2016和2018年江西省信丰县人群华支睾吸虫感染情况和知信行效果分析

doi:10.12140/j.issn.1000-7423.2021.01.010

中国寄生虫学与寄生虫病杂志 ›› 2021, Vol. 39 ›› Issue (1): 69-75.doi: 10.12140/j.issn.1000-7423.2021.01.010

2016和2018年江西省信丰县人群华支睾吸虫感染情况和知信行效果分析

陈喆¹(), 袁长红², 姜唯声¹, 杨玉华², 蓝明兴², 刘克星¹, 曾小军¹, 朱慧慧³^,^*()

1 江西省寄生虫病防治研究所,江西省血吸虫病预防与控制重点实验室,南昌 330096
2 信丰县疾病预防控制中心,赣州 341699
3 中国疾病预防控制中心寄生虫病预防控制所,国家热带病研究中心,世界卫生组织热带病合作中心,科技部国家级热带病国际联合研究中心,卫生部寄生虫病原与媒介生物学重点实验室,上海 200025

收稿日期:2020-05-09 修回日期:2020-06-21 出版日期:2021-02-28 发布日期:2021-03-10
通讯作者: 朱慧慧
作者简介:陈喆（1981-）,男,学士,副主任医师,从事寄生虫病防治工作。E-mail： bjchenzhe@163.com
基金资助:
江西省重点实验室计划项目(2019BCD40006);江西省卫生健康委员会科技计划项目(20203868);江西省卫生健康委员会科技计划项目(20203870)

Infection status of clonorchiasis sinensis and the knowledge, attitudes and practices towards the disease among human population in Xinfeng County of Jiangxi Province in 2016 and 2018

CHEN Zhe¹(), YUAN Chang-hong², JIANG Wei-sheng¹, YANG Yu-hua², LAN Ming-xing², LIU Ke-xing¹, ZENG Xiao-jun¹, ZHU Hui-hui³^,^*()

1 Jiangxi Provincial Institute of Parasitic Diseases Control, Jiangxi Provincal Key Laboratory of Schistosomiasis Prevention and Control, Nanchang 330096, China
2 Xinfeng Center for Disease Control and Prevention, Ganzhou 341699, China
3 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Center of Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China

Received:2020-05-09 Revised:2020-06-21 Online:2021-02-28 Published:2021-03-10
Contact: ZHU Hui-hui
Supported by:
Key Laboratory of Schistosomiasis Prevention and Control Science(2019BCD40006);Technology Planning Project of Jiangxi Health Commission(20203868);Technology Planning Project of Jiangxi Health Commission(20203870)

摘要/Abstract

摘要：

目的分析江西省信丰县华支睾吸虫病综合防治示范区（示范区）实施3年后,人群华支睾吸虫病知识、态度、行为（知信行）效果变化及感染率变化。方法 2016和2018年在示范区26个行政村中,每村整群抽取3周岁以上常住居民150人开展粪检和问卷调查。采用调查问卷了解研究对象的防治知识、行为与态度的变化。采用改良加藤厚涂片法（Kato-Katz法,一粪二检）检查研究对象的华支睾吸虫感染情况。选取两年均参加调查的人群作为研究对象,采用χ ²检验进行组间比较。结果 2016和2018年均参加调查的人群共1 108人,华支睾吸虫感染率由2016年的22.5%（249/1 108）下降至2018年的9.7%（107/1 108）（P < 0.01）。两年男性感染率分别为31.9%（171/536）和13.6%（73/536）,均高于女性的13.6%（78/572）和5.9%（34/572）（P < 0.01）。调查问卷分析结果显示,人群华支睾吸虫感染防治知识知晓率由2016年的4.3%（48/1 108）上升至2018年的25.0%（277/1 108）（P < 0.01）,两年知晓人群感染率（35.4%,17/48;10.1%,28/277）均高于不知晓人群（21.9%,232/1 060;9.5%,79/831）（P < 0.01、P > 0.05）;2018年食“鱼生”者今后拒绝食用“鱼生”、感染后愿意接受治疗人群的比例分别为77.9%（141/181）、99.7%（1105/1 108）,均高于2016年的28.9%（68/235）与95.6%（1 059/1 108）（P < 0.01）;人群食“鱼生”比例由2016年的21.2%（235/1 108）下降至2018年的16.3%（181/1 108）（P < 0.01）,两年食“鱼生”人群感染率（61.3%,144/235;43.1%,78/181）均高于不食者（12.0%,105/873;3.1%,29/927）（P < 0.01）。驱虫覆盖率由2016年的69.9%（174/249）上升至2018年的89.7%（96/107）（P < 0.01）。两年均不知晓华支睾吸虫病危害的人群占73.2%（811/1 108）,两年均食用“鱼生”习惯的人群占10.3%（114/1 108）。结论由于示范区各项防治工作开展,人群华支睾吸虫感染率所有下降,防治知识的知晓率、食“鱼生”者今后拒绝食用“鱼生”与人群如感染后愿意接受治疗的意愿升高,食“鱼生”比例与平均感染率下降,效果显著。

关键词: 华支睾吸虫病, 知信行, 分析, 江西省, 信丰县

Abstract:

Objective To evaluate assess changes in knowledge, attitude, practice (KAP) towards clonorchiasis and the status of human infection three years after the establishment of a demonstration area for clonorchiasis control in Xinfeng County. Methods In 2016 and 2018, 150 permanent residents aged 3 years or above were cluster sampled in each of the 26 administrative villages in the demonstration area, for fecal examination and questionnaire survey. The questionnaires survey was applied to understand the changes of knowledge, behavior and attitude toward clonorchiasis control among participants. The fecal examination was conducted using the modified Kato-Katz thick smear method (two slide-reading/one sample) to assess the status of Clonorchis siensis infection. The participants in the two-year suvey were included in the analysis, and the comparisons between groups were made with the Chi-square test. Results A total of 1 108 residents participated in the two surveys in 2016 and 2018. The infection rate of Clonorchis sinensis dropped from 22.5% (249/1 108) in 2016 to 9.7% (107/1 108) in 2018 (P < 0.01). The infection rate in males (31.9%, 171/536; 13.6%, 73/536) was higher than that in females (13.6%, 78/572; 5.9%, 34/572) in the two years (P < 0.01). The questionnaire analysis revealed that the awareness rate on the knowledge of clonorchiasis control increased significantly from 4.3% (48/1 108) in 2016 to 25.0% (277/1 108)in 2018 (P < 0.01). The infection rate was higher in the awareness group (35.4%, 17/48; 10.1%, 28/277) than that in the unawareness group (21.9%, 232/1 060; 9.5%,79/831) in both years (P₂₀₁₆ < 0.01, P₂₀₁₈ > 0.05). In 2018, 77.9% (141/181) of raw-fish consumers would refuse to eat raw fish again, and 99.7% (1 105/1 108) would be willing to receive treatment after infection, which was higher than 28.9% (68/235) and 95.6% (1 059/1 108) in 2016 respectively (P < 0.01). The proportion of residents eating raw fish decreased from 21.2% (235/1 108) in 2016 to 16.3% (181/1 108) in 2018 (P < 0.01), and the infection rate in those eating raw fish (61.3%, 144/235; 43.1%, 78/181) was significantly higher than that in those not eating raw fish in both years(12.0%, 105/873; 3.1%, 29/927)(P < 0.01). The deworming coverage increased from 69.9% (174/249) in 2016 to 89.7% (96/107) in 2018 (P < 0.01). The percentage of residents who were unaware of clonorchiasis in both years was 73.2% (811/1 108), and the proportion of residents eating raw fish in both years was 10.3% (114/1 108). Conclusion With the implementation of control measures in the demonstration area, there has been a decrease in the Clonorchis infection rate and increases in the awareness rate of knowledge on clonorchiasis control, as well as the proportions of people showing willingness to give up eating raw fish and to receive treatment after being infected. The proportion of behavior of eating raw fish and the average infection rate were significantly decreased. These findings suggest remarkable achievements in clonorchiasis control.

Key words: Clonorchiasis, Knowledge, attitude and practice, Analysis, Jiangxi Province, Xinfeng County

中图分类号:

R532.21

陈喆, 袁长红, 姜唯声, 杨玉华, 蓝明兴, 刘克星, 曾小军, 朱慧慧. 2016和2018年江西省信丰县人群华支睾吸虫感染情况和知信行效果分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(1): 69-75.

CHEN Zhe, YUAN Chang-hong, JIANG Wei-sheng, YANG Yu-hua, LAN Ming-xing, LIU Ke-xing, ZENG Xiao-jun, ZHU Hui-hui. Infection status of clonorchiasis sinensis and the knowledge, attitudes and practices towards the disease among human population in Xinfeng County of Jiangxi Province in 2016 and 2018[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(1): 69-75.

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参考文献 15

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特征Characteristics	调查人数 No. examined	构成比/% Ratio/%	2016		2018
特征Characteristics	调查人数 No. examined	构成比/% Ratio/%	感染人数 No. infected	感染率/% Infection rate/%	感染人数 No. infected	感染率/% Infection rate/%
性别Gender
男Male	536	48.4	171	31.9	73	13.6
女Female	572	51.6	78	13.6	34	5.9
年龄组/岁Age group/Years
3~9	131	11.8	6	4.6	2	1.5
10~19	51	4.6	4	7.8	1	2.0
20~29	42	3.8	8	19.0	4	9.5
30~39	61	5.5	16	26.2	6	9.8
40~49	184	16.6	38	20.7	14	7.6
50~59	255	23.0	77	30.2	35	13.7
60~69	267	24.1	69	25.8	35	13.1
70~79	117	10.6	31	26.5	10	8.5
职业Occupation
商人、公职人员、工人 Businessmen, public servants and workers	61	5.5	10	16.4	7	11.5
农民Peasants	863	77.9	219	25.4	92	10.7
学生Students	141	12.7	9	6.4	5	3.5
其他Others	43	3.9	11	25.6	3	7.0
文化程度Education level
文盲、学龄前儿童 Illiterate and preschool children	224	20.2	44	19.6	11	4.9
小学Primary school	559	50.5	107	19.1	56	10.0
初中Junior high school	278	25.1	82	29.5	36	12.9
高中及以上 Senior high school and above	47	4.2	16	34.0	4	8.5
合计Total	1 108	100	249	22.5	107	9.7

项目Item	2016			2018
项目Item	回答人数 No. of persons completing the questionnaire	正确人数/选择人数 Corret no./Selected no.	正确率/%或构成比/% Positive rate/% or Proportion/%	回答人数 No. of persons completing the questionnaire	正确人数/选择人数 Corret no./Selected no.	正确率/%或构成比/% Positive rate/% or Proportion/%
知识Knowledge
是否知晓华支睾吸虫病 Whether know about clonorchiasis	1 108	48	4.3	1 108	277	25.0
防治知识来源（多选） Source of the knowledge (multiple choice)
媒体Media		64	24.3		79	12.5
宣传册Brochure		7	2.7		127	20.0
学校School		7	2.7		9	1.4
医生Doctor		86	32.7		262	41.3
听人说From others		99	37.6		157	24.8
小计Subtotal	129	263	100	313	634	100
食鱼生行为Eating raw freshwater fish
食鱼生频率Frequency
不吃None		873	78.8		927	83.7
< 1 次/年 < 1/year		151	13.6		100	9.0
≥1 次/年≥1/year		84	7.6		81	7.3
小计Subtotal	1 108	1 108	100	1 108	1 108	100
持续时间/年Duration/year
<1		56	23.8		27	14.9
1~5		98	41.7		62	34.3
≥6		81	34.5		92	50.8
小计Subtotal	235	235	100	181	181	100
地点Location
餐馆Restaurants		32	13.6		57	31.5
家Home		167	71.1		96	53.0
一样多Both		36	15.3		28	15.5
小计Subtotal	235	235	100	181	181	100
季节（多选） Season (multiple choice)
春Spring		92	18.0		53	20.2
夏Summer		95	18.6		17	6.5
秋Autumn		101	19.8		14	5.3
冬Winter		223	43.6		179	68.1
小计Subtotal	235	511	100	181	263	100
态度Attitude
今后拒绝继续食“鱼生” Will refuse to eat raw fish in the future	235	68	28.9	181	141	77.9
感染后会接受治疗 Will receive treatment after infection	1 108	1 059	95.6	1 108	1 105	99.7

2016和2018年江西省信丰县人群华支睾吸虫感染情况和知信行效果分析

Infection status of clonorchiasis sinensis and the knowledge, attitudes and practices towards the disease among human population in Xinfeng County of Jiangxi Province in 2016 and 2018

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项目Item	2016年				2018年
项目Item	调查人数 No. examined	感染人数 No. infected	感染率/% Infection rate/%	χ²值(P值) χ² value (P value)	调查人数 No. examined	感染人数 No. infected	感染率/% Infection rate/%	χ²值(P值) χ² value (P value)
知晓华支睾吸虫病 Aware of clonorchiasis
是Yes	48	17	35.4	31.999 (< 0.01)	277	28	10.1	0.086 (> 0.05)
否No	1 060	232	21.9		831	79	9.5
食“鱼生”频率 Frequency of eating raw fish
无None	873	105	12.0	257.766 (< 0.01)	927	29	3.1	277.237 (< 0.01)
是Yes	235	144	61.3		181	78	43.1
< 1次/年 < 1/year	151	87	57.6	2.386 (> 0.05)	100	31	31.0	13.328 (< 0.01)
≥ 1次/年 ≥ 1/year	84	57	67.9		81	47	58.0
食用“鱼生”持续时间/年 Duration of eating raw fish/year
< 1	56	34	60.7	2.178 (> 0.05)	27	22	81.5	56.564 (< 0.01)
1~5	98	65	66.3		62	41	66.1
> 5	81	45	55.6		92	15	16.3