安徽省涡阳县幼儿园儿童蛲虫感染现状调查

摘要/Abstract

摘要：

目的了解安徽省涡阳县幼儿园儿童蛲虫感染现状及影响因素。方法于2016年6-10月,采用分层随机抽样法调查涡阳县幼儿园儿童蛲虫感染情况。根据地理位置,将全县划分成东、南、西、北等4个片区,每个片区抽取2~3所日托幼儿园,共10所。以幼儿园为单位,随机抽取小班、中班、大班各1个班,各个年龄组和性别保持相对均衡。在家长知情同意情况下,采用透明胶纸肛拭法检查儿童蛲虫感染情况,同时通过问卷调查儿童家庭、学校和个人卫生习惯等情况,分析儿童蛲虫感染的影响因素。结果共调查1 035名儿童,有效问卷1 011份,合格率为97.6%（1 011/1 035）。涡阳县幼儿园儿童的蛲虫总感染率为6.8%（69/1 011）。男、女童的蛲虫感染率分别为8.0%（41/513）和5.6%（28/498）,差异无统计学意义（χ² = 2.231,P > 0.05）。大班儿童的蛲虫感染率最高,为10.1%（36/355）;中班、小班儿童的蛲虫感染率分别为6.4%（22/345）和3.5%（11/311）,不同年级儿童的蛲虫感染率差异有统计学意义（χ² = 11.534,P < 0.05）。公立、私立幼儿园儿童的蛲虫感染率分别为6.4%（32/497）和7.2%（37/514）,差异无统计学意义（χ² = 0.229,P > 0.05）。乡（镇）级、县级幼儿园儿童的蛲虫感染率分别为8.0%（53/661）和4.6%（16/350）,差异有统计学意义（χ² = 4.275,P < 0.05）。家庭居住地为农村、城区的儿童蛲虫感染率分别为8.7%（51/585）和4.2%（18/426）,差异有统计学意义（χ² = 7.824,P < 0.05）。母亲文化程度为高中以上的儿童蛲虫感染率最低,为5.6%（48/854）,母亲文化程度不同的儿童蛲虫感染率差异有统计学意义（χ² = 17.154,P < 0.01）;父亲文化程度不同的儿童蛲虫感染率差异无统计学意义（χ² = 3.813,P > 0.05）。饭前不洗手与饭前洗手、咬手指与不咬手指、咬玩具与不咬玩具的儿童蛲虫感染率分别为8.2%（43/524）和5.3%（26/487）、8.3%（35/423）和5.8%（34/588）、9.0%（25/279）和6.0%（44/732）,差异均无统计学意义（χ² = 3.263、2.402、2.764,均P > 0.05）。幼儿园消毒频率低与消毒频率高、便后不洗手与便后洗手的儿童蛲虫感染率分别为8.3%（49/589）和4.7%（20/422）、10.9%（37/341）和4.8%（32/670）,差异有统计学意义（χ² = 4.955,P < 0.05;χ² = 13.112,P < 0.01）。非条件logistic回归分析显示,涡阳县幼儿园儿童蛲虫感染的影响因素包括年级、幼儿园所在地、家庭居住地、母亲文化程度、幼儿园消毒频率、便后是否洗手等（均P < 0.05）。结论涡阳县幼儿园儿童蛲虫感染率较高,大班、乡（镇）级幼儿园、农村、母亲文化程度低、幼儿园卫生消毒频率低、便后不洗手的儿童是蛲虫的易感人群。

关键词: 蛲虫, 感染, 涡阳县, 幼儿园, 学龄前儿童, 危险因素

Abstract:

Objective To understand the status of Enterobius vermicularis infection among pre-school children in Guoyang County of Anhui Province and its risk factors Methods E. vermicularis infection was surveyed using a stratified random sampling method from June to October, 2016. The whole county was divided geographically into east, south, west and north parts, and in each part 2-3 kindergartens were selected to reach a total of 10. In each kindergarten, age- and sex-matched classes of junior level, middle level, and senior level were randomly selected (n = 1 class for each level). E. vermicularis infection was examined by using adhesive cellophane anal swab in the morning with permission from parents. Information on family and school sanitary conditions and personal health habit was collected through a questionnaire, in order to analyze potential risk factors. Results A total of 1 035 children were surveyed, and 1 011 (97.6%) valid questionnaires were received. The overall infection rate of E. vermicularis was 6.8% (69/1 011). The infection rate in females and males was 5.6% (28/498) and 8.0% (41/513), respectively (χ² = 2.231, P > 0.05). Children in the senior class had highest infection rate of 10.1% (36/355), followed by the middle class 6.4% (22/345) and the junior class 3.5% (11/311) (χ² = 11.534, P < 0.05). There was no significant difference in the infection rate between public (6.4%, 32/497) and private kindergartens (7.2%, 37/514) (χ² = 0.229, P > 0.05). The infection rate in town- and county-level kindergartens was 8.0% (53/661) and 4.6% (16/350), respectively (χ² = 4.275, P < 0.05). The infection rate in rural areas (8.7%, 51/585) was significantly higher than that in urban areas (4.2%, 18/426) (χ² = 7.824, P < 0.05). The infection rate among those with a maternal education level of senior high school and above had the lowest infection rate (5.6%, 48/854). Unlike the significant difference among those with different maternal education levels (χ² = 17.154, P < 0.01), no significant difference was found among those with different paternal education levels (χ² = 3.813, P > 0.05). There was no significant difference in the infection rate between children with and without habit of washing hands before dinner (5.3%, 26/487; 8.2%, 43/524), sucking finger (8.3%, 35/423; 5.8%, 34/588), or biting toys (9.0%, 25/279; 6.0%, 44/732) (χ² = 3.263, 2.402, 2.764, all P > 0.05). There was a significant difference in the infection rate between children in kindergartens with a high sterilization frequency (4.7%, 20/422) and those with a low sterilization frequency (8.3%, 49/589) (χ² = 4.955, P < 0.05 ), and between children having and having not a habit of washing hands after pooping (4.8%, 32/670; 10.9%, 37/341) (χ² = 13.112, P < 0.01). Multivariate logistic regression analysis revealed risk factors of grade level, place of residence, maternal educational level, kindergarten sterilization frequency, and a habit of washing hands after pooping for E. vermicularis infection (P < 0.05). Conclusion There is a high E. vermicularis infection rate among pre-school children in Guoyang County, and grade level, place of kindergarten, place of residence, maternal educational level, kindergarten sterilization frequency, and a habit of washing hands after pooping are risk factors for the infection.

Key words: Enterobius vermicularis, Infection, Guoyang County, Pre-school children, Risk factor

中图分类号:

R532.13

王小莉, 周琦, 石傲, 李亮, 王媛媛, 胡守锋, 崔洁. 安徽省涡阳县幼儿园儿童蛲虫感染现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(2): 139-143.

Xiao-li WANG, Qi ZHOU, Ao SHI, Liang LI, Yuan-yuan WANG, Shou-feng HU, Jie CUI. A survey on Enterobius vermicularis infection among pre-school children in Guoyang County of Anhui Province[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(2): 139-143.

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变量 Variable	变量含义 Variable significance	赋值 Variable assignment
Y	蛲虫感染 E. vermicularis infection	未感染（Not infected）= 0, 感染（Infected）= 1
X1	年级 Grade	小班（Junior class）= 0, 中班（Middle class）= 1, 大班（Senior class）= 2
X2	性别 Gender	女（Female）= 0, 男（Male）= 1
X3	幼儿园性质 Kindergarten nature	公立（Public）= 0, 私立（Private）= 1
X4	幼儿园所在地 Place of Kindergarten	县级（Country）= 0, 乡（镇）级（Town）= 1
X5	家庭居住地 Home residence	城区（Urban）= 0, 农村（Rural）= 1
X6	母亲文化程度 Maternal education	文盲（Illiteracy）= 0,初中及以下（Junior high school and below）= 1,高中及以上（Senior high school and above）= 2
X7	父亲文化程度 Paternal education	文盲（Illiteracy）= 0,初中及以下（Junior high school and below）= 1,高中及以上（Senior high school and above）= 2
X8	饭前洗手 Washing hands before dinner	是（Yes）= 0,否（No）= 1
X9	便后洗手 Washing hands after pooping	是（Yes）= 0,否（No）= 1
X10	咬手指Finger-sucking	是（Yes）= 0,否（No）= 1
X11	咬玩具 Toy-biting	是（Yes）= 0,否（No）= 1
X12	幼儿园消毒频率 Frequency of sterilization	≤每周1次（Once a week or less）= 0,>每周1次（More than once a week）= 1

变量Variable	回归系数 Coefficient	标准误差 Standard error	Wald	P	比值比OR	95%可信区间 95%CI of OR
年级 Grade			7.781	0.020
中班 Middle class	0.598	0.386	2.405	0.121	1.819	0.854~3.876
大班 Senior class	0.992	0.362	7.530	0.006	2.697	1.328~5.478
幼儿园所在地 Place of Kindergarten	0.868	0.315	7.581	0.006	2.383	1.284~4.421
家庭居住地 Home residence	0.798	0.291	7.512	0.006	2.222	1.255~3.932
母亲文化程度 Maternal education			15.508	0.000
初中及以下Junior high school and below	-1.168	0.570	4.199	0.040	0.311	0.102~0.950
高中及以上Senior high school and above	-1.871	0.519	13.019	0.000	0.154	0.056~0.425
便后是否洗手Washing hands after pooping	0.837	0.261	10.270	0.001	2.310	1.384~3.854
幼儿园消毒频率 Frequency of sterilization	-0.635	0.283	5.035	0.025	0.530	0.304~0.923

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