四川省棘球蚴病疫点传播风险评估体系构建研究

doi:10.12140/j.issn.1000-7423.2025.01.007

中国寄生虫学与寄生虫病杂志 ›› 2025, Vol. 43 ›› Issue (1): 37-43.doi: 10.12140/j.issn.1000-7423.2025.01.007

四川省棘球蚴病疫点传播风险评估体系构建研究

张仲双(), 张光葭, 姚人新, 杨柳, 喻文杰, 何伟, 廖沙, 黄燕, 王谦^*()()

四川省疾病预防控制中心，四川成都 610041

收稿日期:2024-11-15 修回日期:2025-02-08 出版日期:2025-02-28 发布日期:2025-03-26
通讯作者: *王谦（ORCID：0000-0003-4487-1601），男，博士，研究员，从事棘球蚴病防治研究。Email: wangqian1967@163.com
作者简介:张仲双，女，硕士，主管技师，从事棘球蚴病防治研究。E-mail：582353251@qq.com
基金资助:
四川省科技计划(2023YFS0221);国家卫生健康委包虫病防治研究重点实验室项目(2021WZK1005);中国疾病预防控制中心2024年度标准化前期研究项目(BZ2024-Q027)

Research on the construction of risk assessment system for the transmission of echinococcosis endemic sites in Sichuan Province

ZHANG Zhongshuang(), ZHANG Guangjia, YAO Renxin, YANG Liu, YU Wenjie, HE Wei, LIAO Sha, HUANG Yan, WANG Qian^*()()

Institute of Parasite Diseases, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, Sichuan, China

Received:2024-11-15 Revised:2025-02-08 Online:2025-02-28 Published:2025-03-26
Contact: *Email: wangqian1967@163.com
Supported by:
Science and Technology Projects of Sichuan Province(2023YFS0221);Key Laboratory Project for Prevention and Control of Echinococcosis of National Health Commission(2021WZK1005);Standardization Preliminary Research Project of the Chinese Center for Disease Control and Prevention in 2024(BZ2024-Q027)

摘要/Abstract

摘要：

目的构建一种评估棘球蚴病疫点传播风险等级的方法。方法通过分析四川省2019—2023年棘球蚴病疫情特征和专家深度访谈，确定棘球蚴病疫点传播风险评估体系的条目与指标，讨论形成评估体系初稿；通过2轮专家函询形成评估体系终稿。选取四川省2023年有新发现患者且患者年龄在15岁以上的村开展传播风险评估，根据疫点的风险等级干预1年，比较干预前后的风险等级，验证评估体系的有效性。结果共11名专家参与问卷函询，2轮问卷有效回收率均为11/11。构建了棘球蚴病疫点传播风险评估体系，体系包括棘球蚴病传播风险等级评估量表（4个一级指标、15个二级指标、39个三级指标）、棘球蚴病传播风险干预地理范围表和棘球蚴病传播风险监测及干预时间范围表；对疫点棘球蚴病传播风险等级的判定标准为：36分以下为一般风险，36~55分为较高风险，55分以上为高风险。壤塘县疫点、若尔盖县疫点1、若尔盖县疫点2和理塘县疫点等4个疫点的验证结果显示，干预后各疫点的风险等级不变或降低，证实评估体系有效。结论本研究构建的棘球蚴病疫点风险评估体系具有可靠性、实用性，能为棘球蚴病疫点处置和干预提供参考。

关键词: 棘球蚴病, 疫点, 风险评估, 体系构建

Abstract:

Objective To construct a method for evaluating the risk of transmission of echinococcosis endemic site. Methods By analyzing the characteristics of the echinococcosis endemic in Sichuan Province from 2019 to 2023 and conducting in-depth interviews with experts, the items of assessment system of echinococcosis endemic site were determined and the first draft of the risk assessment system of echinococcosis endemic site was formed. The final draft of the risk assessment system for transmission of echinococcosis endemic site was formed through expert inquiry. Selected villages in Sichuan Province with newly diagnosed patients and patients aged 15 and above in 2023 to conduct transmission risk assessment. Intervened for one year based on the risk level of the endemic site, compared the risk level before and after intervention, and verify the effectiveness of the assessment system. Results A total of 11 experts participated in the questionnaire inquiry, and the effective response rates for both rounds of questionnaires were 11/11. The risk assessment system of echinococcosis endemic site was constructed successfully, including the evaluation scale of transmission risk of echinococcosis (4 first-grade indexes, 15 second-grade indexes, 39 third-grade indexes), the geographical scope of intervention for transmission risk of echinococcosis and the time range table for monitoring and intervention of transmission risk of echinococcosis. What’s more, a risk assessment scale for the transmission of echinococcosis endemic site was developed, and the criteria for risk levels were determined: general risk with a score below 36, high risk with a score between 36 and 55, and maximum high risk with a score above 55. The verification results of four endemic sites, namely Rangtang County endemic site, Ruoergai County endemic site 1, Ruoergai County endemic site 2 and Litang County endemic site, showed that the risk level of each endemic point remained unchanged or decreased after intervention, confirming the effectiveness of the evaluation system. Conclusion The risk assessment system of echinococcosis endemic site constructed in this study is reliable and practical, and can provide reference for the disposal and intervention of echinococcosis endemic site.

Key words: Echinococcosis, Endemic site, Risk assessment, System construction

中图分类号:

R532.32

张仲双, 张光葭, 姚人新, 杨柳, 喻文杰, 何伟, 廖沙, 黄燕, 王谦. 四川省棘球蚴病疫点传播风险评估体系构建研究[J]. 中国寄生虫学与寄生虫病杂志, 2025, 43(1): 37-43.

ZHANG Zhongshuang, ZHANG Guangjia, YAO Renxin, YANG Liu, YU Wenjie, HE Wei, LIAO Sha, HUANG Yan, WANG Qian. Research on the construction of risk assessment system for the transmission of echinococcosis endemic sites in Sichuan Province[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2025, 43(1): 37-43.

图/表 4

表1

棘球蚴病传播风险等级评估量表

量表维度（一级指标） Scale dimensions (Primary indicators)	维度内容（二级指标） Dimension content (Secondary indicators)			具体条目（三级指标） Items (Third indicators)	条目分类 Classification		分数 Score
基本情况 Basic information	疫情所在村流行情况 Prevalence in the village where the endemic point is located			是否为流行村 Is the endemic prevalent or not	是 Yes		1.1
基本情况 Basic information				是否为流行村 Is the endemic prevalent or not	否 No		0
	疫情毗邻村流行情况 Prevalence in neighboring villages			是否有流行村 Is the endemic prevalent or not	是 Yes		0.9
	疫情毗邻村流行情况 Prevalence in neighboring villages			是否有流行村 Is the endemic prevalent or not	否 No		0
	疫情所在村家畜管理情况 Management of livestock in the village where the endemic occurred			家畜屠宰方式 Livestock slaughtering methods	散宰 Private slaughter		0.8
					非散宰 Not private slaughter		0
					同时存在 Both		0.5
				被屠宰的家畜（牛、羊）是否来自流行区 Livestock comes from endemic areas	是 Yes		0.8
				被屠宰的家畜（牛、羊）是否来自流行区 Livestock comes from endemic areas	否 No		0
				是否规范无害化处理病变脏器 Is the harmless treatment of diseased organs standardized	是 Yes		0
					否 No		0.4
	生产生活方式 Life style			纯牧业 Family-farm			1.0
				半农半牧 Mixed pastor-family			0.8
				农业 Ranch			0.6
				城镇 Urban			0.2
	生活饮食习惯 Dietary habits			每天有1次饭前不洗手 Not washing hands before meals once a day			1.0
				吃生食 Eating raw food			0.5
				喝生水 Drinking raw water			0.5
	饮用水来源 Source of drinking water			塘水 Pond water			1.0
				沟渠水 Canal water			0.8
				河水 River			0.5
				山泉水 Spring			0.4
				井水 Well water			0.2
				经消毒的集中供水 Disinfected centralized water			0
	人群患病情况 Prevalence in population			患病率/% Prevalence/%	≥ 0.1		2.0
	人群患病情况 Prevalence in population			患病率/% Prevalence/%	0~0.1		1.0
	鼠类 Rodents			每样方范围（50 m × 50 m）内鼠洞数量/个 No. mouse holes within each sample area (50 m × 50 m)	≥ 20		1.5
					< 20		1.0
					0		0.5
				定居点小型哺乳类动物种类（按主要种类赋值） Small mammalian species in settlements (Assigned by major species)	青海田鼠 Microtus fuscus		1.5
					其他种类田鼠 Other types of voles		1.0
					鼠兔等其他小型哺乳动物 Pika and other small mammals		0.5
	家犬管理 Domestic dog management			家犬拴养方式（两种及两种以上按最高分计分） Way of raising a domestic dog (Two or more types will be scored based on the highest score)	拴养比例90%以上 Tied up for over 90% of the time		0
					白天拴养晚上放养 Tied up during the day and releasing at night		1.5
					散养 Freely-roaming		2.0
				家犬规范化驱虫覆盖率/% Standardized deworming coverage rate for domestic dogs/%	≥ 85		0
					< 85		1.0
				犬粪无害化处理率/% Rate of harmless treatment of dog feces/%	≥ 90		0
				犬粪无害化处理率/% Rate of harmless treatment of dog feces/%	< 90		1.0
				平均每户家犬数量/只 Average no. domestic dog per household	2		1.0
					≥ 1		0.5
					< 1		0.2
		野外犬科动物 Wild canids	可见频率 Visible frequency			每周可见 Visible every week	2.0
						每月可见 Visible every month	1.0
						每季度可见 Visible every quarter	0.5
						未见 Not observed	0
人群查病情况 Population screening situation		近3年新发现患者情况 Newly diagnosed patient situation in the past 3 years	新发现患者数量/例 No. newly diagnosed patient			≥ 3	5.0
						2	4.0
						1	3.0
						0	0
			新发现患者年龄/岁 Age of newly diagnosed patient/Year			< 7	5.0
						7~15	3.0
						> 15	1.0
			新发现患者的最大病灶大小/cm Maximum lesion size of newly diagnosed patients/cm			≥ 3	3.0
						< 3	5.0
			新发现多房棘球蚴病 Newly discovered alveolar echinococcosis			存在 Exist	5.0
			新发现细粒棘球蚴病的病灶类型^a Lesion type of newly discovered cystic echinococcosis^a			CL，CE1，CE2	5.0
						CE3	3.0
						CE4，CE5	2.0
中间宿主患病情况 Prevalence in intermediate hosts		家畜患病情况 Prevalence in livestocks	疫点发生地所在乡家畜患病率/% Prevalence of livestock in the township where the endemic occurred/%			≥ 8	10.0
						< 8	8.0
						0	0
		小型哺乳类动物患病情况 Prevalence in small mammals	青海田鼠患病率/% Prevalence of Microtus fuscus/%			≥ 3	5.0
						< 3	4.5
						0	0
			其他种类田鼠患病率/% Prevalence of other types of voles/%			≥ 3	3.0
						< 3	2.5
						0	0
			鼠兔等其他小型哺乳动物患病率/% Prevalence of pika and other small mammals/%			≥ 3	2.0
						< 3	1.5
						0	0
终末宿主感染情况 Infection of definitive host		家犬感染情况 Infection of domestic dogs	阳性率/% Positive rate/%			≥ 5	16.0
						3~5	13.0
						1~3	10.0
						0~1	7.0
			阳性犬来源 Source of positive dog			本地 Local	4.0
			阳性犬来源 Source of positive dog			外地 Non local	1.0
		野外犬科动物感染情况 Infection of wild canids	阳性率/% Positive rate/%			≥ 5	14.0
			阳性率/% Positive rate/%			< 5	7.0
			阳性野外犬科动物种类 Species of positive wild canids			野犬 Stray dog	3.0
						狐狸 Fox	2.0
						狼 Wolf	1.0

表1

表2

表3

表4

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量表得分 Score	风险等级 Risk level	干预范围 Intervention scope
36~55	较高风险 High risk	疫情所在村 Village where the endemic point is located
> 55	高风险 Maximum high risk	高风险村及毗邻村 Village where the endemic point is located and nearby village

感染或患病对象 Object	监测及干预时间/年 Time of monitoring or intervention/Year
人（年龄/岁）Human (Age/Year)
0~6	4
7~12	3
13~15	3
> 15	1
小型哺乳类动物 Small mammal	3
牛 Cattle	3
羊 Sheep	3
猪 Pig	2
家犬 Domestic dog	3
野犬 Stray dog	3
狐狸 Fox	4
狼 Wolf	4

疫点 Endemic site	干预前 Before intervention		干预后 After intervention
疫点 Endemic site	得分 Score	风险等级 Risk level	得分 Score	风险等级 Risk level
壤塘 Rangtang	55.5	高风险 Maximum high risk	47.5	较高风险 High risk
若尔盖1 Ruoergai 1	20.5	一般风险 General risk	20.5	一般风险 General risk
若尔盖2 Ruoergai 2	21.5	一般风险 General risk	22.5	一般风险 General risk
理塘 Litang	31.1	一般风险 General risk	22.9	一般风险 General risk

四川省棘球蚴病疫点传播风险评估体系构建研究

Research on the construction of risk assessment system for the transmission of echinococcosis endemic sites in Sichuan Province

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