中国寄生虫学与寄生虫病杂志 ›› 2019, Vol. 37 ›› Issue (5): 583-587.doi: 10.12140/j.issn.1000-7423.2019.05.013

• 论著 • 上一篇    下一篇

2015年四川省人体肠道原虫感染现状调查

罗静雯(), 田洪春*(), 谢红, 钟波, 刘阳, 陈漪澜, 李黎   

  1. 四川省疾病预防控制中心,成都 610041
  • 收稿日期:2019-03-20 出版日期:2019-10-30 发布日期:2019-11-07
  • 通讯作者: 田洪春
  • 作者简介:

    作者简介:罗静雯(1985-),女,硕士,主管医师,研究方向土源性线虫病流行病学。E-mail: jingwenluo922@126.com

Prevalence of human intestinal protozoan infections in Sichuan Province in 2015

Jing-wen LUO(), Hong-chun TIAN*(), Hong XIE, Bo ZHONG, Yang LIU, Yi-lan CHEN, Li LI   

  1. Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
  • Received:2019-03-20 Online:2019-10-30 Published:2019-11-07
  • Contact: Hong-chun TIAN

摘要:

目的 了解四川省人体肠道原虫感染现状。方法 根据全国人体重点寄生虫病现状调查方案和实施细则,于2015年4-6月,采用分层整群随机抽样方法,选取四川省5个生态区的15个调查县(市、区)45个调查点。调查对象为各调查点0岁以上的农村常住居民,每个调查点调查人数不少于250人。采集受检对象粪样,采用卢戈氏碘液染色法(一粪一检)检查粪样原虫包囊,采用生理盐水涂片法(一粪一检)检查新鲜稀粪或脓血便的滋养体。应用SPSS 23.0软件进行统计学分析,感染率通过χ2检验进行比较。结果 共调查11 403人,肠道原虫感染率为2.0%(223/11 403)。共发现9种原虫:溶组织内阿米巴、结肠内阿米巴、蓝氏贾第鞭毛虫、人芽囊原虫、微小内蜒阿米巴、哈门氏内阿米巴的感染率分别为0.2%(22/11 403)、0.7%(78/11 403)、0.1%(9/11 403)、0.5%(60/11 403)、0.6%(67/11 403)、0.2%(17/11 403),结肠小袋纤毛虫、布氏嗜碘阿米巴、肠内滴虫的感染病例数分别为2、1和1例。江河源区-甘南生态区人群原虫感染率最高,为6.5%(148/2 278);四川盆地生态区感染率最低,为0.4%(10/2 289);不同生态区肠道原虫感染率差异有统计学意义(P < 0.01)。马尔康县人群原虫感染率最高,为10.2%(102/1 001);甘孜县感染率次之,为6.1%(46/755);不同县(市、区)原虫感染率差异有统计学意义(P < 0.01)。男、女肠道原虫感染率分别为1.9%(97/5 247)和2.1%(126/6 156),差异无统计学意义(P > 0.05)。20~29岁年龄组肠道原虫感染率最高,为2.8%(23/813);≥ 80岁年龄组人群感染率为0;不同年龄组人群肠道原虫感染率差异无统计学意义(P > 0.05)。文盲人群肠道原虫感染率最高,为3.2%(73/2 317);大专、大学以上人群感染率为0;不同文化程度人群肠道原虫感染率差异有统计学意义(P < 0.01)。牧民原虫感染率最高,为4.8%(20/421);学生感染率次之,为2.0%(30/1 491);不同职业人群肠道原虫感染率差异无统计学意义(P > 0.05)。藏族人群肠道原虫感染率最高,为5.3%(149/2 381);汉族人群感染率次之,为0.9%(74/7 857);不同民族肠道原虫感染率差异有统计学意义(P < 0.01)。结论 四川省江河源区-甘南生态区和马尔康县及文盲、藏族人群的肠道原虫感染率较高,应是今后的重点防治地区和人群。

关键词: 肠道原虫, 感染现状, 四川省

Abstract:

Objective To understand the current status of human intestinal protozoan infections in Sichuan Province. Methods An epidemiological survey was carried out in Sichuan Province according to the Protocol of National Survey Scheme on Major Human Parasitic Diseases from April to June, 2015. Total 45 survey sites were selected from 15 counties (cities and districts) within 5 ecological zones of Sichuan by using a stratified sampling method. No less than 250 rural permanent villagers in each site were enrolled in the survey and the fecal sample was collected from each participant. The protozoan cysts in the feces were examined by Lugol’s iodine staining method(one check for each sample). The protozoan trophozoites were examined only in the fresh diarrheal or bloody fecal samples using saline direct smear method(one check for each sample). Each fecal sample was examined once. SPSS 23.0 software was used for statistical analysis. The prevalence difference among the different groups of people was compared by χ2 test. Results Total 11 403 people were investigated. The overall prevalence of intestinal protozoan infections was 2.0% (223/11 403) province-wide. Total 9 protozoan species were identified in infected people including Entamoeba histolytica (0.2%, 22/11 403), E. coli (0.7%, 78/11 403), Gardia lamblia (0.1%, 9/11 403), Blastocystis hominis (0.5%, 60/11 403), E. hartmani (0.2%, 17/11 403)and Endolimax nana(0.6%, 67/11 403). Two cases of Balantidium coli, one case of each Iodamoeba butschlii and Embadomonas intestinalis were identified. The highest prevalence of intestinal protozoan infections was identified in areas of Source of rivers-Southern Gansu ecological zone (6.5%, 148/2 278),and the lowest prevalence was identified in Sichuan basin zone (0.4%, 10/2 289). There was a significant difference in the prevalence of protozoan infections among different ecological zones (P < 0.01). The highest prevalence of intestinal protozoan infections was identified in Markam County (10.2%, 102/1 001), followed by Ganzi County (6.1%, 46/755). There was significant difference in the prevalence of intestinal protozoa among different counties (cities and districts) (P < 0.01). The prevalence of intestinal protozoa in males and females were 1.9% (97/5 247) and 2.1% (126/6 156), respectively, without significant difference (P > 0.05). People with age 20-29 had the highest prevalence of intestinal protozoa and no protozoa infection was found in people with age of 80 or older, however, there was no significant difference in the prevalence of intestinal protozoa among different age groups (P > 0.05). Regarding the education, people with no education (illiteracy) had the highest prevalence (3.2%, 73/2 317) and no infection was identified in people with education of college and above, with significant difference among people with different education(P < 0.01). In terms of occupation, the highest prevalence of protozoan infections occurred in herdsmen (4.8%, 20/421) followed by students (2.0%, 30/1 491), however, there was no significant difference in the prevalence among different occupations (P > 0.05). In terms of ethnic groups, the highest prevalence was found in Tibetan population (5.3%, 149/2 381) followed by Han population (0.9%, 74/7 857) with significant difference in the prevalence of protozoan infections among different nationalities (P < 0.01). Conclusion Source of rivers Gannan ecological zone and Markam County kept relatively high prevalence of protozoan infections in which more prevention and control measures should be adopted. The people with low education and Tibetan are the main population for the control of intestinal protozoan infections.

Key words: Intestinal protozoa, Infection status, Sichuan Province

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