2016—2020年辽宁省土源性线虫感染现状及流行趋势

doi:10.12140/j.issn.1000-7423.2022.02.012

中国寄生虫学与寄生虫病杂志 ›› 2022, Vol. 40 ›› Issue (2): 211-215.doi: 10.12140/j.issn.1000-7423.2022.02.012

2016—2020年辽宁省土源性线虫感染现状及流行趋势

于维君¹^,²(), 王子江¹, 王博¹, 毛玲玲¹, 吴琪俊², 姚文清¹, 孙英伟¹^,^*()

1.辽宁省疾病预防控制中心,沈阳 110005
2.中国医科大学附属盛京医院,沈阳 110004

收稿日期:2021-08-11 修回日期:2021-09-23 出版日期:2022-04-30 发布日期:2022-03-31
通讯作者: 孙英伟
作者简介:于维君（1991-）,男,硕士研究生,主管医师,从事传染病防制工作。E-mail： lncdcywj@163.com
基金资助:
“十三五”国家科技重大专项(2017ZX10103007)

Surveillance and trends of soil-transmitted helminth infections in Liaoning Province, 2016—2020

YU Wei-jun¹^,²(), WANG Zi-jiang¹, WANG Bo¹, MAO Ling-ling¹, WU Qi-jun², YAO Wen-qing¹, SUN Ying-wei¹^,^*()

1. Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
2. Shengjing Hospital of China Medical University, Shenyang 110004, China

Received:2021-08-11 Revised:2021-09-23 Online:2022-04-30 Published:2022-03-31
Contact: SUN Ying-wei
Supported by:
Major Scientific and Technological Projects for the Prevention and Treatment of Major Infectious Diseases(2017ZX10103007)

摘要/Abstract

摘要：

目的了解辽宁省土源性线虫感染现状及流行趋势,为制定土源性线虫病防治规划、策略和措施提供科学依据。方法 2016—2020年辽宁省根据《全国肝吸虫病和土源性线虫病监测方案（试行）》和实施细则要求开展监测工作。每年每市选择1个县（市、区）作为监测点。监测点按地理方位划分为东、西、南、北、中等5个片区,每个片区抽取1个乡（镇、街道）的1个行政村（社区）开展监测工作,每个行政村（社区）整群抽取3周岁以上居民200人。采集监测对象粪样（> 30 g）,采用改良加藤厚涂片法（一粪二检）检测虫卵,虫卵计数并计算虫种感染率和感染度。钩虫卵阳性者采用试管滤纸培养法鉴定钩虫种类。3~9周岁儿童加做透明胶纸肛拭法检测蛲虫卵。每个行政村（社区）随机抽取5户家庭,每户采集1份田地或菜园的土样≥ 400 g,其中350 g用于钩蚴监测,50 g用于人蛔虫卵监测。率的比较采用χ²检验。结果 2016—2020年全省14个市,共设置70个监测点,共调查69 909人,其中儿童4 659人。土源性线虫总感染率为0.26%（184/69 909）,蛔虫和鞭虫感染率分别为0.25%（178/69 909）和0.01%（6/69 909）,未检出钩虫和蛲虫。2016—2020年人群土源性线虫感染率分别为0.59%（89/15 097）、0.19%（28/14 554）、0.27%（33/12 044）、0.13%（19/14 103）、0.11%（15/14 111）,不同年份差异有统计学意义（χ² = 59.44,P < 0.01）。丹东市土源性线虫感染率最高,为1.77%（89/5 042）,其次为大连市0.56%（28/5 004）和本溪市0.42%（23/5 451）;男性土源性线虫感染率为0.26%（90/34 852）,女性为0.27%（94/35 057）,二者差异无统计学意义（χ² = 0.07,P > 0.05）;60~69岁年龄组感染率最高,为0.36%（50/13 803）,其次为40~49岁年龄组（0.32%,34/10 788）和70岁及以上年龄组（0.31%,23/7 396）,各年龄组间差异有统计学意义（χ² = 18.30,P < 0.01）;仅在满族与汉族人群中检出土源性线虫,感染率分别为0.55%（97/17 643）、0.17%(87/51 154),二者差异有统计学意义（χ² = 75.04,P < 0.01）;医务人员、农民和工人感染率分别为0.67%（2/298）、0.31%（158/50 631）和0.28%（7/2 542）,各职业差异有统计学意义（χ² = 26.90,P < 0.01）;小学、大专及以上和初中感染率分别为0.32%（76/24 019）、0.28%（5/1 815）和0.26%（93/36 406）,各文化程度间差异无统计学意义（χ² = 10.12,P > 0.05）。调查69 909人中,仅232人检查前3个月内服用过驱虫药,占0.33%。2016—2020年全省共采集1 757份土壤样品,蛔虫卵阳性39份,阳性率为2.22%,未检测出钩蚴。结论 2016—2020年辽宁省人群土源性线虫感染率呈下降趋势且维持在较低水平,以蛔虫感染为主。需重点关注60~69岁年龄组、农民、小学、满族及辽南地区人群。

关键词: 土源性线虫, 感染, 监测, 辽宁省

Abstract:

Objective To investigate the prevalence and transmission of soil-transmitted helminth (STH) in Liaoning Province, in order to provide scientific evidence for development of control plans, strategies and measures aagainst these diseases in Liaoning Province. Methods The surveillance was performed during 2016—2020 in Liaoning Province according to the National Surveillance Program and Implementation Guideline for Chlonorchiasis and Soil-transmitted Helminthiasis. One county (city or district) per provincial city was selected annually as a surveillance site. Each surveillance site was further divided 5 regions as geographical east, west, south, north and centre. One village was chosen from each region to conduct surveillance, and 200 permanent residents over 3 years old were randomly enrolled from each village. Fecal samples ( > 30 g) from enrolled residents were collected and were examined for STH eggs (two slide-reading for each sample) using the modified Kato-Katz thick smear method to estimate infection rate and intensity. The samples that are positive for hookworm eggs were further examined by test-tube filter paper incubation for the larva to identify the species. Cellophane anal swab method was used to detect Enterobius vermicularis eggs in children aged 3-9 years. The contamination of Ascaris eggs and hookworm larvae was also monitored in soil samples collected from 5 households in each village. Chi-square test was used to compare the infection rates. Results Total 69 909 people were recruited from 70 surveillance sites in Liaoning Province during 2016—2020, including 4 659 children aged 3-9, and the overall infection rate of STH infection was 0.26% (184/69 909), and the infection rate of A. lumbricoides and Trichuris trichiura were 0.25% (178/69 909) and 0.01% (6/69 909), respectively. Hookworm and E. vermicularis were not detected. The STH infection rate in the residents from 2016—2020 respectively were 0.59% (89/15 097), 0.19% (28/14 554), 0.27% (33/12 044)）, 0.13%(19/14 103), and 0.11%(15/14 111) (χ² = 59.44, P < 0.01). The top three cities with the highest infection rate of STH include Dandong (1.77%, 89/5 042), Dalian (0.56%, 28/5 004) and Benxi (0.42%, 23/5 451). The STH infection rate in females was 0.27% (94/35 057) and in males was 0.26% (90/34 852). The difference was not statistically significant (χ² = 0.07, P > 0.05). The infection rate in the 60-69 age group was the highest (0.36%, 50/13 803), followed by the 40-49 age group (0.32%, 34/10 788) and the age group over 70 years old (0.31%, 23/7 396). The differences were statistically significant among the different age groups (χ² = 18.30, P < 0.01). The infection rate in Man ethnicity (0.55%, 97/17 643) was statistical-significantly higher than that in Han ethnicity (0.17%, 87/51 154) (χ² = 75.04, P < 0.01). The STH infection rate among medical personnel, farmers and workers were 0.67% (2/298), 0.31% (158/50 631) and 0.28% (7/2 542), respectively. The differences were statistically significant (χ² = 26.90, P < 0.01). The infection rate among participants with primary school, education, middle school education and college education or higher were 0.32% (76/24 019), 0.26% (93/36 406) and 0.28% (5/1 815), respectively. The difference was not statistically significant (χ² = 10.12, P > 0.05). Among 69 909 people surveyed, only 232 people (0.33%) had taken deworming medications within 3 months prior to the examination. A total of 1 757 soil samples were examined in Liaoning Province during 2016—2020, and the result indicated the positive rate of A. lumbricoides eggs of 2.22% (39/1 757), while hookworm larvae not found. Conclusion The STH infection rate showed a declining trend and remained at a low level in Liaoning Province during 2016—2020, with mainly Ascaris infection. Attention should be paid to the 60-69 age group, farmers, people with primary school education, Man ethnicity, and the residents in southern Liaoning Province in the control practice.

Key words: Soil-transmitted helminth, Infection, Surveillance, Liaoning Province

中图分类号:

R532.1

于维君, 王子江, 王博, 毛玲玲, 吴琪俊, 姚文清, 孙英伟. 2016—2020年辽宁省土源性线虫感染现状及流行趋势[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(2): 211-215.

YU Wei-jun, WANG Zi-jiang, WANG Bo, MAO Ling-ling, WU Qi-jun, YAO Wen-qing, SUN Ying-wei. Surveillance and trends of soil-transmitted helminth infections in Liaoning Province, 2016—2020[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2022, 40(2): 211-215.

图/表 1

表1

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2016—2020年辽宁省土源性线虫感染现状及流行趋势

Surveillance and trends of soil-transmitted helminth infections in Liaoning Province, 2016—2020

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特征 Feature	检查人数 No. examined	土源性线虫 Soil-transmitted helminth		蛔虫 Ascaris lumbricoides		鞭虫 Trichuris trichiura
特征 Feature	检查人数 No. examined	感染人数 No. infected	感染率/% Infection rate/%	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	34 852	90	0.26	87	0.25	3	0.01
女Female	35 057	94	0.27	91	0.26	3	0.01
小计Subtotal	69 909	184	0.26	178	0.25	6	0.01
年龄组/岁Age group/Year
3~9	4 659	2	0.04	2	0.04	0	0
10~19	5 598	11	0.20	11	0.20	0	0
20~29	4 694	5	0.11	4	0.09	1	0.02
30~39	8 728	16	0.18	14	0.16	2	0.02
40~49	10 788	34	0.32	33	0.31	1	0.01
50~59	14 243	43	0.30	41	0.29	2	0.01
60~69	13 803	50	0.36	50	0.36	0	0
≥ 70	7 396	23	0.31	23	0.31	0	0
小计Subtotal	69 909	184	0.26	178	0.25	6	0.01
民族Nationality
满族Man	17 643	97	0.55	96	0.54	1	0.01
汉族Han	51 154	87	0.17	82	0.16	5	0.01
其他Others	1 112	0	0	0	0.00	0	0
小计Subtotal	69 909	184	0.26	178	0.25	6	0.01
职业Occupation
农民Peasants	50 631	158	0.31	154	0.30	4	0.01
学生Students	7 495	14	0.19	14	0.19	0	0
工人Workers	2 542	7	0.28	5	0.20	2	0.08
医务人员Medical personnel	298	2	0.67	2	0.67	0	0
离退人员Retired people	1 401	2	0.14	2	0.14	0	0
其他Others	7 542	1	0.01	1	0.01	0	0
小计Subtotal	69 909	184	0.26	178	0.25	6	0.01
文化程度Educational level
文盲或半文盲Illiteracy	1 274	2	0.16	2	0.16	0	0
学龄前儿童Preschool	2 368	0	0	0	0	0	0
小学Primary school	24 019	76	0.32	75	0.31	1	0
初中Middle school	36 406	93	0.26	88	0.24	5	0.01
高中、中专或中技 High school or technical secondary school	4 027	8	0.20	8	0.20	0	0
大专及以上College and above	1 815	5	0.28	5	0.28	0	0
小计Subtotal	69 909	184	0.26	178	0.25	6	0.01