中国寄生虫学与寄生虫病杂志 ›› 2017, Vol. 35 ›› Issue (5): 450-455.

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2015年河南省豫东地区人体肠道寄生虫感染现状调查

邓艳, 张雅兰, 陈伟奇, 蔺西萌, 周瑞敏, 刘颖, 杨成运, 钱丹, 张红卫, 许汴利*()   

  1. 河南省疾病预防控制中心,郑州 450016
  • 收稿日期:2017-03-15 出版日期:2017-10-30 发布日期:2018-01-08
  • 通讯作者: 许汴利

A survey on parasite infection in human intestines in the eastern part of Henan Province in 2015

Yan DENG, Ya-lan ZHANG, Wei-qi CHEN, Xi-meng LIN, Rui-min ZHOU, Ying LIU, Cheng-yun YANG, Dan QIAN, Hong-wei ZHANG, Bian-li XU*()   

  1. Henan Center for Disease Control and Prevention, Zhengzhou 450016, China
  • Received:2017-03-15 Online:2017-10-30 Published:2018-01-08
  • Contact: Bian-li XU

摘要:

目的 了解河南省豫东地区肠道寄生虫感染的流行现状,为该地区肠道寄生虫感染的防治提供科学依据。方法 2014年11月-2015年6月按照经济条件和地理方位进行分层整群抽样,随机选择豫东地区的临颍县、濮阳县、台前县、太康县、西平县、息县、项城市、新郑市、虞城县等9个县(市)26个调查点,采集人群粪样,采用改良加藤厚涂片法检查肠道蠕虫感染情况,钩蚴试管滤纸培养法鉴别钩虫(Ancylostoma sp.)虫种,3~6岁儿童采用透明胶纸肛拭法检查蛲虫(Enterobius vermicularis)感染情况,碘液染色法检查肠道原虫感染情况。收集各调查点的主要饮用水源、农民年人均纯收入等基本信息。将不同地区感染率进行标准化后进行比较。不同虫种、性别、年龄和职业以及其他相关因素的感染率间差异比较采用卡方检验。结果 共收集粪样6 696份,检出肠道蠕虫6种,肠道原虫4种。肠道寄生虫总感染率为1.57%(105/6 696),其中肠道蠕虫和原虫感染率分别为0.91%(61/6 696)和0.66%(44/6 696)。感染率较高的3种肠道寄生虫分别为蛲虫(0.36%,24/6 696)、人芽囊原虫(Blastocystis hominis)(0.30%,20/6 696)和蛔虫(Ascaris lumbricoides)(0.19%,13/6 696)。3~6岁儿童蛲虫感染率为2.23%(15/674),其中肛拭蛲虫感染率为1.93%(13/674)。7份钩蚴经鉴定均为十二指肠钩虫(Ancylostoma duodenale)。肠道寄生虫感染率较高的3个县(市)分别是项城市(4.24%)、新郑市(3.51%)和太康县(3.34%)。男性和女性肠道寄生虫感染率分别为1.71%(55/3 214)和1.44%(50/3 482),两者差异无统计学意义(χ2 = 0.82,P > 0.05)。不同文化程度人群中,肠道寄生虫感染率最高的为高中/中专组2.11%(10/473),与其他组比校,差异无统计学意义(χ2 = 2.41,P > 0.05)。不同年龄组人群中,15~29岁组人群的肠道寄生虫感染率最高,为2.38%(21/884),与其他年龄组比较,差异有统计学意义(χ2 = 9.39,P < 0.01)。不同职业人群中,学龄前和学生人群的肠道寄生虫感染率较高,为2.5%(24/720)和2.09%(24/1 148),与其他职业人群比较,差异有统计学意义(χ2 = 9.93,P < 0.05)。饮用水为井水的调查点人群肠道寄生虫感染率为1.21%(31/2 562),高于自来水饮用人群的0.65%(27/4 134)(χ2 = 5.71,P < 0.05)。调查点农民年人均纯收入为1 200~11 600元,中位数为5 604.5元,肠道寄生虫感染率随农民年人均纯收入的增加而降低(χ2 = 11.08,P < 0.01)。结论 河南省豫东地区人体重点寄生虫感染情况较前两次调查有显著下降,学龄前儿童、学生人群是今后监测的重点人群。

关键词: 现状调查, 肠道寄生虫, 豫东地区

Abstract:

Objective To understand the endemic status of human intestinal parasitic infections in the eastern part of Henan Province, in order to facilitate control of the disease in this region. Methods According to the economic level and geographical location, stratified cluster sampling was made to randomly select 26 survey spots in 9 counties including Linying, Puyang, Taiqian, Taikang, Xiping, Xixian, Xiangcheng, Xinzheng and Yucheng, from November 2014 to June 2015. Human fecal samples were collected and examined for intestinal worm infection using Kato-Katz thick smear method. For the hookworm egg-positive samples, larvae were cultured on the filter paper to identify the species of Ancylostoma. The adhesive tape method was used to detect pinworm eggs in children aged 3 to 6, and iodine staining was used to detect protozoan infection in fecal samples. Information on the source of drinking water and the annual per capita net income of farmers was collected. The infection rate was normalized and compared among different regions. The parasitic infection rate was also analyzed in aspects of species, sex, age, and occupation using the Chi-square test. Results A total of 6 696 fecal samples were collected, from which 6 species of intestinal worms and 4 species of intestinal protozoans were found. The overall infection rate of intestinal parasites was 1.57% (105/6 696), comprising 0.91% (61/6 696) for worms and 0.66% (44/6 696) for protozoans. Concerning the infection rate, the top three intestinal parasites were the pinworms(0.36%, 24/6 696), Blastocystis hominis (0.30%, 20/6 696), and Ascaris lumbricoides (0.19%, 13/6 696). The pinworm infection rate was 2.23% (15/674) among children aged 3-6 and that revealed by the adhesive tape method was 1.93% (13/674). The hookworm larvae detected in 7 samples were all identified to be Ancylostoma duodenale. The top three counties with highest intestinal parasite infection rate were Xiangcheng (4.24%), Xinzheng (3.51%) and Taikang (3.34%). There was no significant difference in the intestinal parasite infection rate between males (1.71%, 55/3 214) and females (1.44%, 50/3 482) (χ2 = 0.82, P > 0.05). Among populations with different educational levels, the infection rate was higher in those at a high school or secondary high school level (2.11%, 10/473) (χ2 = 2.41, P > 0.05 vs. other groups). Among different age groups, the infection rate of intestinal parasite was highest in the 15-29 age group (2.38%, 21/884) (χ2 = 9.39, P < 0.01). Among different occupations, the infection rate of intestinal parasite was significantly higher in preschool children (2.5%, 24/720) and students (2.09%, 24/1 148) (χ2 = 9.93, P < 0.05). The infection rate of intestinal parasite was higher in populations in the well water-based spots (1.21%, 31/2 562) than in the tap water-based spots (0.65%, 27/4 134) (χ2 = 5.71, P < 0.05). The average annual per capita net income of farmers in the survey spots was 1 200-11 600 yuan (median, 5 604.5 yuan). The intestinal parasite infection rate decreased with increasing annual per capita net income of farmers (χ2 = 11.08, P < 0.01). Conclusion The intestinal parasite infection in the eastern part of Henan Province has significantly decreased than the previous two surveys. Preschool children and students are the main population targets for surveillance in the future.

Key words: Epidemiological investigation, Intestinal parasite, Eastern Henan

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