四川省藏族农区学龄儿童猪囊尾蚴感染及其对数学学习能力的影响

摘要/Abstract

摘要：

目的了解四川省藏族农区学龄儿童猪囊尾蚴感染及其对儿童数学学习能力的影响。方法于2015年10月,采用多阶段分层整群抽样方法,在凉山州木里县、甘孜州雅江县、阿坝州若尔盖县分别抽取所有位于农业区的小学,采用结构式问卷对五、六年级儿童进行调查,问卷内容包括儿童的社会人口学特征（性别、年龄、民族、家庭固定资产、父母文化程度、家庭孩子数量）、在校情况（上学期数学成绩、上学期缺勤情况）以及自感健康状况（癫痫、头痛、四肢无力、恶心）。运用国际标准化数学能力测试（以下简称数学测试）对儿童的数学学习能力进行评估,由经过统一严格培训的调查员监考,要求儿童在规定时间内自行完成。采集儿童的血清,ELISA检测血清中抗猪囊尾蚴（Cysticercus cellulosae）的抗体水平。运用多元线性回归分析猪囊尾蚴感染对儿童数学学习能力的独立影响。结果本次共调查3 041人,同时有调查问卷、数学测试结果和血清学检测结果的儿童共计2 682人。数学测试平均分为55.65 ± 17.15,儿童猪囊尾蚴血清抗体阳性率为6.67%（179/2 682）。在179名血清抗体阳性的儿童中,自述有头痛症状的占72.07%（129/179）、经常感到四肢无力的占37.99%（68/179）、经常感到恶心的占5.59%（10/179）、有癫痫症状的占2.80%（5/179）。猪囊尾蚴血清抗体阳性且伴有头痛症状的儿童129人,数学测试平均成绩为52.33 ± 1.46;血清抗体阴性且伴有头痛症状的儿童1 648人,数学测试平均成绩为55.94 ± 0.43,两者数学测试成绩差异具有统计学意义（t = 2.28, P < 0.05）。在多元线性回归分析中,控制儿童的社会人口学因素和在校情况后,猪囊尾蚴血清抗体阳性且伴有癫痫症状、血清抗体阳性且伴有头痛症状对儿童数学测试成绩的独立影响具有统计学意义（β = -18.02、-4.06;均P < 0.05）,儿童家庭的固定资产、母亲文化程度、家庭孩子数量也会影响其数学测试成绩（β = 2.61、3.86、-6.19;均P < 0.01）。结论四川省藏族农区学龄儿童猪囊尾蚴感染现状不容小觑,猪囊尾蚴感染对当地儿童的数学学习能力造成一定程度的影响。

关键词: 藏族农区, 儿童, 猪囊尾蚴感染, 数学学习能力

Abstract:

Objective To understand the status of Cysticercus cellulosae infection and its impact on the mathematical learning ability among school-aged children in Tibetan agricultural areas of Sichuan Province.Methods In October 2015, a multistage stratified cluster sampling method was used to employ five- and six-grade children in all primary schools located in agricultural areas in three Tibetan counties (Muli County in Liangshan Prefecture, Yajiang County in Ganzi Prefecture, and Ruoergai County in Aba Prefecture).A survey was made among children in the form of structured questionnaire.The questionnaire content included the social demographics (gender, age, ethnicity, household asset, educational level of parents, number of children in the family), academic performance at school (math score and absence from school in the last semester) and self-reported conditions (seizure, headache, fatigue, and nausea).The mathematical learning ability of school-aged children was evaluated using the international standard mathematical ability test (hereinafter, the mathematical test), which was performed by well-trained investigators and children completed the test by themselves within prescribed time.Serum samples were collected from children to detect the antibodies against C.cellulosae using the enzyme-linked immunosorbent assay (ELISA) method.The independent impact of C.cellulosae infection on the mathematical learning ability was analyzed with the multivariable linear regression.Results 3 041 children in our sample, and 2 682 children participated in all the questionnaire survey, the mathematical test and serological examination.The mean score of the mathematical test was 55.65 ± 17.15.The C.cellulosae seropositive rate was 6.67%(179/2 682).Among the seropositive students, 72.07%(129/179) reported headache, 37.99%(68/179) reported frequent fatigues, 5.59% (10/179) reported frequent feelings of nausea, and 2.80%(5/179) reported occurrence of seizure.129 children were seropositive accompanied by headache, whose mean score of the mathematical test was 52.33 ± 1.46, 1 648 children were seronegative accompanied by headache, whose mean score of the mathematical test was 55.94 ± 0.43, and the difference of mathematical test score in two types children was statistically significant(t = 2.28, P < 0.05).After controlling the factors of social demographics and academic performance at school, the multivariable linear regression analysis showed that the factor of seropositive accompanied by seizure, and seropositive accompanied by headache were statistically significant（β = -18.02, -4.06; P < 0.05).Besides, the household asset, the educational level of mother and the number of children in the family were relevant to the mathematical test score of children (β = 2.61, 3.86, -6.19; P < 0.01).Conclusion The epidemiological status of C.cellulosae infection among children in Tibetan agricultural areas is becoming a problem that needs more attention.C.cellulosae infection has shown detrimental effects on children’s mathematical learning ability to some extent.

Key words: Tibetan agricultural areas, Children, Cysticercus cellulosae infection, Mathematical learning ability

中图分类号:

R532.333

叶睿雪, 吴玉菊, 王庆志, 曹敏, 李调英, 陈兴旺, 周欢. 四川省藏族农区学龄儿童猪囊尾蚴感染及其对数学学习能力的影响[J]. 中国寄生虫学与寄生虫病杂志, 2017, 35(6): 580-585.

Rui-xue YE, Yu-ju WU, Qing-zhi WANG, Min CAO, Tiao-ying LI, Xing-wang CHEN, Huan ZHOU. Status of Cysticercus cellulosae infection and its impact on mathematical learning ability among school-aged children in Tibetan agricultural areas of Sichuan Province[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2017, 35(6): 580-585.

图/表 4

表1

四川省藏族农区学龄儿童的社会人口学特征

社会人口学特征 Social demographics	调查人数 No.children surveyed		构成比/% Constituent ratio/%
县 County
木里 Muli	989		36.88
雅江 Yajiang	1 130		42.13
若尔盖 Ruoergai	563		20.99
小计 Subtotal	2 682		100
年级 Grade
五年级 The fifth Grade	1 441		53.73
六年级 The Sixth Grade	1 241		46.27
小计 Subtotal	2 682		100
性别 Sex
男 Male	1 292		48.17
女 Female	1 390		51.83
小计 Subtotal	2 682		100
年龄 Age
10	27		1.01
11	199		7.42
12	735		27.40
13	863		32.18
14	518		19.31
15	340		12.68
小计 Subtotal	2 682		100
民族Ethnicity
藏族 Tibetan	2 237		83.41
其他^a Others ^a	445		16.59
小计 Subtotal	2 682		100
家庭固定资产^b Household asset ^b
低 Inferior	670		24.98
社会人口学特征 Social demographics		调查人数 No.children surveyed		构成比/% Constituent ratio/%
中下 Below average		883		32.92
中等 Average		543		20.25
较高 Superior		586		21.85
小计 Subtotal		2 682		100
母亲文化程度Mother&#x02019;s educational level
9年以下 Less than 9 years		2 334		87.02
9年及以上 9 years or above		348		12.98
小计 Subtotal		2 682		100
父亲文化程度 Father&#x02019;s educational level
9年以下 Less than 9 years		1 998		74.50
9年及以上 9 years or above		684		25.50
小计 Subtotal		2 682		100
家庭孩子数量 No.of children in family
1个 One		80		2.98
2个及以上 Two or more		2 602		97.02
小计 Subtotal		2 682		100
上学期数学成绩^c Math score in the last semester ^c
非常差 Poor		149		5.56
较差 Below average		578		21.55
一般 Average		1 226		45.71
较好 Above average		646		24.09
非常好 Excellent		83		3.09
小计 Subtotal		2 682		100
上学期缺勤^d Absent from school for some days in the last semester^d
是 Yes		760		28.34
否 No		1 922		71.66
小计 Subtotal		2 682		100

表1

图1

表2

表3

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猪囊尾蚴血清抗体 Cysticercus cellulosae antibody	癫痫 Seizure		头痛 Headache		经常感到四肢无力 Frequent fatigue		经常感到恶心 Frequent nausea
猪囊尾蚴血清抗体 Cysticercus cellulosae antibody	例数 No.positive	数学成绩（x &#x000b1; s） Math score （x &#x000b1; s）	例数 No.positive	数学成绩（x &#x000b1; s） Math score （x &#x000b1; s）	例数 No.positive	数学成绩（x &#x000b1; s） Math score （x &#x000b1; s）	例数 No.positive	数学成绩（x &#x000b1; s） Math score （x &#x000b1; s）
阳性 Positive	5	35.33 &#x000b1; 8.27	129	52.33 &#x000b1; 1.46	68	54.66 &#x000b1; 2.04	10	5.67 &#x000b1; 3.18
阴性 Negative	73	48.49 &#x000b1; 1.98	1 684	55.94 &#x000b1; 0.43	874	57.12 &#x000b1; 0.59	12	4.25 &#x000b1; 1.54
t值 t value		1.67		2.28		1.12		0.26
P值 P value		0.10		0.05		0.26		0.80

变量 Variable	回归系数&#x003b2; Coefficient &#x003b2;	标准误 Standard error	标准化回归系数 Standardized coefficients	t值 t value	P值 P value	95%可信区间 95% confidence interval
猪囊尾蚴血清抗体阳性且伴有癫痫症状 Cysticercosis seropositive with seizure	-18.02	7.83	-0.05	2.30	0.05	(-33.36, -2.67)
猪囊尾蚴血清抗体阳性且伴有头痛症状 Cysticercosis seropositive with headache	-4.06	2.01	-0.05	2.02	0.05	(-8.00, -0.12)
家庭固定资产 Household asset	2.61	0.72	0.07	3.61	0.01	(1.19, 4.03)
母亲文化程度 Education level of mother	3.86	1.05	0.08	3.67	0.01	(1.80, 5.93)
家庭孩子数量 Number of children in family	-6.19	1.94	-0.06	3.20	0.01	(-9.98, -2.39)