2019—2023年山西省土源性线虫感染监测结果分析

doi:10.12140/j.issn.1000-7423.2024.05.010

摘要/Abstract

摘要：

目的分析2019—2023年山西省土源性线虫感染情况，了解其流行现状和趋势，为制定土源性线虫病防治策略提供科学依据。方法 2019—2023年，按照《全国肝吸虫病和土源性线虫病监测方案（试行）》的要求，山西省分别选取14、18、15、18、18个监测县（共79个不同的县，2021—2023年各有2个固定监测县），每个监测县按照东、南、西、北、中5个地理方位划片，每片区随机抽取1个乡（镇、街道）的1个行政村开展监测工作，每个行政村以3周岁及以上常住居民为调查对象，整群抽取人数不少于200人。采集调查对象粪样不少于30 g，采用改良加藤厚涂片法（Kato-Katz法，一粪两检）镜检土源性线虫虫卵，计算感染率。对钩虫阳性的粪样采用试管滤纸培养法进行虫种鉴定。对3~9周岁儿童采用透明胶纸肛拭法加做蛲虫虫卵镜检。感染率的比较采用χ²检验。结果 2019—2023年，山西省监测人群土源性线虫感染率分别为0.05%（7/14 189）、0.05%（9/18 019）、0.12%（18/15 024）、0（0/18 109）、0.11%（21/18 383），不同年份间感染率差异有统计学意义（χ² = 26.464，P < 0.01）。2019—2023年，蛔虫感染率分别为0.02%（3/14 189）、0.01%（1/18 019）、0（0/15 024）、0（0/18 109）、0.04%（8/18 383）；蛲虫感染率分别为0.02%（3/14 189）、0.04%（8/18 019）、0.12%（18/15 024）、0（0/18 109）、0.07%（13/18 383）。蛔虫、蛲虫不同年份间感染率差异有统计学意义（χ² = 13.586、27.674，均P < 0.01）。2019年鞭虫感染率为0.007%（1/14 189），其余年份感染率均为0。2019—2023年，均未查出钩虫感染。2019—2023年，男、女性土源性线虫平均感染率分别为0.07%（30/40 707）、0.06%（25/43 017），差异无统计学意义（χ² = 0.773，P > 0.05）；各年龄组中土源性线虫平均感染率最高的为3~9岁组（0.30%，30/9 913），其次为50~59岁组（0.05%，8/14 828）和20~29岁组（0.05%，3/5 938），不同年龄组间的差异有统计学意义（χ² = 98.579，P < 0.01）；不同职业人群中散居儿童土源性线虫平均感染率最高（0.90%，6/665），幼托儿童次之（0.36%，17/4 707），不同职业人群间的差异有统计学意义（χ² = 64.542，P < 0.01）；不同文化程度人群中，学龄前儿童的土源性线虫平均感染率最高（0.42%，23/5 433），小学的次之（0.07%，16/24 103），不同文化程度人群间的差异有统计学意义（χ² = 57.218，P < 0.01）。2019—2023年，山西省11个市79个不同的监测县（区）中，17个县出现阳性感染者。其中运城市夏县的土源性线虫感染率最高，为1.00%（10/1 000）；吕梁市文水县和晋中市灵石县次之，均为0.60%（6/1 003）和0.60%（6/1 003）。不同监测县间感染率差异有统计学意义（χ² = 29.741，P < 0.05）。结论 2019—2023年山西省土源性线虫感染率呈低水平流行趋势，感染虫种以蛲虫为主，需进一步加强儿童、老人等重点人群土源性线虫感染的综合防治工作。

关键词: 土源性线虫, 感染, 监测县, 山西省

Abstract:

Objective To analyze the surveillance of soil-transmitted nematode (STN) infection in Shanxi Province from 2019 to 2023, to understand its current status and trends, providing scientific basis for developing control strategies. Methods From 2019 to 2023, in accordance with the requirements of the National Surveillance Program and Implementation Guideline for Clonorchiasis and Soil-transmitted Nematodes, in different regions of Shanxi Province, 14, 18, 15, 18, and 18 counties were selected for the surveillance, respectively. Each selected surveillance county was divided into five geographic sectors (east, south, west, north, and center). From each sector, one township (town, street) was randomly selected, and subsequently, one administrative village was chosen from each selected township for the surveillance. In each selected village, the participants were cluster sampled, with no less 200 villigers for the survey. Fecal samples of no less than 30 g were collected from the participants, and examined microscopically using the modified Kato-Katz thick smear method (two slide-reading, each sample) for STN eggs to calculate the infection rate. Hookworm egg positive fecal samples were further examined using the test tube-filter paper cultivation method to identify the parasite species. Additionally, microscopic-detection of Enterobius vermicularis eggs was conducted in children aged 3 to 9 using the transparent adhesive paper anal swab method. χ² test was employed to compare infection rates. Results From 2019 to 2023, the infection rates of STN in the surveillance population in Shanxi Province were 0.05% (7/14 189), 0.05% (9/18 019), 0.12% (18/15 024), 0 (0/18 109), and 0.11% (21/18 383), respectively. There were statistically significant differences in infection rates between years (χ² = 26.464, P < 0.01). During this period, the infection rates of Ascaris lumbricoides were 0.02% (3/14 189), 0.01% (1/18 019), 0 (0/15 024), 0 (0/18 109), 0.04% (8/18 383); and the infection rates of E. vermicularis were 0.02% (3/14 189), 0.04% (8/18 019), 0.12% (18/15 024), 0 (0/18 109), 0.07% (13/18 383), respectively. The infection rates of both A. lumbricoides and E. vermicularis showed statistically significant differences between years (χ² = 13.586 and 27.674, both P < 0.01). The Trichuris trichiura infection rate was 0.007% (1/14 189) in 2019, and 0 in the subsequent years. Notably, no hookworm infections were found from 2019 to 2023. Regarding gender, the infection rates for STNs in male and female were 0.07% (30/40 707), and 0.06% (25/43 017), respectively, with no statistically significant difference (χ² = 0.773, P > 0.05). In age groups, the highest infection rate of STNs was 0.30% (30/9 913) in the 3-9 year-old group, followed by 0.05% (8/14 828) in the 50-59 year-old group, and 0.05% (3/5 938) in the 20-29 year-old group. There were statistically significant differences in the infection rates between different age groups (χ² = 98.579, P < 0.01). Among different occupations, scattered children had the highest average infection rate (0.90%, 6/665), followed by nursery children (0.36%, 17/4 707). The differences in infection rates among different occupations were statistically significant (χ² = 64.542, P < 0.01). In terms of literacy levels, preschool children had the highest average infection rate of 0.42% (23/5 433), followed by elementary school at 0.07% (16/24 103). There was a statistically significant difference in infection rates among different literacy levels (χ² = 57.218, P < 0.01). In 2019—2023, Shanxi Province completed monitoring in 79 different surveillance counties in 11 cities, with positive infections found in 17 of these counties. Xia County of Yuncheng City had the highest infection rate of 1.00% (10/1 000), followed by Wenshui County of Lvliang City, and Lingshi County of Jinzhong City, both at 0.60% (6/1 003) 0.60% (6/1 003). The differences in infection rates among the different surveillance counties were statistically significant (χ² = 29.741, P < 0.05). Conclusion The infection rate of STN in Shanxi Province from 2019 to 2023 showed a trend of low-level prevalence, with E. vermicularis being the primary parasite. It is necessary to further strengthen the comprehensive control of STN infections, particularly among key populations such as children and the elderly.

Key words: Soil-transmitted nematode, Infection, Monitoring county, Shanxi Province

中图分类号:

R532.1

王晶莹, 帖萍, 郑玉华, 白永飞, 王婷, 王三桃. 2019—2023年山西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, 2024, 42(5): 629-634.

WANG Jingying, TIE Ping, ZHENG Yuhua, BAI Yongfei, WANG Ting, WANG Santao. Analysis on the surveillance of soil-transmitted nematode infection in Shanxi Province from 2019 to 2023[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2024, 42(5): 629-634.

图/表 4

表1

表2

2019—2023年山西省监测县人群土源性线虫感染情况分布a

特征 Feature	检查人数 No. examined	感染人数 No. infected	平均感染率/% Average infection rate/%	蛔虫 A. lumbricoides		蛲虫 E. vermicularis		鞭虫 T. trichiura
特征 Feature	检查人数 No. examined	感染人数 No. infected	平均感染率/% Average 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 Male	40 707	30	0.07	5	0.01	24	0.06	1	0.002
女 Female	43 017	25	0.06	7	0.02	18	0.04	0	0
小计 Subtotal	83 724	55	0.07	12	0.01	42	0.05	1	0.001
年龄组/岁Age group/Year
3~9	9 913	30	0.30	1	0.01	29	0.29	0	0
10~19	8 673	2	0.02	2	0.02	0	0	0	0
20~29	5 938	3	0.05	0	0	2	0.03	1	0.017
30~39	11 315	4	0.04	2	0.02	2	0.02	0	0
40~49	10 629	2	0.02	0	0	2	0.02	0	0
50~59	14 828	8	0.05	4	0.03	4	0.03	0	0
60~69	13 424	5	0.04	3	0.02	2	0.01	0	0
≥ 70	9 004	1	0.01	0	0	1	0.01	0	0
小计 Subtotal	83 724	55	0.07	12	0.01	42	0.05	1	0.001
职业 Occupation
农（牧）民 Farmer	53 445	20	0.04	8	0.01	11	0.02	1	0.002
学生 Student	13 665	9	0.07	3	0.02	6	0.04	0	0
民工及工人 Migrant workers and workers	3 763	1	0.03	0	0	1	0.03	0	0
幼托儿童 Nursery children	4 707	17	0.36	0	0	17	0.36	0	0
散居儿童 Scattered children	665	6	0.90	0	0	6	0.90	0	0
餐饮食品业 Restaurant and food industry	433	1	0.23	0	0	1	0.23	0	0
其他 Others	1 284	1	0.08	1	0.08	0	0	0	0
小计 Subtotal	77 962	55	0.07	12	0.02	42	0.05	1	0.001
文化程度 Education level
学龄前儿童 Preschool children	5 433	23	0.42	0	0	23	0.42	0	0
小学 Primary school	24 103	16	0.07	7	0.03	8	0.03	1	0.004
初中 Junior high school	34 606	12	0.04	3	0.01	9	0.03	0	0
高中/中专 High school/technical secondary school	9 135	3	0.03	1	0.01	2	0.02	0	0
大专及以上 College and above	6 211	1	0.02	1	0.02	0	0	0	0
小计 Subtotal	79 488	55	0.07	12	0.02	42	0.05	1	0.001

表2

图1

表3

参考文献 16

[1]	Li TX, Xia SH, Feng BW, et al. First survey of human parasite distribution in Shanxi Province[J]. Chin J Parasitol Parasit Dis, 1994(S1): 88-91. (in Chinese)
	(李同喜, 夏淑慧, 冯步伟, 等. 山西省首次人体寄生虫分布情况的调查[J]. 中国寄生虫学与寄生虫病杂志, 1994(S1): 88-91.)
[2]	Liu Y, Zhang YN, Liang ZB, et al. Study on the characteristics and correlation factors of soil-transmitted nematode infections in Shanxi Province[J]. Dis Surveillance, 2007, 22(5): 338-341. (in Chinese)
	(刘元, 张玉农, 梁之斌, 等. 山西省土源性线虫感染特征及相关因素研究[J]. 疾病监测, 2007, 22(5): 338-341.)
[3]	Zhang YN, Li GH, Yang HX. Report on the status of the 3rd human important parasitic diseases investigation in Shanxi[J]. China Trop Med, 2019, 19(1): 27-30. (in Chinese)
	(张玉农, 李国华, 杨红霞. 山西省第3次人体重点寄生虫病现状调查报告[J]. 中国热带医学, 2019, 19(1): 27-30.)
[4]	Chen Z, Ge J, Jiang WS, et al. Epidemiological trends of soil-transmitted nematode infections in Jiangxi Province, 2015-2021[J]. Chin J Parasitol Parasit Dis, 2023, 41(1): 59-67. (in Chinese)
	(陈喆, 葛军, 姜唯声, 等. 2015—2021年江西省人群土源性线虫感染流行趋势分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 59-67.)
[5]	Ni BX, Xu XZ, Jin XL, et al. Analysis of surveillance on soil-transmitted nematode infections in Jiangsu Province from 2017 to 2021[J]. Chin J Parasitol Parasit Dis, 2022, 40(6): 730-736. (in Chinese)
	(倪碧娴, 徐祥珍, 金小林, 等. 2017—2021年江苏省土源性线虫感染情况监测分析[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(6): 730-736.)
[6]	Zhu HH, Huang JL, Chen YD, et al. Analysis on endemic status of soil-transmitted nematode infection in China in 2019[J]. Chin J Parasitol Parasit Dis, 2021, 39(5): 666-673. (in Chinese)
	(朱慧慧, 黄继磊, 陈颖丹, 等. 2019年全国土源性线虫感染状况分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(5): 666-673.)
[7]	Cai MQ, He YJ, Meng C, et al. Investigation and epidemiological analysis on the infection of intestinal parasites in pupils of a minority territory of Yunnan Province[J]. Lab Med Clin, 2016, 13(16): 2292-2293, 2296. (in Chinese)
	(蔡敏琪, 何宇佳, 孟铖, 等. 云南省某少数民族地区小学生肠道寄生虫感染调查及流行病学分析[J]. 检验医学与临床, 2016, 13(16): 2292-2293, 2296.)
[8]	Zhu AY, Du K, Li AM, et al. Surveillance results of national monitoring site for soil-transmitted nematode infections in Guizhou Province in 2011-2015[J]. Chin J Parasitol Parasit Dis, 2017, 35(5): 445-449, 455. (in Chinese)
	(朱爱娅, 杜坤, 李安梅, 等. 2011—2015年贵州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, 2017, 35(5): 445-449, 455.)
[9]	Peng JH. Investigation of soil-transmitted nematode infections in Xuchang City of Henan Province in 2012[J]. Chin J Parasitol Parasit Dis, 2015, 33(5): 395-396, 398. (in Chinese)
	(彭金华. 河南省许昌市2012年土源性线虫感染调查报告[J]. 中国寄生虫学与寄生虫病杂志, 2015, 33(5): 395-396, 398.)
[10]	Chen YD, Huang JL, Zhu HH, et al. China’s control process of soil-transmitted helminth infections from pandemic to low-endemic levels[J]. Chin J Parasitol Parasit Dis, 2019, 37(4): 395-398. (in Chinese)
	(陈颖丹, 黄继磊, 朱慧慧, 等. 我国土源性线虫高感染到低感染水平的防治历程[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(4): 395-398.)
[11]	Zi JR, Wang LB, Yang YM, et al. Current status of Ascaris lumbricoides infection in populations in Yunan Province, 2015[J]. Chin J Parasitol Parasit Dis, 2021, 39(2): 273-277. (in Chinese)
	(字金荣, 汪丽波, 杨亚明, 等. 2015年云南省人群蛔虫感染现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(2): 273-277.)
[12]	Wu XL, Duan HJ, Fu YR, et al. Prevalence of Ascaris infection and the contamination of soil with Ascaris eggs in the rural areas of Ningxia during 2015-2016[J]. Chin J Parasitol Parasit Dis, 2019, 5(2): 173-177. (in Chinese)
	(吴向林, 段红菊, 付益仁, 等. 2015—2016年宁夏农村地区人群蛔虫感染及土壤蛔虫卵污染情况调查[J]. 中国寄生虫学与寄生虫病杂志, 2019, 5(2): 173-177.)
[13]	Zhang Q, Chen YD, Xu LQ, et al. Effect of control on infections of soil-transmitted helminthes in demonstration plots of China for 3 years[J]. Chin J Schisto Control, 2011, 23(5): 476-482. (in Chinese)
	(张倩, 陈颖丹, 许隆祺, 等. 我国土源性线虫病综合防治示范区3年防治效果[J]. 中国血吸虫病防治杂志, 2011, 23(5): 476-482.)
[14]	Zeng XJ, Jiang WS, Xie SY, et al. Trends of soil-transmitted nematode infections in Jiangxi Province[J]. Chin J Schisto Control, 2017, 29(6): 710-715. (in Chinese)
	(曾小军, 姜唯声, 谢曙英, 等. 江西省土源性线虫病流行趋势分析[J]. 中国血吸虫病防治杂志, 2017, 29(6): 710-715.)
[15]	Criteria for transmission control and interruption of soil-transmitted nematodiasis[J]. J Trop Dis Parasitol, 2018, 16(4): 241-242. (in Chinese)
	(土源性线虫病的传播控制与阻断[J]. 热带病与寄生虫学, 2018, 16(4): 241-242.)
[16]	Chen YD, Zhu HH, Huang JL, et al. Status and working principals of soil-transmitted nematodiasis during new period in China[J]. Chin J Schisto Control, 2019, 31(1): 23-25. (in Chinese)
	(陈颖丹, 朱慧慧, 黄继磊, 等. 我国土源性线虫病流行现状及新时期防控原则[J]. 中国血吸虫病防治杂志, 2019, 31(1): 23-25.)

调查地区 Area investigated	年份 Year	县（市、区） County (City，District)	调查人数 No. exam’d	感染数 No. infected	感染率/% Infection rate/%	蛔虫 A. lumbricoides		蛲虫 E. vermicularis		鞭虫 T. trichiura
调查地区 Area investigated	年份 Year	县（市、区） County (City，District)	调查人数 No. exam’d	感染数 No. infected	感染率/% Infection rate/%	感染数 No. infected	感染率% Infection rate%	感染数 No. infected	感染率/% Infection rate/%	感染数 No. infected	感染率/% Infection rate/%
临汾市 Linfen City	2019	汾西 Fenxi	1 086	1	0.09	0	0	1	0.09	0	0
	2023	霍州 Huozhou	1 000	4	0.40	0	0	4	0.40	0	0
吕梁市 Lvliang City	2019	文水 Wenshui	1 003	6	0.60	3	0.30	2	0.20	1	0.100
	2020	中阳 Zhongyang	997	3	0.30	1	0.10	2	0.20	0	0
	2021	临县 Lin County	998	2	0.20	0	0	2	0.20	0	0
忻州市 Xinzhou City	2020	忻府 Xinfu	1 006	2	0.20	0	0	2	0.20	0	0
	2020	保德 Baode	1 000	4	0.40	0	0	4	0.40	0	0
阳泉市 Yangquan City	2021	郊区 Jiaoqu	1 000	1	0.10	0	0	1	0.10	0	0
运城市 Yuncheng City	2021	闻喜 Wenxi	1 003	2	0.20	0	0	2	0.20	0	0
	2021	夏县 Xia County	1 000	10	1.00	0	0	10	1.00	0	0
	2021	平陆 Pinglu	1 000	3	0.30	0	0	3	0.30	0	0
	2023	稷山 Jishan	1 001	5	0.50	0	0	5	0.50	0	0
	2023	新绛 Xinjiang	1 050	1	0.10	1	0.10	0	0	0	0
	2023	绛县 Jiang County	1 034	2	0.19	0	0	2	0.19	0	0
太原市 Taiyuan City	2023	尖草坪 Jiancaoping	1 037	2	0.19	2	0.19	0	0	0	0
	2023	古交 Gujiao	1 002	1	0.10	1	0.10	0	0	0	0
晋中市 Jinzhong City	2023	灵石 Lingshi	1 003	6	0.60	4	0.40	2	0.20	0	0
合计 Total			17 220	55	0.32	12	0.07	42	0.24	1	0.006