云南省布朗族聚居地区人群肠道寄生虫感染情况调查

doi:10.12140/j.issn.1000-7423.2024.05.009

摘要/Abstract

摘要：

目的了解云南省布朗族聚居地区人群肠道寄生虫感染现状，为制定后续防治策略提供科学依据。方法采用整群随机抽样法，分别于2015和2023年在云南省西双版纳傣族自治州勐海县布朗山乡开展调查，调查对象为居住6个月以上的各年龄层常住居民。收集调查对象的粪样和性别、年龄、文化程度等资料。采用改良加藤厚涂片法（Kato-Katz法，一粪两检）检查肠道蠕虫卵并计数，同时每份粪样均用试管滤纸法进行钩蚴培养；采用碘液直接涂片法检查肠道原虫。检出虫卵、包囊或钩蚴则判定为肠道寄生虫感染者，并计算土源性线虫感染度。将两次调查的人口数据合并作为标准人口对感染率进行标化，标化感染率的比较采用χ²检验。结果 2015年云南省布朗族聚居地区共调查800人，检出寄生虫感染阳性者564例，标化感染率为71.09%；2023年共调查1 128人，检出寄生虫感染阳性者203例，标化感染率为17.84%。2023年的寄生虫标化感染率低于2015年（χ² = 1 107.636，P < 0.01）。2015和2023年肠道蠕虫标化感染率分别为69.36%和12.17%，2023年低于2015年（χ² = 1 304.222，P < 0.01），其中2023年蛔虫、钩虫、鞭虫的标化感染率（2.78%、6.76%、3.13%）均低于2015年（54.67%、25.86%、30.22%）（χ² = 1 266.428、258.666、510.527，均P < 0.01）。2015和2023年蛔虫、钩虫、鞭虫的感染均以轻度感染为主。2015和2023年肠道原虫标化感染率分别为5.21%和6.39%，差异无统计学意义（χ² = 2.518，P > 0.05），其中2023年人芽囊原虫标化感染率（3.11%）高于2015年（1.04%）（χ² = 20.424，P < 0.01）。2015年，女性和男性的标化感染率分别为75.47%和66.18%；2023年，女性和男性的肠道寄生虫标化感染率分别为20.53%和14.92%。2015和2023年，女性标化感染率均高于男性（χ² = 20.035、10.416，均P < 0.01）。2015年各年龄组间肠道寄生虫标化感染率的差异无统计学意义（χ² = 13.211，P > 0.05），2023年标化感染率最高的为20~29岁年龄组（23.53%），各年龄组间差异有统计学意义（χ² = 14.683，P < 0.05）。2015年不同文化程度肠道寄生虫标化感染率的差异有统计学意义（χ² = 21.108，P < 0.01），2023年的差异无统计学意义（χ² = 2.007，P > 0.05）。2015年布朗族的肠道寄生虫标化感染率为71.03%，高于其他民族的1.39%（χ² = 155.480，P < 0.01）；2023年布朗族的肠道寄生虫标化感染率（17.73%）与其他民族（20.83%）的差异无统计学意义（χ² = 0.456，P > 0.05）。结论 2023年云南省布朗族聚居地区人群肠道寄生虫感染率较2015年大幅下降，肠道蠕虫感染率下降明显，肠道原虫感染率有所上升。

关键词: 肠道寄生虫, 云南省, 布朗族, 感染率

Abstract:

Objective To investigate the current status of intestinal parasitic infections in areas inhabited by Bulang nationality in Yunnan Province, and to provide a scientific basis for formulating prevention and control strategies. Methods In 2015 and 2023, the survey was carried out in Bulang Township, Menghai County, Xishuangbanna Dai Autonomous Prefecture, Yunnan Province using cluster random sampling, and the survey subjects were permanent residents of all ages who lived for more than 6 months. The fecal samples and information of survey subjects such as gender, age and education level were collected. The modified Kato-Katz thick smear method (two slides per sample) was used to detect and count the eggs of intestinal worms, and each fecal sample was cultured to detect the hookworm used tube-filter paper culture method. Intestinal protozoa were detected by iodine staining smear method. Eggs, cysts or hookworms detected during fecal examination were judged to be intestinal parasitic infections, and the intensity of soil-transmitted nematode was determined. The population data of the two surveys were combined as the standard population to standardize the infection rate. The chi-square test was used for the comparison of the standardized infection rate. Results In 2015, a total of 800 people were surveyed in areas inhabited by Bulang nationality in Yunnan Province, and 564 people were positive for parasitic infection, with a standardized infection rate of 71.09%. In 2023, a total of 1 128 people were surveyed, and 203 people were positive for parasitic infection, with a standardized infection rate of 17.84%. The standardized infection rate of parasites in 2023 was lower than that in 2015 (χ² = 1 107.636, P < 0.01). The standardized infection rates of intestinal worms in 2023 was 12.17%, which was lower than that in 2015 (69.36%) (χ² = 1 304.222, P < 0.01). The standardized infection rates of Ascaris lumbricoides, hookworm and Trichuris trichura in 2023 (2.78%, 6.76% and 3.13%) were lower than those in 2015 (54.67%, 25.86% and 30.22%) (χ² = 1 266.428, 258.666, 510.527, all P < 0.01). In 2015 and 2023, the intensity of A. lumbricoides, hookworm and T. trichura were mainly mild infected. In 2015 and 2023, the standardized infection rates of intestinal protozoa were 5.21% and 6.39%, respectively, with no significant difference (χ² = 2.518, P > 0.05). The standardized infection rate of Blastocystis hominis in 2023 (3.11%) was higher than that in 2015 (1.04%) (χ² = 20.424, P < 0.01). The standardized infection rates of females and males were 75.47% and 66.18% in 2015 and 20.53% and 14.92% in 2023, respectively. The standardized infection rates of females in 2015 and 2023 were higher than those in males (χ² = 20.035, 10.416, both P < 0.01). The 20-29 year age group had the highest standardized infection rate of 23.53% in 2023, and there were statistically significant differences between the age groups (χ² = 14.683, P < 0.05); but no significant difference in 2015 (χ² = 13.211, P > 0.05). There was a significant difference in the standardized infection rate among the different education levels in 2015 (χ² = 21.108, P < 0.01), but no significant difference in 2023 (χ² = 2.007, P > 0.05). The standardized infection rate of Bulang nationality was 71.03%, which was higher than that of other nationalities (1.39%) (χ² = 155.480, P < 0.01) in 2015, and there was no significant difference between the standardized infection rate of Bulang nationality (17.73%) and other nationalities (20.83%) in 2023 (χ² = 0.456, P > 0.05). Conclusion In 2023, the infection rate of intestinal parasites in areas inhabited by Bulang nationality in Yunnan Province decreased significantly compared with 2015. The infection rate of intestinal worms decreased significantly, and the infection rate of intestinal protozoa increased.

Key words: Intestinal parasites, Yunnan Province, Bulang nationality, Infection rate

中图分类号:

陈萌, 陶洪, 李彦忠, 张娟, 周晓梅. 云南省布朗族聚居地区人群肠道寄生虫感染情况调查[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(5): 623-628.

CHEN Meng, TAO Hong, LI Yanzhong, ZHANG Juan, ZHOU Xiaomei. Investigation of intestinal parasitic infections among the population in areas inhabited by Bulang nationality in Yunnan Province[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2024, 42(5): 623-628.

图/表 3

表1

表2

表3

参考文献 15

[1]	Wu FW, Peng J, Zi JR, et al. Surveillance on soil-transmitted helminth infections in Yunnan Province from 2016 to 2022[J]. Chin J Parasitol Parasit Dis, 2023, 41(6): 718-724, 732. (in Chinese)
	(吴方伟, 彭佳, 字金荣, 等. 2016—2022年云南省土源性线虫感染监测结果分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(6): 718-724, 732.)
[2]	Peng J, Wu FW, Yang YM, et al. Infectious status of human parasites in ecological area of Sichuan basin, Yunnan[J]. China Trop Med, 2019, 19(1): 23-26, 39. (in Chinese)
	(彭佳, 吴方伟, 杨亚明, 等. 云南省四川盆地生态区人体重点寄生虫病感染调查[J]. 中国热带医学, 2019, 19(1): 23-26, 39.)
[3]	Chen JX, Cai YC, Ai L, et al. Epidemic status and challenges of important human parasitic diseases in China[J]. Lab Med, 2021, 36(10): 993-1000. (in Chinese)
	(陈家旭, 蔡玉春, 艾琳, 等. 我国重要人体寄生虫病防控现状与挑战[J]. 检验医学, 2021, 36(10): 993-1000.)
[4]	Yang JL, Yang HM, Wang YK, et al. A survey of human intestinal parasite in Yunnan[J]. Chin J Parasit Dis Contr, 1992(4): 245-248. (in Chinese)
	(杨家伦, 杨洪模, 王云昆, 等. 云南省人体寄生虫分布调查[J]. 中国寄生虫病防治杂志, 1992(4): 245-248.)
[5]	Office of the Leading Group for the Seventh National Population Census of the State Council. Tabulation on 2020 China population census by county[M]. Beijing: China Statistics Press, 2022: 851-853. (in Chinese)
	(国务院第七次全国人口普查领导小组办公室. 中国人口普查分县资料2020[M]. 北京: 中国统计出版社, 2022: 851-853.)
[6]	Wang LD. Survey on the current situation of important human parasitic diseases[M]. Beijing: People’s Medical Publishing House, 2008: 7. (in Chinese)
	(王陇德. 全国人体重要寄生虫病现状调查[M]. 北京: 人民卫生出版社, 2008: 7.)
[7]	Du ZW, Wang XZ, Wang LB, et al. Survey of infection rate of human intestinal parasites in Bulang Ethnic population in Yunnan Province[J]. China Trop Med, 2006, 6(1): 168-169. (in Chinese)
	(杜尊伟, 王学忠, 汪丽波, 等. 云南布朗族人群肠道寄生虫感染率调查[J]. 中国热带医学, 2006, 6(1): 168-169.)
[8]	Li BF, Wu FW, Yan XL, et al. Survey of key human parasitic infections in the Eastern Tibet and Western Sichuan Eco-region, Yunnan Province, China[J]. Chin J Parasitol Parasit Dis, 2019, 37(6): 718-722. (in Chinese)
	(李奔福, 吴方伟, 严信留, 等. 云南省藏东-川西生态区人体重点寄生虫病流行现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(6): 718-722.)
[9]	Cai X, Yang YM, Li BF, et al. Investigation on the prevalence of human parasitic infections in the ecoregion of southern part of Yunnan-Guangxi-Guangdong neighboring area, Yunnan Province in 2015[J]. Chin J Parasitol Parasit Dis, 2021, 39(6): 848-852. (in Chinese)
	(蔡璇, 杨亚明, 李奔福, 等. 2015年云南省滇桂粤南部生态区人体重点寄生虫感染情况调查[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(6): 848-852.)
[10]	You WQ, Zeng YL. On the development drive of minority nationalities: a study based on the poverty alleviation practice of directly-entering-socialism ethnic groups in Yunnan[J]. Soc Sci Yunnan, 2020(6): 117-124. (in Chinese)
	(尤伟琼, 曾宇龙. 中国人口较少民族的发展驱动研究: 基于云南直过民族整族脱贫实践[J]. 云南社会科学, 2020(6): 117-124.)
[11]	Sun DW, Liu Y, Wang GZ, et al. Endemic status of human important parasitic infection in Hainan Province, China in 2015[J]. Chin J Parasitol Parasit Dis, 2019, 37(3): 254-259. (in Chinese)
	(孙定炜, 刘莹, 王光泽, 等. 2015年海南省人体重点寄生虫感染现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(3): 254-259.)
[12]	Tang L, Xing ZF, Ge T, et al. Current status of key parasitic infections of humans in Heilongjiang Province in 2015[J]. Chin J Parasitol Parasit Dis, 2018, 36(4): 388-391, 398. (in Chinese)
	(唐磊, 邢智锋, 葛涛, 等. 2015年黑龙江省人体重点寄生虫感染现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(4): 388-391, 398.)
[13]	Deng Y, Zhang YL, Chen WQ, et al. A survey on parasite infection in human intestines in the eastern part of Henan Province in 2015[J]. Chin J Parasitol Parasit Dis, 2017, 35(5): 450-455. (in Chinese)
	(邓艳, 张雅兰, 陈伟奇, 等. 2015年河南省豫东地区人体肠道寄生虫感染现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2017, 35(5): 450-455.)
[14]	Jiang T, Wang JZ, Yu YF, et al. Hospital-based study on the risk factors for Blastocystis hominis infection in the Tengchong City, Yunnan Province, China[J]. Chin J Zoonoses, 2019, 35(10): 964-969, 972. (in Chinese)
	(江涛, 王加志, 俞英昉, 等. 云南省腾冲市住院患者人芽囊原虫感染情况及影响因素研究[J]. 中国人兽共患病学报, 2019, 35(10): 964-969, 972.)
[15]	Chen HH, Liu Q, Deng Y, et al. Advances in the research of comorbidity of Blastocystis hominis infections and other diseases[J]. Chin J Schisto Control, 2021, 33(5): 535-539. (in Chinese)
	(陈慧慧, 刘琴, 邓艳, 等. 人芽囊原虫感染合并其他疾病研究进展[J]. 中国血吸虫病防治杂志, 2021, 33(5): 535-539.)

年份 Year	调查人数No. examined cases	肠道蠕虫感染人数（标化感染率/%） No. cases of intestinal worm infection (standardized infection rate/%)				肠道原虫感染人数（标化感染率/%） No. cases of intestinal protozoa infection (standardized infection rate/%)
年份 Year	调查人数No. examined cases	蛔虫 A. lumbricoides	钩虫 Hookworm	鞭虫 T. trichura	带绦虫Tapewo-rm	溶组织阿米巴 E. histolyt-ica	结肠阿米巴 E. coli	微小内蜓阿米巴 E. nana	布氏嗜碘阿米巴 I. butschlii	哈氏内阿米巴 E. hartmanni	蓝氏贾第鞭毛虫 G. lamblia	人芽囊原虫 B. hominis
2015	800	424（54.67）	219（25.86）	229（30.22）	8（0.99）	0（0）	7（0.78）	19（2.35）	0（0）	4（0.39）	7（0.84）	7（1.04）
2023	1 128	34（2.78）	71（6.76）	39（3.13）	7（0.59）	2（0.14）	4（0.39）	18（1.57）	1（0.09）	0（0）	15（1.17）	35（3.11）

虫种 Species	感染人数 No. infected	重度感染 Severe infection		中度感染 Moderate infection		轻度感染 Mild infection
虫种 Species	感染人数 No. infected	感染人数 No. infected	构成比/% Composition ratio/%	感染人数 No. infected	构成比/% Composition ratio/%	感染人数 No. infected	构成比/% Composition ratio/%
2015年 Year 2015
蛔虫 A. lumbricoides	424	0	0	27	6.37	397	93.63
钩虫 Hookworm	219	2	0.91	0	0	217	99.09
鞭虫 T. trichura	229	0	0	10	4.37	219	95.63
2023年 Year 2023
蛔虫 A. lumbricoides	34	0	0	3	8.82	31	91.18
钩虫 Hookworm	71	0	0	4	5.63	67	94.37
鞭虫 T. trichura	39	0	0	0	0	39	100

特征 Feature	2015年 Year 2015			2023年 Year 2023
特征 Feature	调查人数 No. examined	感染人数 No. infected	标化感染率/% Standardized infection rate/%	调查人数 No. examined	感染人数 No. infected	标化感染率/% Standardized infection rate/%
性别 Gender
男 Male	375	246	66.18	556	85	14.92
女 Female	425	318	75.47	572	118	20.53
年龄/岁 Age/year
0~9	126	91	72.22	387	80	20.67
10~19	101	71	70.30	62	9	14.52
20~29	131	85	64.89	85	20	23.53
30~39	130	99	76.15	217	34	15.67
40~49	136	92	67.65	146	23	15.75
50~59	98	73	74.49	113	15	13.27
60~69	54	38	70.37	82	14	17.07
≥ 70	24	15	62.50	36	8	22.22
文化程度 Educational level
文盲 Illiteracy	422	296	70.25	460	84	18.30
学龄前 Preschool	73	46	63.01	70	11	15.71
小学 Primary school	233	169	78.28	502	93	18.58
初中及以上 Middle school and above	72	53	70.76	96	15	15.11
民族 Nationality
布朗族 Bulang nationality	799	563	71.03	1 057	188	17.73
其他 Other nationalities	1	1	1.39	71	15	20.83