ⫼
S.ratti L3Ўᡫॳᇍ㉏㒓㰿ሲ䖯㸠⌟ᅮˈ䆹Ẕ⌟ⱘ
ᣛ㙴䌒㰿⒊㒘㒛ݙ䰓㉇Ꮘᛳᶧ䰇ᗻ⥛П䯈ⱘᏂᓖ ᮴ᰒ㨫ᗻᛣНDŽ
䇗ᶹЁ䩽㰿䰇ᗻᷛᴀॉ᭄ԩᑇഛ᭄᮴ᰒ㨫 ᗻᏂᓖ˄㸼
1
˅DŽ1995
ᑈ2
᳜䇗ᶹⱘ↯佪䶁ᔶ㒓㰿ॉ᭄ԩᑇഛ᭄ᰒ㨫催Ѣ݊Ҫ䇗ᶹⱘ∈ᑇ˄
P < 0.001
˅˄㸼
1
˅DŽ䖭Ͼ㒧ᵰৃ㛑Ϣ䇗ᶹܓス˄0–14
ቕ˅ⱘ㰿ॉ䅵᭄催᳝݇DŽ ᑈ啘ᗻ߿↨䕗
219ৡফ䇗ᶹ㗙ⱘᑈ啘Ёԡ᭄Ў11ቕ˄ಯԡߚ᭄䯈䎱
Ў6–29ቕ˅˄㸼1˅˗129ৡܓスᑈ啘0–14ቕП䯈˄㑺ऴܓスҎষ᭄ⱘ37%˅ˈ91ৡফ䇗ᶹ៤Ҏᑈ啘
15ቕঞҹϞ˄㑺ऴ៤ҎҎষ᭄ⱘ12%˅DŽᄺ啘ܓ ス˄5–14ቕ˅ⱘӏϔᆘ⫳㰿ᛳᶧ⥛ഛ催Ѣᄺ啘ࠡܓス
˄0–4ቕ˅ˈབ䩽㰿ǃ↯佪䶁ᔶ㒓㰿䰓㉇Ꮘሲ㉏ᆘ
⫳㰿DŽϢᄺ啘ܓスⳌ↨ˈ៤Ҏ˄ı15ቕ˅ⱘ㉾㉏㒓 㰿ǃ㒺㰿ǃकѠᣛ㙴䌒㰿ǃ䰓㉇Ꮘሲ㉏ᆘ⫳㰿ᛳᶧ
⥛䕗Ԣ˄㸼1˅DŽ䩽㰿ǃ↯佪䶁ᔶ㒓㰿ǃ㒺㰿䰓㉇Ꮘ ሲ㉏ᆘ⫳㰿ᄬѢ0–1ቕܓスԧݙDŽ᠔᳝6⾡ᆘ⫳㰿ഛ ᄬѢ2–4ቕܓスԧݙ˄1˅DŽ
ᗻ˄
2000–3999
ॉ᭄↿छ㉾֓˅˖1%
DŽT.
䶁㰿˖䰈 ᗻ ˖
16%
ˈ ᔅ 䰇 ᗻ ˄1–999
ॉ ᭄ ↿ छ ˅ ˗ Ё ᑺ 䰇 ᗻ ˄1000–9999
ॉ ᭄ ↿ छ ˅ ˖30%
ˈ ᔎ 䰇 ᗻ˄ı
10 000
ॉ᭄↿छ˅˖4%
DŽ39ৡখϢ㗙ⱘ㸔⏙ᄺ䆞ᮁᰒ⼎28%Ў㉾㉏㒓㰿
ᛳᶧ䰇ᗻˈ18%Ўৃ⭥䰇ᗻˈ21%Ў⭥⢀㲨㰿ᛳᶧ䰇 ᗻˈ5%Ўৃ⭥䰇ᗻDŽᑈ啘Ёԡ᭄Ў32ቕ˄ಯߚԡ᭄䯈 䎱Ў24–41˅DŽ7
䇗ᶹ↨䕗55
˄18%
˅ৡখϢ㗙খࡴ䇗ᶹ᭄䍙䖛DŽ䩽㰿䰇 ᗻ⥛Ϣ㉾㉏㒓㰿䰇ᗻ⥛П䯈ⱘᏂᓖ᳝ᰒ㨫ᗻᛣН˄㸼
1
˅DŽ䩽㰿䰇ᗻ⥛1994
ᑈ10
᳜䲼ᄷࠡ䕗催ˈৃ㛑⬅Ѣ䰓㣃䖒偅㰿⊏⭫乍Ⳃⱘᅲᮑˈᬙ
1995
ᑈ8
᳜ 䰇ᗻ⥛䕗Ԣˈ1995
ᑈ12
᳜䲼ᄷᯊ䕗催DŽ1994
ᑈ10
᳜ Ϣ1 9 9 6
ᑈ1 0
᳜ Ⳍ ↨ ˈ 䩽 㰿 䰇 ᗻ ⥛ ᳝ ᯢ ᰒ 䰡 Ԣ˄
P < 0 . 0 0 2
˗㸼1
˅ DŽ ㉾ ㉏ 㒓 㰿 䰇 ᗻ ⥛ Ѣ1995
ᑈ5
᳜ᯊ䕗催ˈৃ㛑䱣ⴔ䰓㣃䖒偅㰿⊏⭫乍Ⳃ ⱘᅲᮑˈ1995
ᑈ8
᳜ᯊ䕗Ԣˈ1995
ᑈ12
᳜䲼ᄷᯊ䕗 催ˈ1996
ᑈ10
᳜䕗Ԣ˄㸼1
˅DŽ↯佪䶁ᔶ㒓㰿ǃकѠ㸼1. 1994ᑈ7᳜㟇1996ᑈ10᳜▇߽Ѯ࣫乚ഄ㙴䘧ᆘ⫳㰿䇗ᶹҎ㕸䰇ᗻ⮙՟᭄ঞ↨՟ˈn = 383
䇗ᶹ᮹ᳳ ফẔ Ҏ᭄
ӏϔᆘ⫳㰿 䩽㰿 ↯佪䶁ᔶ㒓㰿 ㉾㉏㒓㰿 㒺㰿 कѠᣛ㙴䌒㰿 ݙ䰓㉇Ꮘሲ 䰇ᗻ᭄
(%)
䰇ᗻ᭄
(%)
ԩᑇഛ᭄
ॉ᭄↿छ [Exp (CI)]
䰇ᗻ᭄
(%)
ԩᑇഛ᭄
ॉ᭄↿छ [Exp (CI)]
䰇ᗻ᭄
(%)
䰇ᗻ᭄
(%)
䰇ᗻ᭄
(%)
䰇ᗻ᭄
(%)
1994ᑈ7᳜ 62 57 (92) 19 (31) 200 53 (86) 820 13 (21) 15 (24) 10 (16) 18 (29)
[120–350] [520–1300]
1994ᑈ10᳜ 76 73 (94) 43 (57)* 180 68 (89) 560 13 (16) 13 (16) 9 (11) 22 (27)
[120–250] [390–800]
1994ᑈ12᳜ 37 31 (84) 17 (46) 110 29 (78) 400 4 (11) 3 (8) 3 (8) 11 (30)
[61–190] [260–620]
1995ᑈ5᳜ 48 44 (92) 16 (33) 120 40 (83) 800 17 (35)* 7 (15) 0 (0) 10 (21)
[73–200] [460–1400]
1995ᑈ6᳜ ऩࠖ䞣䰓㣃䖒偅㰿⊏⭫ᮍḜ᳓ҷ৽⬆㣃⊏⭫ᮍḜ
1995ᑈ8᳜ 63 57 (90) 7 (11)*噛 130 53 (84) 520 6 (19)* 12 (19) 4 (6) 23 (37)
[42–420] [360–740]
1995ᑈ12᳜ 44 41 (93) 15 (34)* 140 38 (86) 2200*噜 13 (30)* 12 (27) 5 (11) 17 (27)
[79–250] [1400–3300]
1996ᑈ10᳜ 53 46 (87) 13 (25)噛 100 44 (83) 380 4 (8)* 7 (13) 5 (9) 21 (40)
[53–180] [230–640]
ᘏ䅵c 383 349 (91) 130 (34) 100 325 (85) 650 70 (18) 69 (18) 36 (9) 122 (32)
[110–190] [550–780]
Exp (CI)㕂ֵऎ䯈˗ԩഛ᭄ˈফᛳᶧⱘԩᑇഛ᭄DŽ
Ϣҹࠡⱘ䇗ᶹⳌ↨ᰒ㨫ᏂᓖDŽ
噛 Ϣϔᑈࠡ䇗ᶹⳌ↨᳝ᰒ㨫ᏂᓖDŽ
噜 Ϣ᠔᳝݊ᅗ䇗ᶹⱘԩഛ᭄Ⳍ↨᳝ᰒ㨫ᏂᓖDŽ
c ᶤѯ䇗ᶹ㗙খϢ䇗ᶹDŽ
ऩࠖ䞣
20
↿ܟगܟˈ⬆㣃↣᮹100
↿ܟˈϔ ᮹ϸˈ䖲㓁Փ⫼3
DŽ㞾1995
ᑈ5
᳜䍋ˈ䰓㣃䖒˄ ԧ 䞡
8–10
݀ ᭸ П 䯈 ⱘ ܓ ス ऩ ࠖ 䞣200
↿ ܟ ˈ 䍙 䖛1 0
݀ ᭸ ⱘ ܓ ス ऩ ࠖ 䞣 Ў4 0 0
↿ ܟ ˅ ᓔ ྟ Ў ↣ ᑈ ܓ ス ԧ Ẕ ⱘ ᐌ ⫼ 偅 㰿 㥃 ˗ ៤ Ҏ ܓ ス ⭥ Ԑ ⹂ 䆞 㙴 䘧 ᆘ ⫳ 㰿 ⮙ ᛳ ᶧ 㗙 ˈ ᷛ ޚ ⊏ ⭫ ᑣ ᰃ↣ ᮹
400
↿ ܟ 䰓 㣃 䖒 ˈ 䖲 㓁 Փ ⫼3
DŽ ㉾ ֓ Ẕ⌟ ߎ ⱘ ᆘ ⫳ 㰿 ⾡ ㉏ ৠ ϔ ഄ ऎ ৠ ᯊ ᓔ ሩ ⱘ ϸ Ͼ ᇣ ൟ ⷨ お Ё Ⳍ Ԑ[10,13]ˈ Ԛ ᰃ ᴀ ⷨ お ᕫ ߎ ⱘ 䰇 ᗻ
⥛ 催 DŽ 䖭 ৃ 㛑 ᰃ Ў ⬆ 䝯 Э 䝮 ᅮ 䞣 ⊩ ⱘ ♉ ᬣ ᑺ
催 ᠔ 㟈 DŽ ሑ ㅵ 䖭 ⾡ ᮍ ⊩ ⱘ ♉ ᬣ ᑺ 催 Ѣ Ⳉ
⍖⠛⊩ˈԚᰃ䖭г᳝ৃ㛑Ϣ㉾֓Ẕᶹⱘ᭄䞣Ⳍᇍ᳝
݇ˈᑊϨ䆹ᮍ⊩ᕜৃ㛑ԢԄњᅲ䰙ᙷ⮙⥛˗՟བˈᇣ
㒘˄
n = 39
˅㸔⏙ᄺẔ⌟䰇ᗻⱘ㉾㉏㒓㰿ᙷ⮙⥛Ўᄺ 啘 ܓ ス ⱘ ↯ 佪 䶁 ᔶ 㒓 㰿 ॉ ᭄ ⱘ ԩ ᑇ ഛ ᭄
˄
1200
ॉ↿छ˅ᰒ㨫催Ѣᄺ啘ࠡܓス˄400
ॉ↿छ˅៤Ҏ˄
410
ॉ↿छ˅˄P<0.001
˅DŽᑈ啘↉ ᵘ䩽㰿ॉ᭄ⱘԩᑇഛ᭄П䯈ⱘᏂᓖ᮴ᰒ㨫ᗻDŽ᳝ᯢ⹂ᗻ߿䆄ᔩⱘ䇗ᶹ㗙Ёˈ⬋ᗻ
100ৡˈཇ
ᗻ115ৡDŽ⬋ᗻফ䇗ᶹ㗙Ё䩽㰿ᛳᶧ⥛˄47%ᇍ↨
30%ˈ P = 0.012˅ǃ↯佪䶁ᔶ㒓㰿ᛳᶧ⥛˄92%ᇍ
↨79%ˈ
P = 0.0082˅कѠᣛ㙴䌒㰿17%ᇍ↨
6% P = 0.011ᛳᶧ⥛ᰒ㨫催ѢཇᗻDŽ
䞡ᆘ⫳㰿ᛳᶧ
314ৡ 㹿 䇗 ᶹ 㗙 Ё ˈ 152Ҏ ˄ 48%˅ ᛳ ᶧ ⾡ ᆘ ⫳
㰿ˈ109Ҏ˄35%˅ϡҙᛳᶧϔ⾡ঞҹϞⱘᆘ⫳㰿㗠 Ϩᛳᶧ⾡ॳ㰿˄㸼2˅DŽᆘ⫳㰿Ϣॳ㰿ᛳᶧП䯈᳝㒳䅵ᄺ݇㘨˄P = 0.0039˅DŽ 䩽㰿⾡㉏
Ң㳁㉾֓ݏ㦋ᕫⱘᛳᶧᗻᑐ㰿ഛ⹂䅸Ў䩽ষ㒓㰿 ሲˈ᳔᳝ৃ㛑ЎकѠᣛ㙴䩽㰿DŽҢ⢫䑿Ϟᬊ䲚ࠄⱘ៤ 㰿⹂䅸Ў⢀ᄨ㒺㰿DŽ
䅼䆎
ҹϞ㒧ᵰ㸼ᯢˈሑㅵⷨおᓔྟࠡᏆ㒣ᓔሩњܓス 偅㰿䅵ߦˈԚ1994ᑈ㟇
1996ᑈ䇗ᶹ⼒ऎЁҎ㕸ᛳ
ᶧϔ⾡⾡㙴䘧ᆘ⫳㰿⮙ⱘᙷ⮙⥛ҡ✊䴲ᐌ催DŽ1994ᑈˈ㙴䘧ᆘ⫳㰿⮙ⱘᷛޚ⊏⭫ᮍḜЎ৽
㸼2. 1994ᑈ᳜ࠄ1996ᑈ10᳜▇߽Ѯ࣫乚ഄ㷩㰿 ড়ᑊॳ⫳䴲ॳ⫳ࡼ⠽ᛳᶧ᠔ऴ↨՟˄n = 314˅*
*᳝ᆘ⫳㰿ᛳᶧॳ㰿ᛳᶧ˄P = 0.0039˅ⱘ㒳䅵Ϟᰒ㨫݇㘨 0
10 20 30 40 50
0 1 2 3 4
ᛳᶧ↨՟ᛳᶧ↨՟
㷩㰿⾡㉏ 㷩㰿⾡㉏
ҙ⳱⯻Ყ ⳱⯻ේ↢ࡼ‛ว䅵Ყ
0 20 40 60 80 100
0–1 2–4 5–14 15ቕએ
䰇ᗻ⥛䰇ᗻ⥛%
ᑈ啘㒘˄ቕ˅
ᑈ啘㒘˄ቕ˅
A. duodenale T. trichiura S. stercoralis R. nana G. duodenalis Entamoeba spp
㸼
1. 1994
ᑈ7
᳜㟇1996
ᑈ10
᳜▇߽Ѯ࣫䚼乚ഄᑈ啘㒘䇗ᶹ㗙Ёϡৠ㙴䘧ᆘ⫳㰿䰇ᗻ⥛* ᑈ啘㒘ᦤկ219খϢ㗙˄70 ˁ˅ˈ 0–4ቕᑈ啘㒘ߚЎ0–12–4DŽ
कѠᣛ㙴䩽ষ㒓㰿
↯佪䶁ᔶ㒓㰿
㉾㉏㒓㰿 㒺㰿 कѠᣛ㙴䌒㰿 ݙ䰓㉇Ꮘሲ
ᔩ[33]ˈ䖭гৃ㛑ᰃ⬅Ѣೳ㨫Ҏ㕸Ёᅲᮑњ䰓㣃䖒偅 㰿乍ⳂDŽ
⢀㲨㰿ᐌᆘ⫳Ѣ⢫ˈѻॉ៤㰿Џ㽕ᆘ⫳Ѣ⢫ᑐ
DŽ៥Ӏᇍ
21%
ⱘফẔҎ㕸䖯㸠⢀㲨㰿⡍ᓖᗻLgG
ᡫ ԧẔ⌟ˈ㒧ᵰᰒ⼎Ҏ㉏ᲈ䴆ᛳᶧ⥛䕗催˄ৃ㛑⬅Ѣ㰿ॉᨘܹ᠔㟈˅DŽⳌ↨Пϟˈ
20
Ϫ㑾90
ᑈҷⱘ䇗ᶹᰒ⼎ˈ䕗䖰ⱘ▇߽Ѯϰ࣫䚼䰓㒇ྚഄऎⱘϔೳ㨫 Ҏ㕸Ё㸔⏙䰇ᗻ⥛Ў
43%
[10]ˈ࣫乚ഄⱘϔᮣ㕸㸔⏙䰇ᗻ⥛Ў
11.1%
ˈ㗠▇߽Ѯ᱂䗮Ҏ㕸㸔⏙䰇ᗻ⥛Ў5.7%
[34]DŽೳ㨫ҎষЁⱘ↯佪䶁ᔶ㒓㰿ᛳᶧⱘЈᑞϹ 䞡ᗻᇮϡ⏙ἮDŽᑐ㰿ৃᓩ䍋㙱㛣⮒⮙˄ݙ㛣ᑐ㰿⿏㸠⮛˅ⴐ䚼⮙ব˄ⴐᑐ㰿⿏㸠⮛˅[19]DŽݙ㛣ᑐ㰿⿏㸠
⮛᳒㒣࣫䚼ഄऎ䴲ೳ㨫Ҏ㕸Ёথ⦄ˈԚᰃ䖥ᑈᑊ
≵᳝থ⦄ೳ㨫ሙ⇥⹂䆞⮙՟
Bart Currie
ˈ䖒ᇨ᭛ⱛᆊ ए䰶থ㸼᭄DŽ㉾㉏㒓㰿ᛳᶧ䰇ᗻ⥛ⱘব࣪ᕜ䲒㾷䞞DŽ᳝᳒䆄 ᔩᰒ⼎ℸ⠽⾡ৃ䯈ℛᥦߎᑐ㰿[35]ˈৃ㛑⫼Ѣ㾷䞞ᛳᶧ
⥛ব࣪DŽϔ⾡ৃ㛑ᗻᰃ৽ǃ⬆㣃䰓㣃 䖒ㄝ㥃⠽ϡ㛑ḍ䰸ᛳᶧˈҙ㛑᱖ᯊᗻⱘޣᇥᑐ㰿ᥦ ߎDŽⳂࠡˈՓ⫼Ӟ㓈㦠㋴ৃҹᦤ催⊏⭫ࡳᬜ[25]DŽ ᇍܼ⼒ऎՓ⫼Ӟ㓈㦠㋴⊏⭫㉾㉏㒓㰿ᛳᶧⱘ᳝ᬜᗻ 䆘Ԅℷᅲᮑ[26]DŽ
1996ᑈ10᳜ⱘ䇗ᶹ㒧ᵰᰒ⼎ˈ䰓㣃䖒⊏⭫乍
Ⳃℷ䰡Ԣ䩽㰿ⱘᙷ⮙⥛ˈॳᰃϔᑈЁकѠᣛ㙴 䩽㰿ӥᑐ㰿៤❳ᳳ䯈䇗ᶹ㗙ⱘ䩽㰿ᛳᶧ⥛ᰒ㨫䰡 ԢDŽ䖭ϔ㒧ᵰгϢফ䰓㣃䖒⊏⭫㗙ৃҹ⍜䰸ӥᑐ㰿ᰃϔ㟈ⱘDŽ1995ᑈ8᳜䩽㰿䰇ᗻ⥛ߎ⦄䰡ԢϢ䰓 㣃䖒⊏⭫乍Ⳃᓔྟᅲᮑ᳝݇DŽ䖥ᳳᎹᰒ⼎ˈकѠ ᣛ㙴䩽㰿Ꮖᕫࠄᕜདⱘࠊ[36,37]ˈԚᰃܓスᛳᶧ↯佪 䶁ᔶ㒓㰿㒺㰿ⱘ↨՟ҡ✊ᕜ催[37]DŽ᳔䖥ⱘϔ㆛Ѣ ᅲ偠ᅸ᭄ⱘ㓐䗄ᰒ⼎ˈ࣫䚼乚ഄ↯佪䶁ᔶ㒓㰿ⱘẔ ߎ⥛䖛এᑈਜᯢᰒϟ䰡䍟[14]DŽऩࠖ䞣䰓㣃䖒
⍜䰸ܓス↯佪䶁ᔶ㒓㰿ⱘ᳝ᬜᗻԢѢ៤Ҏ[38]ˈৠᯊг ԢѢ⍜䰸㒺㰿᳝ᬜᗻ[39]DŽ៥Ӏⱘ㒧ᵰϢℸᰃϔ㟈ⱘDŽ 䖲㓁3↣Փ⫼䰓㣃䖒ৃҹᦤ催⍜䰸↯佪䶁ᔶ㒓 㰿ǃ㒺㰿कѠᣛ㙴䌒㰿ㄝⱘ᳝ᬜᗻ[38,39]DŽ
ⷨおЁ㾖⌟ࠄⱘ䰓㉇Ꮘ㦠ሲᆘ⫳㰿ᛳᶧϡ㛑⹂
ᅮᰃ৺᳝݀݅ि⫳ᛣНDŽ㽕⹂ᅮ㹿䇗ᶹ㗙Ёᛳᶧ⒊ 㒘㒛䰓㉇Ꮘ
moshkovski
䰓㉇Ꮘ⮙ॳԧⱘᛳᶧᑺ䳔 㽕䖯㸠㉾֓ߚᄤẔ⌟ˈ㱑✊⦄ৃҹᅲᮑ䖭乍Ẕ⌟ᡔ ᴃˈԚᔧᯊᰃ᮴⊩䖯㸠ⱘDŽϔϾৃ㛑ᇐ㟈催ᙷ⮙⥛ⱘ㋴ᰃ↣᠋䇗ᶹᆊᒁ Ё᳝䞣Ҏਬሙԣϔ䍋[40]ˈ䲒ҹֱ䆕亳⠽ޚ⏙
⋫䖛ⱘि⫳ˈ⍜↦䆒ᮑгϡᅠ[41]DŽ᳔䖥ˈᔧഄℷ
28%ˈ㗠㒘˄n = 314˅䗮䖛⬆䝯Э䝮⊩Ẕ⌟ᰒ⼎ᙷ
⮙⥛߭Ў19%DŽϔϾⳌԐⷨおᰒ⼎ˈՓ⫼Э䝌Э䝃 ҷ᳓Э䝮ৢ♉ᬣᑺᰒ㨫ԢѢՓ⫼⨐㛖ᑇᵓݏ⊩[24]DŽ 㸔⏙ᄺẔ⌟䰇ᗻ䆩偠㸼ᯢབᵰ㉾㉏㒓㰿偅䰸ˈ䗮䖛
3–6Ͼ᳜ⱘ᳝ᬜ⊏⭫ᡫԧৃҹ䕀䰈
[25,26]DŽ㱑✊Ң㳁ݏЁ㦋ᕫⱘᑐ㰿Ў䩽㰿⾡ሲˈϨ
᳔ৃ㛑ЎकѠᣛ㙴䩽㰿ˈԚᰃ㕢⌆䩽㰿Ѻϡ㛑ᥦ 䰸DŽकѠᣛ㙴䩽㰿гৃ㛑ᄬˈЎ▇߽Ѯ⢫ԧݙ ᄬ䆹ᆘ⫳㰿[27]ˈҎԧݙѺẔ⌟ߎ䆹ᆘ⫳㰿[28]DŽ៥ Ӏ㾖ᆳࠄ䩽㰿ᛳᶧ䰇ᗻ⥛䱣ⴔᄷ㡖㗠ব࣪ˈ䖭ϔ䆕
㸼ᯢकѠᣛ㙴䩽㰿ᕜৃ㛑Ў䩽㰿ᛳᶧⱘЏ㽕⾡ሲDŽ䖭
⾡ᄷ㡖ᗻব࣪ᕜৃ㛑ᰃЎˈᑐ㰿ᯅᄷ⌏ࡼԢˈ 㗠䲼ᄷӴ᪁Ⳍᇍᔎ[29]DŽकѠᣛ㙴䩽㰿៤㰿ⱘᇓ
ੑὖЎϾ᳜DŽᑐ㰿䲼ᄷৢᳳ䖯ܹ䑿ԧ㳄ӣˈѢ ᯅᄷৢᳳ៤❳DŽ৽ৃҹᴔ⅏कѠᣛ㙴䩽㰿៤ 㰿ˈԚ᮴⊩⍜♁ӥᳳⱘᑐ㰿[29]DŽ䰇ᗻ⥛ⱘ催ዄԡѢ
1994
ᑈ10
᳜ˈ݊ЎᯅᄷৢᳳDŽ䩽㰿䲼ᄷӴ᪁ᔎৃ㛑ᰃ䗴៤
1994
ᑈ1995
ᑈⱘ12
᳜ӑकѠᣛ㙴䩽 㰿ᛳᶧ䰇ᗻ⥛催ⱘॳDŽᴀⷨおথ⦄ϸ⾡ҹϞ⾡㙴䘧ᆘ⫳㰿ᛳᶧⱘᙷ
⮙⥛催ˈؐᕫ݇⊼DŽ⬅Ѣϡৠⱘᆘ⫳㰿⠽⾡ৃᓩথϡ ৠ⮙⧚ᄺᬍবˈҢ㗠ᇐ㟈᳝䞡ᆘ⫳㰿ᛳᶧⱘϾԧ ⱘথ⮙⥛催[18]DŽ⬋ᗻ䕗ཇᗻᯧᛳᶧ䩽㰿ǃ↯佪䶁 ൟ㒓㰿कѠᣛ㙴䌒㰿ˈ݊Ҫഄऎг᳒㾖ᆳࠄ㉏Ԑ 㒧ᵰ[30]DŽ
Ϣ݊ҪⷨおⳌԐˈᴀⷨおгথ⦄᷵ܓスⱘ㙴 䘧ᆘ⫳㰿ᛳᶧ⥛催Ѣ݊Ҫᑈ啘㒘[18]DŽ
2–4
ቕᑈ啘㒘 ᆘ⫳㰿ᛳᶧⱘ䰇ᗻ⥛гᕜ催ˈ㗠䖭ϔᑈ啘ℷ໘Ѣ݇䬂 ⱘথ㚆䰊↉DŽ㒺㰿कѠᣛ㙴䌒㰿Џ㽕ᛳᶧ15
ቕ ҹϟܓスˈ䖭Ϣ▇߽Ѯ㽓䚼ೳ㨫⼒ऎⱘⷨお㒧ᵰ ϔ㟈[9]DŽখϢ䇗ᶹⱘ᷵ܓスϢ៤Ҏ䩽㰿ǃ↯佪䶁 ൟ㒓㰿ᛳᶧ⥛П䯈ⱘᏂᓖ᮴㒳䅵ᄺᛣНˈԚᰃ᷵ܓ スⱘ↯佪䶁ൟ㒓㰿ᛳᶧᔎᑺᰒ㨫催Ѣ៤ҎDŽ៤Ҏ䇗ᶹᇍ䈵Ёг᳝Ⳍᔧ䚼ߚᛳᶧ䩽㰿ǃ↯佪 䶁ൟ㒓㰿Ҏԧ㉾㉏㒓㰿ˈ䇈ᯢњᐌ㾘偅㰿⊏⭫
៤ҎܓスЁഛᑨᓔሩDŽϢᄺ啘ܓスⳌ↨ˈ៤Ҏ䇗ᶹ ᇍ䈵Ёᛳᶧ㉾㉏㒓㰿ⱘ䰇ᗻ↨՟䕗Ԣˈ䖭ϔ㒧ᵰᓩ Ҏ ݇ ⊼ ˈ Ў བ ᵰ ϡ 䞛 প ᳝ ᬜ ⊏ ⭫ ˈ ㉾ ㉏ 㒓 㰿
ৃ㒜⫳ᛳᶧ[31]DŽऩࠖ䞣䰓㣃䖒⊏⭫ᑊϡ㛑᳝ᬜ⍜䰸 ᛳᶧ[25]DŽ
⢀াⱘ⢀ᮄᄶᄤ㰿ᛳᶧৃҹࡴҎᛳᶧⱘৃ㛑 ᗻˈҎ㉏ৃ㸼⦄Ў᮴⮛⢊ᛳᶧথ⫳ர䝌ᗻ㙴♢[32]DŽ 㸔⏙⌕㸠⮙ᄺⷨお㸼ᯢ90ᑈҷᯚ݄ഄऎ䆹ᛳᶧ 䕗Ўᐌ㾕[32]DŽ㱑✊࣫䚼ഄऎⱘ䴲ೳ㨫Ҏ㕸ЁᏆ㒣 থ⦄ர䝌ᗻ㙴♢ˈԚᰃᑊ≵᳝ೳ㨫Ҏ㕸ᙷ⮙ⱘЈᑞ䆄
Surveillance and Response Journal, 2015, 6(1):44–51.
doi:10.5365/wpsar.2015.6.1.008
খ㗗᭛⤂1. Jose DG, Welch JS. Growth retardation, anaemia and infection, with malabsorption and infestation of the bowel. The syndrome of protein-calorie malnutrition in Australian Aboriginal children.
The Medical Journal of Australia, 1970, 1:349–356.
pmid:5439141
2. Layrisse M, Roche M. The relationship between anemia and hookworm infection. Results of surveys of rural Venezuelan population. American Journal of Hygiene, 1964, 79:279–301.
pmid:14159948
3. Lucas SB et al. Aberrant form of Hymenolepis nana: possible opportunistic infection in immunosuppressed patients. Lancet, 1979, 2:1372–1373. doi:10.1016/S0140-6736(79)92859-9 pmid:92715
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S0140-6736(86)92093-3 pmid:2874297
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Ⳃࠡ䖿ߛ䳔㽕䞛⫼عᒋ֗䖯ܼ⊏⭫ㄝ㓐ড়ᗻ 䰆⊏↉ᴹ䖯㸠ᆘ⫳㰿ࠊDŽ݊Ёϔ乍䞡㽕↉ህᰃ 䗮䖛៤Ҏ⼒ऎᬭ㚆䖯㸠⼒ऎࡼਬǃখϢ䰆⊏DŽ
ᴀⷨおЁˈḋᴀ≵᳝㒣䖛䱣ᴎᢑḋˈḋᴀ䞣䕗 ᇣˈᑊϨখϢ㗙Ўᮄࢳᇍ䈵DŽ䇗ᶹ䖛Ёˈܓ ス᠔ऴ↨՟ϡᮁব࣪˄45–70%˅ˈ⬋ཇᗻ߿↨՟г
ব࣪˄0.8–1.7˅DŽ⫼Ѣ↨䕗ϡৠᑈ啘ǃᗻ߿ǃ䞡 ᛳᶧⱘড়ᑊؐᑊ≵᳝㗗㰥䩽㰿㉾㉏㒓㰿ⱘᄷ㡖ব
࣪DŽᴹ⑤ѢعᒋЁᖗⱘ᭛ḷ䆄ᔩᑊϡᅠᭈˈ᮴⊩њ㾷 ϾҎⱘ偅㰿⊏⭫ᅲᮑᚙމ˗ℸ៥Ӏҙߚᵤњ⊏⭫ᑆ 乘乍Ⳃᇍᆘ⫳㰿ᙷ⮙⥛ⱘᕅડDŽ䇗ᶹЁᑊ䆩ऎ ߚᮄথᛳᶧ㗙᮶ᕔᛳᶧ㗙DŽ
㒧䆎
ሑㅵᄬ䇌䰤ࠊˈԚᰃᴀⷨお䞡⚍থ⦄њϞϪ㑾90 ᑈҷأ䖰ೳ㨫⼒ऎᇸ݊ᰃ᷵ᄺ⫳Ё㙴䘧ᆘ⫳㰿ᛳᶧ ⱘᙷ⮙⥛催ˈϨ䞡ᆘ⫳㰿ᛳᶧ⥛催DŽ䇗ᶹ᭄ᰒ
⼎ˈ䱣ⴔ↣ᑈϔᇍܓスᓔሩऩࠖ䞣䰓㣃䖒⊏⭫ᑆ 乘乍Ⳃˈ䇗ᶹ㗙Ё䩽㰿⮙ⱘ䰇ᗻ⥛᳝ᰒ㨫䰡ԢˈԚᰃ
݊Ҫ⾡㉏ⱘ㙴䘧ᆘ⫳㰿⮙ᛳᶧ⥛≵᳝ᰒ㨫ব࣪DŽ䆹ग़
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᮴
䌘䞥ᬃᣕ
ᴀⷨお⬅
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عᒋЁᖗ݀݅ि⫳ⷨおথሩྨਬⱘ䩽㰿⮙ⷨおϧ乍䌘䞥ᬃᣕˈ䆹䌘䞥 ᴹ⑤Ѣᆊि⫳ए⭫ⷨおྨਬӮ乍ⳂDŽ
Kieran Aland
㦋ᕫᯚ݄ᄺमৢ༪ᄺ䞥ᬃᣕDŽ㟈䇶
ᛳ 䇶Galiwin’ku⼒ ऎ ሙ ⇥ ᦤ կ њ ㉾ ֓ 㸔 ḋ Փ ᕫ ᴀ
ⷨおৃҹ乎߽䖯㸠˗ᛳ䇶Јᑞ⮙⧚एᄺⷨお᠔ⱘ
John WalkerRogan LeeЎᴀⷨおᦤկњ㸔⏙ᄺ㒧ᵰ
ҹঞԧ᪡ᮍ⊩DŽᛳ䇶David ShieldЎᴀⷨおⱘ᭄ߚᵤᦤկ㒳䅵ᄺᬃᣕDŽ ᓩ⫼ᴀ᭛ഄഔ˖
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