2016—2020年广西壮族自治区人群土源性线虫感染监测结果

doi:10.12140/j.issn.1000-7423.2021.06.011

摘要/Abstract

摘要：

目的了解和分析广西壮族自治区（简称广西）土源性线虫病的流行现状和发展趋势,为制定土源性线虫病防治策略与评价防治效果提供科学依据。方法 2016—2020年,将全区按GDP分为高、中、低GDP地区,从中随机抽取39个县（市、区）设立监测点。监测点以县为单位,按地理方位划分为东、西、南、北、中5个片区,每个片区随机抽取1个乡（镇）的1个行政村开展监测,每个行政村整群抽取3周岁以上常住居民不少于200人。收集监测对象粪样,采用改良加藤厚涂片法检测土源性线虫卵并计数,采用透明胶纸肛拭法检测3~9岁儿童蛲虫卵。采用卡方检验和趋势卡方检验分析比较不同地区、性别、年龄、民族、文化程度、职业等人群土源性线虫感染情况。结果 39个监测点生产方式以农业为主,饮用水以自来水和井水为主。2016—2020年监测点无害化厕所覆盖率分别为77.39%（36 403/47 040）、94.19%（47 120/50 026）、94.47%（55 499/58 750）、86.72%（68 913/79 467）和94.99%（56 188/59 154）,各年度间差异有统计学意义（χ² = 12813.53,P < 0.05）。2016—2020年共调查监测点66 355人,土源性线虫（钩虫、蛔虫、鞭虫）总感染率分别为4.20%（533/12 699）、2.98%（312/10 458）、2.21%（276/12 485）、1.75%（285/16 329）和1.54%（222/14 384）,差异有统计学意义（χ² = 260.67,P < 0.05）,且感染率呈逐年下降趋势（χ² = 316.05,P < 0.05）。高、中、低GDP地区土源性线虫总感染率分别为1.11%（244/22 049）、2.65%（722/27 273）和3.89%（662/17 033）,差异有统计学意义（χ² = 317.57,P < 0.05）。女性钩虫感染率为2.68%（900/33 548）,高于男性的1.40%（458/32 807）（χ² = 136.98,P < 0.05）;男性、女性鞭虫感染率分别为0.29%（95/32 807）和0.32%（108/33 548）,蛔虫感染率分别为0.11%（37/32 807）和0.13%（43/33 548）,男、女童蛲虫感染率分别为11.69%（274/2 343）和12.17%（257/2 112）,不同性别间差异均无统计学意义（χ² = 0.569、0.326、0.24,P > 0.05）。≥ 80岁年龄组钩虫感染率最高,为4.93%（69/1 399）;3~9岁年龄组蛔虫感染率最高,为0.28%（31/11 183）;70~79岁年龄组鞭虫感染率最高,为0.62%（31/4 961）。壮族人群的钩虫感染率最高,为2.77%（870/31 352）,其他民族人群的蛔虫、鞭虫感染率最高,分别为0.60%（18/2 976）、0.60%（18/2 976）。文盲人群的钩虫、鞭虫感染率最高,分别为5.36%（195/3 635）和0.61%（22/3 635）;学龄前儿童的蛔虫感染率最高,为0.35%（20/5 674）。农民的钩虫感染率最高,为2.80%（1 285/45 943）;散居儿童的蛔虫感染率最高,为0.71%（10/1 399）;事业单位人员的鞭虫感染率最高,为0.45%（5/1 105）。2016—2020年3~9岁儿童蛲虫感染率分别为8.45%（24/284）、17.99%（86/478）、15.66%（155/990）、11.48%（182/1 586）和7.52%（84/1 117）,差异有统计学意义（χ² = 54.10,P < 0.05）,且呈先上升后下降趋势（χ² = 21.07,P < 0.05）。结论广西人群土源性线虫感染率逐年下降,呈低度流行趋势。但儿童蛲虫感染率仍较高,应加强对儿童土源性线虫感染的综合防治。

关键词: 土源性线虫, 感染, 监测, 广西

Abstract:

Objective To understand and analyze the epidemic status and development trends of soil-transmitted nematodiasis in Guangxi Zhuang Autonomous Region (Guangxi), to provide scientific basis for formulating the disease control strategy, and evaluating the control effect. Methods In 2016—2020, Guangxi was assigned to high-, medium- and low-GDP regions, from which 39 counties (cities, districts) were selected as surveillance sites. Each county under surveillance was divided into 5 regions according to geographic location, i.e., east, west, south, north, and central. From each region, one townships was randomly selected, and an administrative village was selected from the township for the surveillance. In the sampled village, no less than 200 permanent residents aged > 3 years were cluster sampled for examination. Fecal samples were collected from the villagers, and soil-transmitted nematode eggs were detected with the modified Kato-Katz thick smear method. The eggs of Enterobius vermicularis were examined in children aged 3-9 years with the adhesive tape method. Chi-square test and Chi-square trend test were used to analyze and compare the infection status of soil-transmitted nematodes in different areas, gender, age groups, nationalities, education levels and occupations. Results In the 39 surveillance sites, the production modes was mainly agriculture, and the drinking water was mostly tap water and well water. From 2016 to 2020, the coverage rates of sanitary toilets was 77.39% (36 403/47 040), 94.19% (47 120/50 026), 94.47% (55 499/58 750), 86.72% (68 913/79 467), and 94.99% (56 188/59 154), respectively, which differed significantly (χ² = 12 813.53, P < 0.05). A total of 66 355 people were examined, and the infection rates of soil-transmitted nematodes were 4.20% (533/12 699), 2.98% (312/10 458), 2.21% (276/12 485), 1.75% (285/16 329) and 1.54% (222/14 384) in 2016—2020, respectively, showing significant difference between years (χ² = 260.67, P < 0.05), and a decreasing trend year by year (χ² = 316.05, P < 0.05). The rates in the high-, medium- and low-GDP areas were 1.11% (244/22 049), 2.65% (722/27 273) and 3.89% (662/17 033) respectively, and differed significantly between the areas (χ² = 317.57, P < 0.05). The hookworm infection rate in females was 2.68% (900/33 548), which was higher than that in males (1.40%, 458/32 807) (χ² = 136.98, P < 0.05). The Trichuris trichura infection rate in males and females were 0.29% (95/32 807) and 0.32% (108/33 548), respectively; the Ascaris lumbricoides infection rates in males and females were 0.11% (37/32 807) and 0.13% (43/33 548), respectively; and the E. vermicularis infection rates in boys and girls were 11.69% (274/2 343) and 12.17% (257/2 112), respectively. There was no significant differences in the infection rate between genders (χ² = 0.569, 0.326, 0.24; P > 0.05). Among the different age groups, the infection rate of hookworm was highest in the group aged > 80 years, at 4.93% (69/1 399); the rate of A. lumbricoides was highest in the group aged 3-9 years, at 0.28% (31/11 183); and the rate of T. trichura was highest in the group aged 70-79 years, at 0.62% (31/4 961). The infection rate of hookworm was the highest in the Zhuang minority population at 2.77% (870/31 352); and the rates of A. lumbricoides and T. trichura were highest in other minorities, both at 0.60% (18/2 976). The infection rates of hookworm and T. trichura were highest in the illiterate group, at 5.36% (195/3 635) and 0.61% (22/3 635) respectively. The A. lumbricoides infection rate was highest in preschool children, at 0.35% (20/5 674). The infection rate of hookworm was highest in farmers, at 2.80% (1 285/45 943); that for A. lumbricoides in live-scattered children, at 0.71%(10/1 399); and that of T. trichura in institutional personnel, at 0.45% (5/1 105). The infection rate of E. vermicularis in children aged 3-9 years was 8.45% (24/284), 17.99% (86/478), 15.66% (155/990), 11.48% (182/1 586) and 7.52% (84/1 117) in 2016—2020, respectively, which differed significantly (χ² = 54.10, P < 0.05), and showed an increasing trend and then a decreasing trend with time (χ² = 21.07, P < 0.05). Conclusion The infection rate of soil-transmitted nematodes in Guangxi decreased year by year, and displayed low prevalence. However, the E. vermicularis infection rate in children maintained at a considerable high level. Therefore, it is imperative to strengthen comprehensive prevention and control measures in children.

Key words: Soil-transmitted nematode, Infection, Surveillance, Guangxi

中图分类号:

R532.1

万孝玲, 吕国丽, 蒋智华, 区方奇, 韦海艳, 唐雯茜, 林源, 张伟尉, 黄铿凌, 石云良, 刘多, 刘健, 孟军, 杨益超. 2016—2020年广西壮族自治区人群土源性线虫感染监测结果[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(6): 800-806.

WAN Xiao-ling, LV Guo-li, JIANG Zhi-hua, OU Fang-qi, WEI Hai-yan, TANG Wen-qian, LIN Yuan, ZHANG Wei-wei, HUANG Keng-ling, SHI Yun-liang, LIU Duo, LIU Jian, MENG Jun, YANG Yi-chao. Surveillance on soil-transmitted nematode infections in population in Guangxi Zhuang Autonomous Region during 2016—2020[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(6): 800-806.

图/表 4

表1

表2

表3

2016—2020年广西壮族自治区土源性线虫感染人群分布

特征 Feature	调查人数 No. exam’d	钩虫Hookworm		蛔虫A. lumbricoides		鞭虫T. trichiura		合计Total
特征 Feature	调查人数 No. exam’d	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/%	感染人数 No. infected	感染率/%Infection rate/%
性别Gender
男性Male	32 807	458	1.40	37	0.11	95	0.29	586	1.79
女性Female	33 548	900	2.68	43	0.13	108	0.32	1 042	3.11
年龄Age
3~9	11 183	28	0.25	31	0.28	32	0.29	87	0.78
10~19	6 664	23	0.35	12	0.18	28	0.42	63	0.95
20~29	3 710	31	0.84	3	0.08	7	0.19	41	1.11
30~39	8 009	100	1.25	5	0.06	30	0.37	135	1.69
40~49	9 940	201	2.02	12	0.12	23	0.23	233	2.34
50~59	11 369	328	2.89	5	0.04	23	0.20	354	3.11
60~69	9 120	352	3.86	5	0.05	24	0.26	380	4.17
70~79	4 961	226	4.56	5	0.10	31	0.62	260	5.24
≥ 80	1 399	69	4.93	2	0.14	5	0.36	75	5.36
民族Nationality
汉族Han	32 027	421	1.31	33	0.10	76	0.24	527	1.65
壮族Zhuang	31 352	870	2.77	29	0.09	109	0.35	1 001	3.19
其他Others	2 976	67	2.25	18	0.60	18	0.60	100	3.36
文化程度Education
文盲Illiteracy	3 635	195	5.36	6	0.17	22	0.61	220	6.05
学龄前儿童 Preschoolers	5 674	13	0.23	20	0.35	8	0.14	40	0.70
小学 Primary school	26 834	678	2.53	36	0.13	100	0.37	808	3.01
初中 Middle school	24 604	415	1.69	17	0.07	58	0.24	488	1.98
高中/中专 Senior high school	4 341	52	1.20	1	0.02	13	0.30	65	1.50
大专及以上 College and above	1 267	5	0.39	0	0.00	2	0.16	7	0.55
职业Occupation
幼托儿童 Childcare children	4 201	8	0.19	9	0.21	6	0.14	23	0.55
散居儿童 Scattered children	1 399	4	0.29	10	0.71	2	0.14	15	1.07
学生Student	12 054	39	0.32	24	0.20	51	0.42	111	0.92
事业单位人员 Institution personnel	1 105	6	0.54	0	0.00	5	0.45	11	1.00
农民Farmer	45 943	1 285	2.80	36	0.08	139	0.30	1 451	3.16
其他Others	1 653	16	0.97	1	0.06	0	0.00	17	1.03

表3

表4

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