中国寄生虫学与寄生虫病杂志

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河南省人体肠道原虫感染现状分析

刘颖1,李素华1,张雅兰1,刘若凝2,钱丹1, 杨成运1,周瑞敏1,贺丽君1,鲁德领1,邓艳1,陈伟奇1,赵玉玲1,张红卫1,许汴利1*   

  1. 河南省疾病预防控制中心,郑州 450016
  • 出版日期:2018-06-30 发布日期:2018-07-02

Analysis of current status of human intestinal protozoal infection in Henan Province

LIU Ying1, LI Su-hua1, ZHANG Ya-lan1, LIU Ruo-ning2, QIAN Dan1, YANG Cheng-yun1,ZHOU Rui-min1, HE Li-jun1, LU De-ling1, DENG Yan1, CHEN Wei-qi1, ZHAO Yu-ling1, ZHANG Hong-wei1, XU Bian-li1*   

  1. 1 Henan Center for Disease Control and Prevention, Zhengzhou 450016, China; 2 West China School of Public Health, Sichuan University, Chengdu 610041, China
  • Online:2018-06-30 Published:2018-07-02

摘要:

目的 了解河南省人体肠道原虫的感染现状。 方法 2014-2015年按照《全国人体重要寄生虫病现状调查方案》要求,根据河南省生态区划分及经济水平确定调查县,根据地形和经济水平等因素分层,每层随机数字表法抽取1个自然村为调查点,每个调查点调查当地农村常住人口250人。收集被调查者的新鲜粪样,采用生理盐水和碘液直接涂片法分别检查肠道原虫感染情况。不同人群感染率采用χ2检验进行比较。 结果 本次共调查河南省35个县(市)104个村26 866人。肠道原虫总感染率为0.57%(152/26 866)。检出肠道原虫7种,分别是布氏嗜碘阿米巴、哈门氏内阿米巴、微小内蜒阿米巴、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,其中以微小内蜒阿米巴感染率最高(0.19%,50/26 866),不同原虫感染率差异有统计学意义(P < 0.05)。在不同生态区中,以华北平原生态区的原虫感染率为高,为0.67%(45/6 696),但不同生态区的感染率差异无统计学意义(P > 0.05)。经人口标化后,在检出肠道原虫的27个县(市)中,项城市的原虫感染率最高,为2.69%。女性肠道原虫感染率为0.41%(57/13 901),低于男性的0.73%(95/12 965)(P < 0.05);不同年龄组中,以< 20岁和20~岁年龄组人群肠道原虫感染率为高,均为0.66%(31/4 667,18/2 742),且以人芽囊原虫感染为主。不同职业人群中,工人肠道原虫感染率为0.76%(4/528),高于农民的0.54%(96/17 896)。不同文化程度人群中,高中及以上人群肠道原虫感染率为0.71%(18/2 550),高于小学的0.52%(42/8 014)。不同民族人群中,汉族感染率最高,为0.57%(151/26 434)(P < 0.05)。调查点农民年人均纯收入1 200~23 590元,中位数为5 950元。不同年龄、职业、文化程度、收入水平人群的肠道原虫感染率差异无统计学意义(P > 0.05)。  结论 河南省人体肠道原虫调查共检出7种原虫,总体感染率较低。

关键词: 人体, 肠道原虫, 感染, 现状调查, 河南省

Abstract:

 Objective To understand the current status of human intestinal protozoal infection in Henan Province. Methods An epidemiological survey was carried out in Henan Province according to the Protocol of National Survey Scheme on Major Human Parasitic Diseases, in counties selected based on the ecological and economic conditions. A stratified sampling method was used to select one village in each county, and 250 residents in each village were examined. Fresh human fecal samples were collected, in which trophozoites and/or cysts of intestinal protozoa were examined by physiological saline direct smear method and iodine stain method, respectively. The infection rate was compared between different populations using the chi-square test.  Results  A total of 26 866 persons from 104 villages in 35 counties(cities) were examined, and the overall infection rate of intestinal protozoa was 0.57%(152/26 866). Seven species of intestinal protozoa were detected: Iodamoeba buetschlii, Entamoeba hartmani, Endolimax nana, Entamoeba histolytica, Entamoeba coli, Giardia lamblia and Blastocystis hominis, of which the Endolimax nana conferred the highest infection rate (0.19%, 50/26 866). There was a significant difference in infection rate among the species (P < 0.05). Among the 4 ecological regions, the North China Plain Ecological Region had higher infection rate (0.67%, 45/6 696), with no significant difference (P > 0.05). After normalization, Xiangcheng had the highest infection rate among the 27 counties (cities) detected with human intestinal protozoa (2.69%). The infection rate was higher in males (0.73%, 95/12 965) than in females (0.41%, 57/13 901) (P < 0.05). Among different age groups, the infection rate was higher in the groups of < 20 (0.66%, 31/4 667) and 20- (0.66%, 18/2 742), predominated by Blastocystis hominis. Furthermore, among different occupations, infection rate in workers and farmers was 0.76% (4/528) and 0.54% (96/17 896), respectively. Populations with a level of high school or above and a primary school showed an infection rate of 0.71% (18/2 550) and 0.52% (42/8 014), respectively. The Han ethnicity had a higher infection rate (0.57%, 151/26 434) (P < 0.05). The average annual income per farmer in the survey was 1 200-23 590 yuan, with a median of 5 950 yuan. There was no significant difference in the intestinal protozoa infection rate in age, occupation, education level, or income (P > 0.05).  Conclusion Seven species of intestinal protozoa are identified with a low rate of infection in Henan Province.

Key words: Human, Intestinal protozoa, Infection status, Henan Province