2021年全国棘球蚴病防治进展

doi:10.12140/j.issn.1000-7423.2023.02.003

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (2): 142-148.doi: 10.12140/j.issn.1000-7423.2023.02.003

2021年全国棘球蚴病防治进展

蒉嫣¹, 薛垂召¹, 王旭¹, 刘白雪¹, 王莹¹, 王立英¹, 杨诗杰¹, 韩帅¹^,^*(), 伍卫平¹, 肖宁¹

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)，国家卫生健康委员会寄生虫病原与媒介生物学重点实验室，世界卫生组织热带病合作中心，国家级热带病国际联合研究中心，上海 200025

收稿日期:2023-01-27 修回日期:2023-03-27 出版日期:2023-04-20 发布日期:2023-04-20
通讯作者: 韩帅
基金资助:
国家重点研发计划(2021YFC2300800);国家自然科学基金地区项目(2021YFC2300804)

Progress of echinococcosis control in China, 2021

KUI Yan¹, XUE Chuizhao¹, WANG Xu¹, LIU Baixue¹, WANG Ying¹, WANG Liying¹, YANG Shijie¹, HAN Shuai¹^,^*(), WU Weiping¹, XIAO Ning¹

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai 200025, China

Received:2023-01-27 Revised:2023-03-27 Online:2023-04-20 Published:2023-04-20
Contact: HAN Shuai
Supported by:
National Key Research and Development Program of China(2021YFC2300800);National Key Research and Development Program of China(2021YFC2300804)

摘要/Abstract

摘要：

为掌握全国棘球蚴病防治进展，对2021年全国棘球蚴病防治工作数据进行了汇总和分析。截至2021年底，全国共有370个棘球蚴病流行县（市、区、旗）30 421个流行村，流行乡常住人口4 758.41万人。2021年全国流行县（市、区、旗）现有棘球蚴病患者26 773例，平均患病率为0.06%（26 773/47 584 117），其中细粒棘球蚴病16 625例，多房棘球蚴病8 327例，混合感染311例，未分型1 510例；新发现棘球蚴病患者1 346例，其中细粒棘球蚴病1 075例，多房棘球蚴病86例，混合感染7例，未分型178例；< 12岁人群147例，≥ 12岁常住人群1 199例。2021年，全国棘球蚴病流行省（自治区）共开展人群腹部超声筛查447.17万人次，其中，< 12岁人群筛查87.15万人次，≥ 12岁常住人群筛查360.02万人次；血清学检测11 358人次。2021年370个监测点< 12岁人群超声筛查患病检出率为0.02%（72/336 959），其中新发现患者占检出患者数的58.33%（42/72）；≥ 12岁常住人群中，Ⅰ、Ⅱ类流行县（市、区、旗）监测点超声筛查患病检出率为0.26%（922/355 006），新发现患者占检出患者数的10.52%（97/922）。2021年开展药物治疗19 552人，肝肾功能检查及不良反应处置14 440人，手术治疗1 792人，其中以细粒棘球蚴病（占71.15%，1 275/1 792）和多房棘球蚴病（占23.66%，424/1 792）为主；2021年随访结果显示，治愈3 063例，治疗有效22 660例，治疗无效2 356例，死亡（死因非棘球蚴病）359例，排除棘球蚴病285例，失访301例，未到随访时间312例，病例外迁他地146例。2021年全国流行乡（镇）共有犬2 626 679条，其中登记管理的犬2 389 828条。35 019个村开展了犬驱虫工作，家犬药物驱虫25 844 226次，野外犬科动物驱虫投药131 315份。采集并检测家犬粪样555 688份，粪棘球绦虫抗原阳性2 614份，阳性率为0.47%；采集并检测野外犬科动物粪样54 266份，粪棘球绦虫抗原阳性422份，阳性率为0.78%。2021年抽查屠宰的家畜222 844头，阳性1 408头，阳性率为0.63%；检查野外啮齿类动物56 124只，阳性599只，阳性率为1.07%。棘球蚴病流行态势得到基本控制，但防治工作还存在诸多困难和挑战，部分流行区传染源控制可能存在漏洞，不排除在野外环境中存在传播链的可能。应继续以棘球蚴病综合干预区为抓手，探索优化防治策略，提高基层疾控机构的棘球蚴病防治能力，开展棘球蚴病野外传播控制试点，强化监测预警体系，进一步遏制棘球蚴病流行。

关键词: 棘球蚴病, 细粒棘球蚴病, 多房棘球蚴病, 流行病学, 中国

Abstract:

In order to understand the work progress in nationwide control of echinococcosis, data related to echinococcosis prevention and control in 2021 were collected and analyzed. As of the end of 2021, echinococcosis was found endemic in 370 counties (city, district, banner) covering 30 421 endemic villages in China. There were 47 584 117 permanent residents living in endemic townships. In 2021, 26 773 echinococcosis cases were documented in endemic counties (cities, districts, banners), with an average prevalence 0.06% (26 773/47 584 117), among them, 16 625 cases were of cystic, and 8 327 cases alveolar echinococcosis, 311 cases mixed infection, 1 510 cases unclassified. A total of 1 346 cases were newly diagnosed in 2021, including 1 075 cases of cystic echinococcosis, 86 cases of alveolar echinococcosis, 7 cases of mixed infection, and 178 cases of unclassified. In 2021, population screening by abdominal ultrasound scanning was performed in all endemic provinces (autonomous regions) for 4.471 7 million person/times, of them, 0.871 5 million person/examinations were for people under age of 12, 3.600 2 million person/times for permanent residents aged ≥ 12; serological examination was carried out for 11 358 person/times. Recorded from 370 surveillance sites in 2021, positive rate of ultrasound detection in people under age of 12 was 0.02% (72/336 959), of which 58.33% (42/72) were newly diagnosed. The positive rate of ultrasound imaging in permanent residents aged ≥ 12 was 0.26% (922/355 006) in type Ⅰ, Ⅱ endemic counties (city, district, banner), and the newly diagnosed patients accounted for 10.52% (97/922) of the detected patients. In 2021, 19 552 people received drug treatment, 14 440 people received liver and kidney function tests or treatment of adverse reactions. A total of 1 792 patients received surgical treatment, among them cystic echinococcosis accounted for 71.15% (1 275/1 792) and alveolar echinococcosis accounted for 23.66% (424/1 792). In 2021, the follow-up results showed that 3 063 cases were cured, 22 660 cases responded to the treatment, 2 356 cases failed in the treatment, 359 cases died (the cause of death was not echinococcosis), 285 cases were excluded, 301 cases were lost in follow-up, 312 cases had not completed the follow-up, and 146 cases migrated to other places. In 2021, there were 2 626 679 dogs in endemic townships (towns) nationwide, of which 2 389 828 were registered and documented. In 35 019 villages, deworming was conducted for dogs, with 25 844 226 deworming for domestic dogs and 131 315 deworming drug sites were distributed for wild canines. A total of 555 688 fecal samples from domestic dogs were collected and tested, of which 2 614 were found Echinococcus coproantigen positive, with a positive rate of 0.47% (2 614/555 688). Of wild canidae, 54 266 field fecal samples were collected and tested, among which, 422 were found Echinococcus coproantigent positive, with a positive rate of 0.78%. A total of 222 844 slaughtered livestock were randomly examined, among which 1 408 were positive, with a positive rate of 0.63% (1 408/222 844); and 56 124 field rodents were examined, of which 599 were found positive, with a positive rate of 1.07% (599/56 124). The epidemic state of echinococcosis has been basically controlled, but there are still many difficulties and challenges in the control and prevention. It is noted that there may be flaws in the control of the source of infection in some endemic areas, and it is likely that there might exist transmission chain in wild environment. It is imperative to continuously advance the comprehensive intervention areas as gripper to explore and optimize the control strategy, enhance the capacity of primary disease control institutions for control of echinococcosis, carry out pilot trial for controlling echinococcosis transmission in wild field, strengthen the surveillance-early warning system to further curb the epidemic of echinococcosis.

Key words: Echinococcosis, Cystic echinococcosis, Alveolar echinococcosis, Epidemiology, China

中图分类号:

R532.32

蒉嫣, 薛垂召, 王旭, 刘白雪, 王莹, 王立英, 杨诗杰, 韩帅, 伍卫平, 肖宁. 2021年全国棘球蚴病防治进展[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 142-148.

KUI Yan, XUE Chuizhao, WANG Xu, LIU Baixue, WANG Ying, WANG Liying, YANG Shijie, HAN Shuai, WU Weiping, XIAO Ning. Progress of echinococcosis control in China, 2021[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(2): 142-148.

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参考文献 16

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省（自治区） Province（Autonomous Region）		流行县（市、区、旗）数 No. endemic county (citiy, district, banner)		常住人口数 No. resident			患病人数/例 No. patient/case
省（自治区） Province（Autonomous Region）		流行县（市、区、旗）数 No. endemic county (citiy, district, banner)		常住人口数 No. resident			细粒棘球蚴病 Cystic echinococcosis			多房棘球蚴病 Alveolar echinococcosis		混合感染 Mixed infection		未分型 Unclassified		合计 Total
内蒙古 Inner Mongolia		26		1 565 605			57			0		0		0		57
四川 Sichuan		35		1 827 119			5 298			5 446		82		32		10 858
云南 Yunnan		24		2 305 706			80			0		0		1		81
西藏 Tibet		74		3 159 263			4 887			253		155		724		6 019
陕西 Shaanxi		2		365 874			0			0		0		19		19
甘肃 Gansu		57		12 580 729			1 273			45		1		2		1 321
青海 Qinghai		39		4 813 070			2 978			2 422		61		677		6 138
宁夏 Ningxia		19		3 189 908			924			106		7		0		1 037
新疆（含兵团） Xinjiang (include XPPC)		94		17 776 843			1 128			55		5		55		1 243
合计 Total		370		47 584 117			16 625			8 327		311		1 510		26 773
省（自治区） Province（Autonomous Region）	新发现患病例数 No. newly diagnosed case
	< 12岁 Age < 12								≥ 12岁 Age ≥ 12
	细粒棘球蚴病 Cystic echinococcosis		多房棘球蚴病 Alveolar echinococcosis		混合感染 Mixed infection	未分型 Unclassifiedd		合计 Total	细粒棘球蚴病 Cystic echinococcosis		多房棘球蚴病 Alveolar echinococcosis		混合感染 Mixed infection		未分型 Unclassified		合计 Total
内蒙古 Inner Mongolia	0		0		0	0		0	9		0		0		0		9
四川 Sichuan	0		0		0	0		0	27		23		1		11		62
云南 Yunnan	0		0		0	0		0	16		0		0		0		16
西藏 Tibet	25		1		0	1		27	103		1		2		117		223
陕西 Shaanxi	0		0		0	0		0	0		0		0		3		3
甘肃 Gansu	0		0		0	0		0	131		4		0		3		138
青海 Qinghai	3		3		0	1		7	92		37		0		11		140
宁夏 Ningxia	0		0		0	0		0	50		3		0		0		53
新疆（含兵团） Xinjiang (include XPPC)	106		0		0	7		113	513		14		4		24		555
合计 Total	134		4		0	9		147	941		82		7		169		1 199

省（自治区） Province（Autonomous Region）	< 12岁 Age < 12					≥ 12岁 Age ≥ 12
	总筛查人次 Total no. screened	监测点 Surveillance site				总筛查人次 Total no. screened	Ⅰ、Ⅱ类流行县监测点 Surveillance site in type Ⅰ and Ⅱ county
	总筛查人次 Total no. screened	筛查人次 No. screened	患者例数 No. patient	新发现患者例数 No. newly diagnosed patient	检出率/% Prevalence/%	总筛查人次 Total no. screened	筛查人次 No. screened	患者例数 No. patient	新发现患者例数 No. newly diagnosed patient	检出率/% Prevalence/%
内蒙古 Inner Mongolia	55 274	28 448	0	0	0	182 533	22 729	4	3	0.02
四川 Sichuan	87 735	27 221	2	0	0.01	337 058	33 104	208	1	0.63
云南 Yunnan	75 426	37 733	0	0	0	269 276	8 726	2	2	0.02
西藏 Tibet	106 008	41 551	38	22	0.09	382 008	96 765	533	77	0.55
陕西 Shaanxi	4 444	1 037	0	0	0	96 978	2 013	0	0	0
甘肃 Gansu	137 376	47 019	0	0	0	674 217	45 363	7	1	0.02
青海 Qinghai	87 812	20 227	13	2	0.06	223 551	42 386	135	4	0.32
宁夏 Ningxia	54 664	25 303	0	0	0	240 175	18 640	17	4	0.09
新疆（含兵团） Xinjiang (include XPPC)	262 788	108 420	19	18	0.02	1 194 363	85 280	16	5	0.02
合计 Total	871 527	336 959	72	42	0.02	3 600 159	355 006	922	97	0.26

省（自治区） Province（Autonomous Region）	药物治疗/例 Drug treatment/case								手术治疗/例 Surgical treatment/case
省（自治区） Province（Autonomous Region）	细粒棘球蚴病 Cystic echinococcosis	多房棘球蚴病 Alveolar echinococcosis		混合感染 Mixed infection		未分型 Unclassified		合计 Total	细粒棘球蚴病 Cystic echinococcosis			多房棘球蚴病 Alveolar echinococcosis			混合感染 Mixed infection	未分型 Unclassified		合计 Total
内蒙古 Inner Mongolia	28	0		0		0		28	7			0			0	0		7
四川 Sichuan	4 454	5 255		39		18		9 766	92			232			1	11		336
云南 Yunnan	66	0		0		0		66	6			0			0	0		6
西藏 Tibet	2 956	177		112		589		3 834	185			14			0	4		203
陕西 Shaanxi	0	0		0		0		0	1			0			0	1		2
甘肃 Gansu	905	41		1		2		949	93			1			0	2		96
青海 Qinghai	1 408	1 235		31		288		2 962	225			157			1	28		411
宁夏 Ningxia	693	85		3		0		781	65			5			0	0		70
新疆（含兵团） Xinjiang (include XPPC)	1 066	48		4		48		1 166	601			15			3	42		661
合计 Total	11 576	6 841		190		945		19 552	1 275			424			5	88		1 792
省（自治区） Province（Autonomous Region）			随访情况/例 Follow-up of patient/case
省（自治区） Province（Autonomous Region）			治愈 Cured		有效 Effective treatment		无效 Ineffective treatment			死亡 Died	排除 Excluded		失访 Loss to follow-up	未访 Unvisited			外迁 Moved out
内蒙古 Inner Mongolia			3		49		5			0	0		1	0			0
四川 Sichuan			316		9 991		658			44	126		5	209			4
云南 Yunnan			26		38		12			2	0		1	1			1
西藏 Tibet			551		4 446		730			97	93		5	88			59
陕西 Shaanxi			0		2		19			1	0		1	0			1
甘肃 Gansu			89		1 089		181			37	57		44	5			13
青海 Qinghai			1 603		5 249		661			156	0		192	0			37
宁夏 Ningxia			90		899		79			19	0		31	0			28
新疆（含兵团）Xinjiang (include XPPC)			385		897		11			3	9		21	9			3
合计 Total			3 063		22 660		2 356			359	285		301	312			146

省（自治区） Province（Autonomous Region）	犬管理 Dog management		驱虫 Deworming treatment			粪样检测数 No. fecal sample tested
省（自治区） Province（Autonomous Region）	犬总数 Total no. dog	登记管理犬数 No. dog under management	驱虫村数 No. village deworming	驱虫次数 No. deworming	野外犬科动物驱虫投药份数 No. deworming treatment for wild canines	家犬 Domestic dog	阳性数 No. positive	阳性检出率/% Positive rate/%	野外犬科 Wild canine	阳性数 No. positive	阳性检出率/% Positive rate/%
内蒙古 Inner Mongolia	339 569	336 675	1704	3 202 790	8 017	32 283	80	0.25	400	0	0
四川 Sichuan	183 550	183 035	3 828	2 184 372	12 490	37 758	202	0.53	6 014	74	1.23
云南 Yunnan	145 900	17 736	190	87 120	438	5 904	124	2.10	1 062	22	2.07
西藏 Tibet	160 776	154 383	5 364	1 813 084	32 949	41 164	389	0.95	3 603	42	1.17
陕西 Shaanxi	11 471	10 008	205	77 536	0	1 134	0	0	10	0	0
甘肃 Gansu	780 389	690 082	7 204	7 743 629	36 629	156 515	935	0.6	17 092	95	0.56
青海 Qinghai	346 547	345 422	4 039	3 858 174	27 425	87 034	354	0.41	13 672	105	0.77
宁夏 Ningxia	262 763	261 378	2 114	2 679 401	3 683	25 145	114	0.45	2 552	64	2.51
新疆（含兵团） Xinjiang (include XPPC)	395 714	391 109	10 371	4 198 120	9 684	168 751	416	0.25	9 861	20	0.20
合计 Total	2 626 679	2 389 828	35 019	25 844 226	131 315	555 688	2 614	0.47	54 266	422	0.78

省（自治区） Province（Autonomous Region）	屠宰家畜 Livestock			野外啮齿类动物^aWild rodent^a
省（自治区） Province（Autonomous Region）	检查数 No. exam’d	阳性数 No. positive	阳性率/% Positive rate/%	检查数 No. exam’d	阳性数 No. positive	阳性率/% Positive rate/%
内蒙古 Inner Mongolia	13 623	23	0.17	0	0	0
四川 Sichuan	9 148	82	0.90	12 684	442	3.48
云南 Yunnan	5 136	4	0.08	0	0	0
西藏 Tibet	99 567	379	0.38	15 376	0	0
陕西 Shaanxi	1 011	26	2.57	0	0	0
甘肃 Gansu	29 170	209	0.72	4 147	9	0.22
青海 Qinghai	10 265	40	0.39	7 386	38	0.51
宁夏 Ningxia	16 526	82	0.50	1 519	0	0
新疆（含兵团）Xinjiang (include XPPC)	38 398	563	1.47	15 012	110	0.73
合计 Total	222 844	1 408	0.63	56 124	599	1.07

2021年全国棘球蚴病防治进展

Progress of echinococcosis control in China, 2021

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