2023年全国棘球蚴病防治工作进展

doi:10.12140/j.issn.1000-7423.2025.01.002

中国寄生虫学与寄生虫病杂志 ›› 2025, Vol. 43 ›› Issue (1): 6-13.doi: 10.12140/j.issn.1000-7423.2025.01.002

2023年全国棘球蚴病防治工作进展

刘白雪()(), 蒉嫣, 薛垂召, 王旭, 王莹, 王立英, 杨诗杰, 韩帅^*(), 许学年()

中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心）；传染病溯源预警与智能决策全国重点实验室；国家卫生健康委员会寄生虫病原与媒介生物学重点实验室；世界卫生组织热带病合作中心；科技部国家级热带病国际联合研究中心，上海 200025

收稿日期:2024-11-14 修回日期:2024-12-26 出版日期:2025-02-28 发布日期:2025-03-26
通讯作者: *韩帅（ORCID：0009-0001-2729-9642），男，硕士，副研究员，从事寄生虫病防治工作。E-mail: hanshuai@nipd.chinacdc.cn
作者简介:刘白雪（ORCID：0009-0001-2984-8908），女，硕士，助理研究员，从事寄生虫病防治工作。E-mail：liubx@nipd.chinacdc.cn
基金资助:
上海市卫生健康委员会科研课题(20214Y0207);中国疾病预防控制中心寄生虫病预防控制所科技创新支撑计划(LY2024012);国家重点研发计划(2021YFC2300800);国家重点研发计划(2021YFC2300804)

Progress of the national echinococcosis control programme in China, 2023

LIU Baixue()(), KUI Yan, XUE Chuizhao, WANG Xu, WANG Ying, WANG Liying, YANG Shijie, HAN Shuai^*(), XU Xuenian()

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases; Key Laboratory on Parasite and Vector Biology, National Health Commission; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai 200025, China

Received:2024-11-14 Revised:2024-12-26 Online:2025-02-28 Published:2025-03-26
Contact: *E-mail: hanshuai@nipd.chinacdc.cn
Supported by:
Scientific and Research Project of Shanghai Municipal Health Commission(20214Y0207);Technology Innovation Support Program of the National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention(LY2024012);National Key Research and Development Program of China(2021YFC2300800);National Key Research and Development Program of China(2021YFC2300804)

摘要/Abstract

摘要：

目的全面掌握2023年全国棘球蚴病防治工作进展，总结防治经验、发现存在的问题，为制定防治策略和措施提供科学依据。方法收集2023年中国疾病预防控制中心寄生虫病防治信息管理系统报送的全国棘球蚴病流行区防治工作数据，建立数据库。使用Microsoft Excel 2016对流行区人群查治病情况、传染源感染情况以及中间宿主患病情况等进行概括分析。结果截至2023年底，全国共有370个棘球蚴病流行县（市、区、旗）、3 580个流行乡（镇）、29 415个流行村。2023年全国现有棘球蚴病患者25 362例，患病率为0.05%（25 362/46 201 537），其中细粒棘球蚴病占62.61%（15 878/25 362），多房棘球蚴病占29.98%（7 604/25 362），混合感染占1.18%（300/25 362），未分型占6.23%（1 580/25 362）。新发现棘球蚴病患者1 695例，其中细粒棘球蚴病占81.00%（1 373/1 695），多房棘球蚴病占7.96%（135/1 695），混合感染占0.24%（4/1 695），未分型占10.80%（135/1 695）；< 12岁患者占10.44%（177/1 695），≥ 12岁患者占89.56%（1 518/1 695）。2023年全国共开展人群腹部超声筛查5 241 196人次，其中，< 12岁人群筛查904 370人次，≥ 12岁人群筛查4 336 826人次；对超声结果为疑似的对象，开展血清学检查12 426人次。2023年，370个监测点 < 12岁人群超声筛查患病检出率为0.02%（72/315 612），新发现病例占检出病例数的37.50%（27/72）；Ⅰ、Ⅱ类流行县（市、区、旗）监测点 ≥ 12岁人群超声筛查患病检出率为0.24%（693/288 437），新发现病例占检出病例数的11.54%（80/693）。2023年开展药物治疗17 629人；手术治疗1 920人，细粒棘球蚴病手术患者占70.31%（1 350/1 920），多房棘球蚴病手术患者占21.35%（410/1 920）。2023年随访结果显示，治愈2 706例，治疗有效18 729例，治疗无效4 860例，死亡（死因非棘球蚴病）480例，排除414例，失访273例，未访（未到访问时间）138例，外迁他地156例。2023年全国流行乡（镇）共有犬2 189 335条，其中登记管理的犬2 045 374条。34 561个村开展了犬驱虫工作，药物驱虫22 124 218次，野外犬科动物驱虫投药235 862份。采集并检测家犬粪样395 885份，粪棘球绦虫抗原阳性1 968份，阳性率为0.50%；采集并检测野外犬科动物粪样75 693份，粪棘球绦虫抗原阳性2 011份，阳性率为2.66%。2023年抽查屠宰的家畜171 102头，检出患病家畜1 533头，患病率为0.90%；检查野外啮齿类动物47 527只，检出患病啮齿类动物229只，患病率为0.48%。结论 2023年全国棘球蚴病流行态势得到基本控制，疫情趋于稳定，但棘球蚴病流行因素复杂，防治工作仍存在诸多困难和挑战，需持续加大防治工作力度，完善监测体系，充分发挥综合防治干预区和区域联防联控机制作用，贯彻落实各项综合防治措施。

关键词: 棘球蚴病, 防治进展, 中国

Abstract:

Objective To understand the progress, summarize the experiences, and investigate the problems of the national echinococcosis control programme in China in 2023, in order to provide insights for the formulation of echinococcosis control strategies and interventions. Methods All data pertaining to the national echinococcosis control programme across all endemic foci in China in 2023 were captured from the China Information Management System for Prevention and Control of Parasitic Diseases, which was operated by Chinese Center for Disease Control and Prevention, and were used to create a database. The examinations and treatments of echinococcosis in humans, the prevalence of Echinococcus infections in sources of infections, and the prevalence of echinococcosis in intermediate hosts in echinococcosis-endemic areas of China were analyzed using Microsoft Excel 2016. Results Echinococcosis was endemic in 29 415 villages across 3 580 townships from 370 counties (cities, districts, banners) in China by the end of 2023. A total of 25 362 echinococcosis cases were documented in China in 2023, with a prevalence of 0.05% (25 362/46 201 537), and there were 15 878 cases with cystic echinococcosis (62.61%), 7 604 cases with alveolar echinococcosis (29.98%), 300 cases with mixed infections (1.18%) and 1 580 cases with unclassified type (6.23%). There were 1 695 cases with newly diagnosed echinococcosis, including 1 373 cases with cystic echinococcosis (81.00%), 135 cases with alveolar echinococcosis (7.96%), 4 case with mixed infections (0.24%) and 135 cases with unclassified type (10.80%), and there were 177 cases under 12 years of age (10.44%), and 1 518 cases at ages of 12 years and older (89.56%). A total of 5 241 196 person-times received abdominal ultrasound scans for screening of echinococcosis in China in 2023, including 904 370 person-times at age of less than 12 years, and 4 336 826 person-times at ages of 12 years and older, and serological tests were performed among 12 426 person-times suspected of echinococcosis as revealed by ultrasound scans. The detection of echinococcosis by ultrasound screening was 0.02% (72/315 612) among residents under 12 years of age in 370 surveillance sites across China in 2023, including 27 cases with newly diagnosed echinococcosis (37.50%), and the detection of echinococcosis by ultrasound screening was 0.24% (693/288 437) among residents at ages of 12 years and older in surveillance sites with class Ⅰ and Ⅱ endemic counties (cities, districts, banners), including 80 cases with newly diagnosed echinococcosis (11.54%). A total of 17 629 cases with echinococcosis received drug treatment in China in 2023, and 1 920 cases received surgical treatment, including 1 350 cases with cystic echinococcosis (70.31%) and 410 cases with alveolar echinococcosis (21.35%). Follow-up results showed a cure among 2 706 cases with echinococcosis, a response to treatment among 18 729 cases, a failure in treatment among 4 860 cases, deaths among 480 cases (not deaths of echinococcosis), exclusion among 414 cases, loss to follow-up among 273 cases, a failure in follow-up among 138 cases (not reaching the time of follow-up), and migration to other places among 156 cases in China in 2023. A total of 2 189 335 dogs were recorded in echinococcosis-endemic townships in China in 2023, including 2 045 374 dogs registered for management, and dog deworming was performed in 34 561 villages, including deworming with chemotherapeutic agents given to 22 124 218 dog-times and 235 862 doses of chemotherapeutic agents given to wild canines. A total of 395 885 fecal samples were collected from domestic dogs in China in 2023 and 1 968 samples tested positive for Echinococcus coproantigen, with a positive rate of 0.50%, while 75 693 fecal samples were collected from wild canines, and 2 011 samples were tested positive for Echinococcus coproantigen, with a positive rate of 2.66%. A total of 171 102 slaughtered livestock were randomly detected for echinococcosis in China in 2023, and there were 1 533 livestock detected with echinococcosis, with a prevalence rate of 0.90%. In addition, a total of 47 527 wild rodents were examined for echinococcosis in China in 2023, and there were 229 rodents detected with echinococcosis, with a prevalence rate of 0.48%. Conclusion The epidemic status was almost controlled and tended to be stable in China in 2023; however, there are still multiple difficulties and challenges in the national echinococcosis control programme because of the complex factors affecting the transmission of echinococcosis. It is recommended to intensify continuously the echinococcosis control measures, improve the echinococcosis surveillance system, fully exert the role of comprehensive echinococcosis control intervention areas and regional joint prevention and control mechanisms, and promote the implementation of comprehensive echinococcosis control measures.

Key words: Echinococcosis, Progress of control, China

中图分类号:

R532.32

刘白雪, 蒉嫣, 薛垂召, 王旭, 王莹, 王立英, 杨诗杰, 韩帅, 许学年. 2023年全国棘球蚴病防治工作进展[J]. 中国寄生虫学与寄生虫病杂志, 2025, 43(1): 6-13.

LIU Baixue, KUI Yan, XUE Chuizhao, WANG Xu, WANG Ying, WANG Liying, YANG Shijie, HAN Shuai, XU Xuenian. Progress of the national echinococcosis control programme in China, 2023[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2025, 43(1): 6-13.

图/表 5

表1

2023年全国棘球蚴病流行概况

省（自治区） Province (Autonomous Region)		流行县（市、区、旗）数 No. endemic county (city, district, banner)	流行乡（镇）数 No. endemic township	流行行政村数No. endemic administrative village			常住人口数No. resident		患病数/例 No. patient/case
省（自治区） Province (Autonomous Region)		流行县（市、区、旗）数 No. endemic county (city, district, banner)	流行乡（镇）数 No. endemic township	流行行政村数No. endemic administrative village			常住人口数No. resident		细粒棘球蚴病 Cystic echinococcosis		多房棘球蚴病Alveolar echinococcosis		混合感染Mixed infection		未分型Pending		合计 Total
内蒙古 Inner Mongolia		26	154	1 216			1 994 890		58		0		0		2		60
四川 Sichuan		35	420	1 629			1 816 671		4 613		5 073		77		36		9 799
云南 Yunnan		24	80	173			2 626 778		71		0		0		2		73
西藏 Xizang		74	683	5 434			3 200 813		4 495		178		165		786		5 624
陕西 Shaanxi		2	16	46			377 468		20		0		0		1		21
甘肃 Gansu		57	763	7 153			10 602 221		1 157		46		0		26		1 229
青海 Qinghai		39	365	4 039			4 329 062		2 665		2 173		47		378		5 263
宁夏 Ningxia		19	141	628			2 720 905		719		72		1		5		797
新疆 Xinjiang		81	841	7 533			16 760 369		1 974		58		9		325		2 366
兵团 XPCC		13	117	1 564			1 772 360		106		4		1		19		130
合计 Total		370	3 580	29 415			46 201 537		15 878		7 604		300		1 580		25 362
省（自治区） Province (Autonomous Region)	新发现病例数/例 No. newly diagnosed/case
	< 12岁 Age < 12									≥ 12岁 Age ≥ 12
	细粒棘球蚴病Cystic echinococcosis		多房棘球蚴病Alveolar echinococcosis		混合感染Mixed infection	未分型Pending		合计Total		细粒棘球蚴病Cystic echinococcosis		多房棘球蚴病Alveolar echinococcosis		混合感染Mixed infection		未分型Pending		合计 Total
内蒙古 Inner Mongolia	0		0		0	0		0		14		0		0		1		15
四川 Sichuan	9		2		0	0		11		20		54		0		3		77
云南 Yunnan	0		0		0	0		0		9		0		0		0		9
西藏 Xizang	31		0		0	1		32		210		13		2		12		237
陕西 Shaanxi	0		0		0	0		0		0		0		0		0		0
甘肃 Gansu	2		0		0	0		2		134		6		0		10		150
青海 Qinghai	9		0		0	0		9		104		33		0		20		157
宁夏 Ningxia	0		0		0	0		0		34		4		0		0		38
新疆 Xinjiang	108		0		0	9		117		634		23		2		115		774
兵团 XPCC	5		0		0	1		6		50		0		0		11		61
合计 Total	164		2		0	11		177		1 209		133		4		172		1 518

表1

表2

表3

表4

表5

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省（自治区） Province (Autonomous Region)	< 12岁 Age < 12					≥ 12岁 Age ≥ 12
	总筛查人次 Total no. screened	监测点 Surveillance site				总筛查人次 Total no. screened	Ⅰ、Ⅱ类流行县监测点 Surveillance site in type Ⅰ and Ⅱ county
	总筛查人次 Total no. screened	筛查人次 No. screened	患病人数 No. patient	新发现病例数 No. newly diagnosed patient	检出率/% Prevalence/%	总筛查人次 Total no. screened	筛查人次 No. screened	患病人数 No. patient	新发现病例数 No. newly diagnosed patient	检出率/% Prevalence/%
内蒙古 Inner Mongolia	49 204	27 478	0	0	0	150 032	12 103	1	1	0.01
四川 Sichuan	95 445	24 952	7	0	0.03	429 562	32 102	95	1	0.3
云南 Yunnan	71 714	30 153	0	0	0	702 895	9 397	0	0	0
西藏 Xizang	123 105	40 707	25	13	0.06	583 759	87 583	473	66	0.54
陕西 Shaanxi	4 503	1 463	0	0	0	12 096	2 066	0	0	0
甘肃 Gansu	135 652	46 061	0	0	0	504 809	43 281	3	1	0.01
青海 Qinghai	100 846	20 976	28	2	0.13	268 297	40 865	112	5	0.27
宁夏 Ningxia	79 709	19 822	0	0	0	221 332	12 108	7	4	0.06
新疆 Xinjiang	199 711	82 045	12	12	0.01	864 646	46 932	2	2	0
兵团 XPPC	44 481	21 955	0	0	0	599 398	2 000	0	0	0
合计 Total	904 370	315 612	72	27	0.02	4 336 826	288 437	693	80	0.24

省（自治区） Province (Autonomous Region)	犬管理 Dog management		驱虫 Deworming treatment			粪抗原检测 Coproantigen tested
省（自治区） Province (Autonomous Region)	犬总数 Total no. dog	登记管理犬数 No. dog under management	驱虫村数 No. village deworming	驱虫次数 No. deworming	野外犬科动物投药份数 No. drug unit for wild canine deworming	家犬粪样数 No. fecal sample from domestic dog	阳性粪样数 No. positive fecal sample	阳性率/% Positive rate/%	野外犬科动物粪样数 No. fecal sample from wild canine	阳性粪样数 No. positive fecal sample	阳性率/% Positive rate/%
内蒙古 Inner Mongolia	209 944	208 994	1 824	2 188 829	80	18 570	28	0.15	601	1	0.17
四川 Sichuan	151 568	151 403	3 828	1 838 309	12 800	36 066	86	0.24	12 688	54	0.43
云南 Yunnan	132 134	94 526	201	149 531	2 120	6 186	99	1.6	2 206	38	1.72
西藏^a Xizang^a	140 215	127 021	5 101	1 466 641	9 839	47 534	606	1.27	13 904	416	2.99
陕西 Shaanxi	10 097	9 298	205	115 564	0	1 230	0	0	0	0	0
甘肃 Gansu	716 695	641 221	7 561	7 397 579	44 949	84 978	329	0.39	9 750	39	0.40
青海 Qinghai	297 133	289 493	4 039	3 481 688	148 877	63 357	434	0.69	21 661	1 390	6.42
宁夏 Ningxia	207 779	206 633	2 072	2 082 863	5 900	21 021	58	0.28	6 224	42	0.67
新疆 Xinjiang	284 505	277 684	7 773	3 181 173	10 983	93 419	248	0.27	8 659	31	0.36
兵团 XPPC	39 265	39 101	1 957	222 041	314	23 524	80	0.34	0	0	0
合计 Total	2 189 335	2 045 374	34 561	22 124 218	235 862	395 885	1 968	0.5	75 693	2 011	2.66

省（自治区） Province (autonomous region)	屠宰的家畜 Livestock slaughterd			野外啮齿类动物^a Wild rodent^a
省（自治区） Province (autonomous region)	抽查数 No. Exam’d	患病数 No. diseased	患病率/% Prevalence/%	抽查数 No. Exam’d	患病数 No. diseased	患病率/% Prevalence/%
内蒙古 Inner Mongolia	13 461	14	0.10	88	0	0
四川 Sichuan	14 953	380	2.54	9 286	129	1.39
云南 Yunnan	5 663	7	0.12	0	0	0
西藏 Xizang	6 214	88	1.42	10 339	2	0.02
陕西 Shaanxi	1 467	0	0	0	0	0
甘肃 Gansu	22 552	94	0.42	4 041	9	0.22
青海 Qinghai	50 044	255	0.51	7 142	11	0.15
宁夏 Ningxia	13 969	25	0.18	1 513	7	0.46
新疆 Xinjiang	37 990	644	1.70	15 118	71	0.47
兵团 XPPC	4 789	26	0.54	0	0	0
合计 Total	171 102	1 533	0.90	47 527	229	0.48

2023年全国棘球蚴病防治工作进展

Progress of the national echinococcosis control programme in China, 2023

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省（自治区） Province (Autonomous Region)	药物治疗/例 Drug treatment/case					手术治疗/例 Surgical treatment/case					随访情况/例 Follow-up of patients/case
省（自治区） Province (Autonomous Region)	细粒棘球蚴病 Cystic echinococcosis	多房棘球蚴病 Alveolar echinococcosis	混合感染Mixed infection	未分型 Pending	合计Total	细粒棘球蚴病Cystic echinococcosis	多房棘球蚴病Alveolar echinococcosis	混合感染Mixed infection	未分型 Pending	合计Total	治愈Cured	有效Effective treatment	无效Ineffective treatment	死亡Died	排除Excluded	失访Lose to follow-up	未访Unvisited	外迁Moved out
内蒙古 Inner Mongolia	25	0	0	0	25	19	0	0	0	19	2	46	10	1	2	1	0	0
四川 Sichuan	4 326	5 307	79	19	9 731	92	252	0	2	346	518	6 110	3 634	89	192	59	55	3
云南 Yunnan	70	0	0	0	70	8	0	0	0	8	25	40	9	1	3	0	0	1
西藏 Xizang	2 456	100	70	425	3 051	284	38	5	12	339	1 240	3 815	420	114	82	43	59	60
陕西 Shaanxi	0	0	0	0	0	0	0	0	1	1	5	3	13	4	2	0	0	0
甘肃 Gansu	820	40	0	16	876	94	8	0	4	106	128	887	263	36	5	32	0	20
青海 Qinghai	931	1 188	16	56	2 191	122	93	1	11	227	560	4 594	492	176	117	125	15	40
宁夏 Ningxia	537	76	1	0	614	42	0	0	0	42	101	767	8	18	2	8	0	14
新疆 Xinjiang	859	41	1	106	1 007	643	18	3	113	777	114	2 353	8	38	9	5	0	16
兵团 XPPC	51	3	0	10	64	46	1	0	8	55	13	114	3	3	0	0	9	2
合计 Total	10 075	6 755	167	632	17 629	1 350	410	9	151	1 920	2 706	18 729	4 860	480	414	273	138	156

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