中国寄生虫学与寄生虫病杂志 ›› 2018, Vol. 36 ›› Issue (6): 611-615.

• 论著 • 上一篇    下一篇

福建省2015年人体土源性线虫感染调查分析

林陈鑫*(), 谢汉国, 张榕燕, 江典伟, 谢贤良   

  1. 福建省疾病预防控制中心,福建省人兽共患病研究重点实验室,福州 350001
  • 收稿日期:2018-07-31 出版日期:2018-12-30 发布日期:2019-01-08
  • 通讯作者: 林陈鑫

Epidemiological survey of soil-transmitted helminth infections in Fujian Province in 2015

Chen-xin LIN*(), Han-guo XIE, Rong-yan ZHANG, Dian-wei JIANG, Xian-liang XIE   

  1. Fujian Center for Diseasa Control and Prevention, Fuzhou 350001, China
  • Received:2018-07-31 Online:2018-12-30 Published:2019-01-08
  • Contact: Chen-xin LIN

摘要:

目的 了解福建省人群土源性线虫感染流行现状,为制定防治对策提供科学依据。方法 于2014-2015年根据生态区、经济水平、地理方位进行分层整群随机抽样,选择福建省10个地市25县63个调查点。采用改良加藤厚涂片法,对受检者进行粪检(一粪两检),检查肠道蠕虫卵感染情况。透明胶纸肛拭法检查12岁以下儿童蛲虫卵。感染率间差异采用卡方检验。结果 共调查17 090人,检出土源性线虫感染560例,感染率为3.28%,与1992年第一次(77.30%,41 290/53 416)和2003年第二次(36.01%,7 300/20 195)调查的结果比较,分别下降了95.76%和90.89%。3种土源性线虫中,钩虫感染率最高,为3.03%(518/17 090),鞭虫和蛔虫的感染率分别为0.20%(34/17 090)和0.05%(8/17 090)。各地市中,三明的感染率最高,为9.21%(154/1 673);宁德最低,为0.20%(3/1 514)。女性感染率为3.72%(325/8 728),高于男性的2.81%(235/8 362)(P < 0.01)。浙闽山地丘陵生态区的感染率为3.52%(271/7 701),滇、桂、粤中部-闽南山地丘陵生态区为3.08%(289/9 389),二者差异无统计学意义(P > 0.05)。不同年龄组人群感染率随着年龄的增大总体呈上升趋势,其中3~9年龄组人群的感染率最低,为0.43%(9/2 076);60~69年龄组人群的感染率最高,为7.34%(180/2 453);不同年龄组差异有统计学意义(P < 0.01)。职业分布以农民的感染率最高,为4.33%(524/12 095);不同职业间差异有统计学意义(P < 0.01)。文化程度以小学文化人群感染率最高,为4.09%(322/7 875);不同文化程度间差异有统计学意义(P < 0.01)。检查12岁以下儿童共3 472人,检出蛲虫感染205例,感染率为5.90%。结论 福建省土源性线虫感染率呈持续下降趋势,处于较低流行水平,但农民群体、儿童和老年人为重点防治人群,钩虫和蛲虫为重点防治虫种。

关键词: 福建省, 土源性线虫, 感染, 调查

Abstract:

Objective To understand the endemic status of soil-transmitted helminth (STH) infections in Fujian Province so as to provide evidence-based information for the better prevention and control. Methods An epidemiological survey was performed in pilot sites selected by stratified cluster random sampling method based on the ecological zone, economic level and geographic location in Fujian Province from 2014 to 2015. The modified Kato-Katz thick smear method was used to examine fecal samples in duplicate to detect eggs of STH. The Enterobius vermicularis infection in children under 12 years old was examined using an anal tape test. The chi-square test was used to determine the statistical difference in infection rates between different population and areas. Results The fecal examination was performed in total 17 090 people from 63 pilot study sites in 25 counties, Fujian Province. Among them 560 people were found to be infected with STH’ with average infection rate of 3.28%. The prevalence of STH has been reduced by 95.76% compared with the infection rate of 77.30% (41 290/53 416) in the first province-wide survey in 1992 and by 90.89% compared to the second survey performed in 2003 (36.01%, 7 300/20 195). Among the three STH, hookworm had the highest infection rate in the investigated population (3.03%, 518/17 090), followed by infections of Trichuris trichiura (0.20%, 34/17 090) and Ascaris lumbricoides (0.05%, 8/17 090). Regarding the infection location, the infection rate of STH in Sanming area was among the highest (9.21%, 154/1 673), and Ningde was among the lowest (0.20%, 3/1 514). The prevalence in female people was 3.72% (325/8 728), which was higher than 2.81% (235/8 362) in males with statistical difference (χ2 = 11.24, P < 0.01). The prevalence of STH infection in the areas of Zhejiang/Fujian Mountain Ecological Zone was 3.52% (271/7 701), which was not statistically different (χ2 = 2.60, P > 0.05) compared to the prevalence in the areas of Yunnan/Guangxi/Guangdong/Fujian Mountain Ecological Zone. Generally, the prevalence of STH infections in different age groups increased with age, with the lowest infection rate in children of 3-9 years old (0.43%, 9/2 076) and the highest infection rate in old people of 60-69 years old (7.34%, 180/2 453) (χ2 = 314.64, P < 0.01). The farmers had the highest infection rate of 4.33% (524/12 095) compared with other occupations with statistical significance (χ2 = 151.02, P < 0.01). The prevalence of STH was higher in people with primary school education only (4.09%, 322/7 875) compared with people with higher education level (χ2 = 48.00, P < 0.01). A total of 3 472 children under the age of 12 were examined for E. vermicularis infection and 205 people were found to be positive with a infection rate of 5.90%. Conclusion The infection rate of soil-transmitted helminthes in Fujian Province has continuously declined since the first survey in 1992, and it is at a low prevalence level. However, farmers and the elderly are the key groups of people that need more attention to pay for the prevention and control of STH. Hookworm is the major STH that infects people in the Province and children is still vulnerable to the infection of E. vermicularis.

Key words: Fujian Province, Soil-transmitted helminth, Infection, Survey

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