2019年全国土源性线虫感染状况分析

doi:10.12140/j.issn.1000-7423.2021.05.015

中国寄生虫学与寄生虫病杂志 ›› 2021, Vol. 39 ›› Issue (5): 666-673.doi: 10.12140/j.issn.1000-7423.2021.05.015

2019年全国土源性线虫感染状况分析

朱慧慧(), 黄继磊, 陈颖丹, 周长海, 诸廷俊, 钱门宝, 张米禛, 李石柱, 周晓农^*()

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）,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,国家级热带病国际联合研究中心,上海 200025

收稿日期:2021-04-02 修回日期:2021-06-01 出版日期:2021-10-30 发布日期:2021-11-10
通讯作者: 周晓农
作者简介:朱慧慧（1986-）,女,硕士,助理研究员,从事土源性、食源性寄生虫病研究。E-mail： zhuhh@nipd.chinacdc.cn
基金资助:
国家自然科学基金面上项目(81973108)

Analysis on endemic status of soil-transmitted nematode infection in China in 2019

ZHU Hui-hui(), HUANG Ji-lei, CHEN Ying-dan, ZHOU Chang-hai, ZHU Ting-jun, QIAN Men-bao, ZHANG Mi-zhen, LI Shi-zhu, ZHOU Xiao-nong^*()

National Center for International Research on Tropical Diseases, Shanghai 200025, China

Received:2021-04-02 Revised:2021-06-01 Online:2021-10-30 Published:2021-11-10
Contact: ZHOU Xiao-nong
Supported by:
National Natural Science Foundation of China(81973108)

摘要/Abstract

摘要：

目的了解2019年我国土源性线虫感染情况和特点,为制订防控策略提供数据支撑。方法 2019年在全国31个省（直辖市、自治区）的土源性线虫病国家监测点（县）开展调查工作。各监测点抽样方法一致,按地理方位东、西、南、北、中划分为5个片区,每个片区抽取1个行政村,每个行政村整群抽取3岁以上常住居民200人,每个监测点共调查1 000人。收集被调查者粪样,采用改良加藤厚涂片法（一粪二检）检查虫卵并计数,计算感染率、感染度等指标,感染率间的比较采用卡方检验;在北京、福建和甘肃等23个省（直辖市、自治区）监测点开展土壤中人蛔虫卵监测工作,每个行政村随机抽取5户居民,每户采集1份田地或菜园的土壤样品,采用45 ℃、5%的盐水分离鉴定土壤样品中钩蚴,采用饱和硝酸钠漂浮法检查土壤样品中的人蛔虫卵。对2019年与2018年重叠监测点的感染率进行比较分析。结果 2019年全国共有414个监测点,共检测424 766人,土源性线虫总感染率为1.40%（5 959/424 766）,其中,四川土源性线虫感染率最高,为8.05%（2 518/31 292）,其次为云南（5.30%,885/16 693）和重庆（3.87%,238/6 149）;男性土源性线虫感染率为1.37%（2 842/207 188）,女性为1.43%（3 117/217 578）（χ² = 2.84,P > 0.05）;≥ 60岁年龄组土源性线虫感染率最高,为2.51%（2 722/108 260）,其次是45~59岁组和7~14岁组,感染率分别为1.19%（1 237/104 218）和1.12%（657/58 556）,各年龄组间感染率差异有统计学意义（χ² = 1 351.00,P < 0.01）。钩虫、蛔虫、鞭虫的感染率分别为0.84%（3 580/424 766）、0.36%（1 528/424 766）和0.27%（1 126/424 766）,且绝大部分为轻度感染。2019年共检测了2 056份土壤样品,土壤蛔虫卵检出率为5.79%（119/2 056）,钩蚴检出率为3.45%（71/2 056）。2019年共25个省（直辖市、自治区）77个土源性线虫病监测点与2018年的重叠,这些监测点2019年土源性线虫感染率为1.43%,与2018年的1.42%差异无统计学意义（χ² = 0.01,P > 0.05）。结论 2019年全国监测点人群土源性线虫整体感染呈现较低水平,但高感染省份和传播风险依然存在,需要继续开展监测和防控工作。

关键词: 土源性线虫, 感染率, 监测, 钩虫, 蛔虫, 鞭虫

Abstract:

Objective To understand the endemic status and characteristics of soil-transmitted nematode infection in China in 2019 to provide data support for developing control strategies. Methods Survey was carried out in nationwide surveillance sites (counties) in 31 provinces/municipalities/autonomous regions in China in 2019. A unified sampling method was used in all surveillance sites: each site was divided into five areas geographically (east, west, south, north, and mid part), followed by selecting one administrative village from each area; 200 permanent residents older than 3 years were cluster sampled, resulting in 1 000 residents being surveyed in each surveillance site. Stool samples were collected from survey participants and examined microscopically using the modified Kato-Katz thick smear method (two slide-reading/sample) for parasite eggs, which were counted for estimating infection rate and infection intensity. Infection rates were analyzed using Chi-square test. In addition, soil surveys Ascaris eggs were conducted in 23 provinces/municipalities/autonomous regions, including Beijing, Fujian, and Gansu; one soil sample was collected from farmer’s field or vegetable garden from each of five households randomly selected from each village. From the soill samples, hook worm larvae were identified using 5% salt solution at 45 ℃, while Ascaris eggs were examined by floating method with sodium nitrate solution. A comparative analysis of the infection rates of overlapping surveillance sites in 2019 and 2018 was conducted. Results In total, 424 766 people from 414 nationwide surveillance sites were investigated in 2019, the overall infection rate of soil-transmitted nematodes was 1.40% (5 959/424 766), with the highest found in Sichuan (8.05%, 2 518/31 292), followed by Yunnan (5.30%, 885/16 693) and Chongqing (3.87%, 238/6 149). There was no significant difference between infection rate in males (1.37%, 2 842/207 188) and females(1.43%, 3 117/217 578) (χ ² = 2.84, P > 0.05). The participant group aged ≥ 60 years had the highest infection rate, of 2.51% (2 722/108 260), followed by the 45-59 age group (1.19%, 1 237/104 218) and the 7-14 age group (1.12%, 657/58 556), with statistically significant differences among the age groups (χ² = 1 351.00, P < 0.01). The infection rates of hookworm, Ascaris lumbricoides, and Trichuris trichiura were 0.84% (3 580/424 766), 0.36% (1 528/424 766) and 0.27% (1 126/424 766), respectively, with the majority were of light infection. In 2019, 2 056 soil samples were examined, and found the detection rate of Ascaris eggs and hookworm larvae was 5.79% (119/2 056) and 3.45% (71/2 056), respectively. In 2019, 77 surveillance sites in 25 provinces/municipalities/autonomous regions overlapped with the sites in 2018, where the infection rate was 1.43% in 2019, being compared with 1.42% in 2018, showing no statistically significant difference (χ² = 0.01, P > 0.05). Conclusion The overall infection rate of soil-transmitted nematodes in China in 2019 was at a low level, but provinces with higher infection rate and transmission risk remained, thus continuing surveillance and control are urged.

Key words: Soil-transmitted nematode, Infection rate, Surveillance, Hookworm, Ascaris lumbricoides, Trichuris trichiura

中图分类号:

R532.1

朱慧慧, 黄继磊, 陈颖丹, 周长海, 诸廷俊, 钱门宝, 张米禛, 李石柱, 周晓农. 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.

ZHU Hui-hui, HUANG Ji-lei, CHEN Ying-dan, ZHOU Chang-hai, ZHU Ting-jun, QIAN Men-bao, ZHANG Mi-zhen, LI Shi-zhu, ZHOU Xiao-nong. Analysis on endemic status of soil-transmitted nematode infection in China in 2019[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(5): 666-673.

图/表 4

表1

2019年全国监测点土源性线虫感染情况

省（直辖市、自治区） Province (municipality, autonomous region)	检查人数 No. exam’d	土源性线虫 Soil-transmitted nematode		钩虫 Hookworm		蛔虫 Ascaris lumbricoides		鞭虫 Trichuris trichura
省（直辖市、自治区） Province (municipality, autonomous region)	检查人数 No. exam’d	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/%	感染人数 No. infected	感染率/% Infection rate/%
北京 Beijing	3 008	0	0	0	0	0	0	0	0
天津 Tianjin	2 028	2	0.10	0	0	2	0.10	0	0
河北 Hebei	15 239	0	0	0	0	0	0	0	0
山西 Shanxi	14 189	4	0.03	0	0	3	0.02	1	0.01
内蒙古 Inner Mongolia	10 185	0	0	0	0	0	0	0	0
辽宁 Liaoning	14 085	19	0.13	0	0	19	0.13	0	0
吉林 Jilin	12 000	39	0.33	0	0	39	0.33	0	0
黑龙江 Heilongjiang	19 082	1	0.01	0	0	1	0.01	0	0
上海 Shanghai	3 090	0	0	0	0	0	0	0	0
江苏 Jiangsu	11 538	30	0.26	11	0.10	16	0.14	3	0.03
浙江 Zhejiang	11 538	100	0.87	100	0.87	0	0	0	0
安徽 Anhui	14 982	96	0.64	78	0.52	2	0.01	16	0.11
福建 Fujian	12 686	117	0.92	100	0.79	1	0.01	16	0.13
江西 Jiangxi	14 203	159	1.12	115	0.81	33	0.23	11	0.08
山东 Shandong	14 537	127	0.87	10	0.07	16	0.11	104	0.72
河南 Henan	21 660	30	0.14	18	0.08	10	0.05	2	0.01
湖北 Hubei	10 168	2	0.02	0	0	1	0.01	1	0.01
湖南 Hunan	28 092	399	1.42	278	0.99	108	0.38	23	0.08
广东 Guangdong	22 879	68	0.30	13	0.06	21	0.09	34	0.15
广西 Guangxi	20 370	332	1.63	233	1.14	31	0.15	72	0.35
海南 Hainan	3 205	105	3.28	86	2.68	0	0	19	0.59
重庆 Chongqing	6 149	238	3.87	202	3.29	38	0.62	2	0.03
四川 Sichuan	31 292	2 518	8.05	1 849	5.91	384	1.23	455	1.45
贵州 Guizhou	14 151	312	2.20	72	0.51	150	1.06	106	0.75
云南 Yunnan	16 693	885	5.30	414	2.48	294	1.76	245	1.47
西藏 Tibet	6 441	94	1.46	0	0	85	1.32	9	0.14
陕西 Shaanxi	9 053	6	0.07	0	0	6	0.07	0	0
甘肃 Gansu	18 705	41	0.22	0	0	40	0.21	1	0.01
青海 Qinghai	7 043	43	0.61	0	0	43	0.61	0	0
宁夏 Ningxia	12 017	171	1.42	1	0.01	168	1.40	2	0.02
新疆 Xinjiang	24 458	21	0.09	0	0	17	0.07	4	0.02
合计 Total	424 766	595 9	1.40	3 580^a	0.84	1 528^a	0.36	1 126^a	0.27

表1

图1

表2

图2

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虫种Species	2018			2019			χ²	P
虫种Species	检查人数 No. exam’d	感染人数 No. infected	感染率/% Infection rate/%	检查人数 No. exam’d	感染人数 No. infected	感染率/%Infection rate/%	χ²	P
土源性线虫 Soil-transmitted nematode	75 734	1 078	1.42	79 700	1 138	1.43	0.01	> 0.05
钩虫^a Hookworm^a	75 734	754	1.00	79 700	705	0.88	5.15	< 0.05
蛔虫^a Ascaris lumbricoides^a	75 734	220	0.29	79 700	290	0.36	6.39	< 0.01
鞭虫^a Trichuris trichiura^a	75 734	138	0.18	79 700	195	0.24	7.08	< 0.01

2019年全国土源性线虫感染状况分析

Analysis on endemic status of soil-transmitted nematode infection in China in 2019

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