2015—2021年江西省人群土源性线虫感染流行趋势分析

doi:10.12140/j.issn.1000-7423.2023.01.009

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (1): 59-67.doi: 10.12140/j.issn.1000-7423.2023.01.009

2015—2021年江西省人群土源性线虫感染流行趋势分析

陈喆(), 葛军, 姜唯声, 邱婷婷, 温琪, 曾小军^*()

江西省寄生虫病防治研究所，江西省血吸虫病预防与控制重点实验室，南昌330096

收稿日期:2022-06-16 修回日期:2022-09-16 出版日期:2023-02-28 发布日期:2023-02-26
通讯作者: * 曾小军（1964-），男，本科，主任技师，从事寄生虫病防治工作。E-mail：zengxiaojunnc@163.com
作者简介:陈喆（1981-），男，本科，副主任医师，从事寄生虫病防治工作。E-mail：bjchenzhe@163.com
基金资助:
江西省重点实验室计划项目(2019BCD40006);江西省医学领先学科建设项目(2021030107)

Epidemiological trends of soil-transmitted nematode infections in Jiangxi Province, 2015—2021

CHEN Zhe(), GE Jun, JIANG Weisheng, QIU Tingting, WEN Qi, ZENG Xiaojun^*()

Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang 330096, China

Received:2022-06-16 Revised:2022-09-16 Online:2023-02-28 Published:2023-02-26
Contact: * E-mail: zengxiaojunnc@163.com
Supported by:
Key Laboratory of Schistosomiasis Prevention and Control Science(2019BCD40006);Medical Leading Disciplines of Schistosomiasis Epidemiology(2021030107)

摘要/Abstract

摘要：

目的了解和分析2015—2021年江西省土源性线虫病流行态势与变化趋势，为制订土源性线虫病传播控制与阻断策略、评价防治效果提供科学依据。方法 2015—2021年，江西省分别选取13、86、86、86、86、24和24个县（市、区）设立土源性线虫病国家监测点与省级监测点，各监测点按地理方位划分为东、西、南、北、中等5个片区，每个片区随机抽取1个乡（镇）的1个行政村，整群抽取3周岁以上常住居民为监测对象。收集监测对象粪样，采用改良加藤厚涂片法（一粪二检）检查土源性线虫感染情况，计算各虫种感染率和感染度，并分析不同生态区土源性线虫感染情况。收集2015—2021年《江西统计年鉴》全省农村居民可支配收入相关数据，采取问卷调查从监测村村委会收集卫生厕所建设等信息，分析土源性线虫感染率与居民可支配收入和卫生厕所覆盖率的相关性。感染率和构成比的比较采用卡方检验，相关性研究采用Pearson相关性分析。结果 2015—2021年，江西省监测人群土源性线虫感染率分别为1.8%（126/7 137）、1.3%（947/71 766）、1.1%（803/70 547）、0.9%（604/69 507）、0.9%（628/69 620）、0.7%（151/21 884）和0.9%（202/21 757），呈逐年下降趋势，各年度之间感染率差异有统计学意义（χ² = 158.639，P < 0.01）。2015—2021年，钩虫感染率分别为1.1%（82/7 137）、0.6%（466/71 766）、0.6%（450/70 547）、0.5%（336/69 507）、0.5%（362/69 620）、0.4%（98/21 884）和0.7%（148/21 757）；蛔虫感染率分别为0.3%（24/7 137）、0.5%（393/71 766）、0.4%（287/70 547）、0.3%（221/69 507）、0.3%（225/69 620）、0.2%（40/21 884）和0.2%（42/21 757）；鞭虫感染率分别为0.3%（21/7 137）、0.2%（125/71 766）、0.1%（74/70 547）、0.1%（57/69 507）、0.1%（49/69 620）、0.1%（13/21 884）和0.1%（14/21 757）。钩虫、蛔虫和鞭虫各年度之间感染率差异均有统计学意义（χ² = 75.456、112.506、75.383，均P < 0.01）。2015—2021年男性土源性线虫感染率分别为2.0%（73/3 623）、1.3%（469/35 788）、1.1%（378/35 207）、0.8%（273/34 703）、0.9%（295/34 801）、0.6%（65/11 110）和0.8%（88/10 620），女性感染率分别为1.5%（53/3 514）、1.3%（478/35 978）、1.2%（425/35 340）、1.0%（331/34 804）、1.0%（333/34 819）、0.8%（86/10 774）和1.0%（114/11 137），男、女性各年度之间感染率差异有统计学意义（χ² = 122.146、49.615，均P < 0.01）；仅2018年男女性别之间感染率差异有统计学意义（χ² = 5.450，P < 0.05）。2015—2021年均以≥ 70岁年龄组人群土源性线虫感染率最高，分别为3.4%（19/554）、2.3%（129/5 559）、2.1%（127/5 965）、2.0%（129/6 507）、1.7%（119/7 105）、1.3%（36/2 811）和2.1%（68/3 177），各年度各年龄组之间土源性线虫感染率差异均有统计学意义（χ² = 39.763、150.459、212.140、219.129、132.674、43.997、115.627，均P < 0.01）。2015—2021年钩虫重度感染者分别占钩虫感染者总数的1.2%（1/82）、3.9%（18/466）、1.3%（6/450）、1.5%（5/336）、0.3%（1/362）、2.0%（2/98）和5.4%（8/148），各年度之间构成比差异有统计学意义（χ² = 22.853，P < 0.01）；仅2016年检出蛔虫重度感染者，占蛔虫感染者总数的1.0%（4/393）；仅2015年检出鞭虫重度感染者，占鞭虫感染者总数的4.8%（1/21）。2016—2017、2019—2021年均以浙闽山地丘陵生态区的土源性线虫感染率最高，分别为2.3%（316/13 852）、1.5%（217/14 402）、1.4%（194/14 063）、1.2%（69/5 527）和1.1%（60/5 535），2015、2018年分别以湘赣丘陵山地生态区、长江中下游平原生态区最高，为2.5%（63/2 471）和1.2%（234/18 883）；各年度不同生态区之间感染率差异有统计学意义（χ² = 21.112、156.920、67.104、73.315、73.493、37.022、9.351，均P < 0.01或0.05）。2015—2021年江西省全省农村居民可支配收入分别为10 117、11 139、12 138、13 242、14 460、15 796和16 981元，监测村卫生厕所覆盖率分别为82.7%（200 994/243 000）、85.7%（256 437/299 398）、87.3%（257 553/294 951）、88.9%（250 381/281 699）、92.1%（69 428/75 380）和93.8%（77 259/82 376），2015—2021年土源性线虫感染率与全省农村居民可支配收入呈负相关（r = -0.834，P < 0.05），而与监测村无害化厕所覆盖率无相关性（r = -0.799，P > 0.05）。结论 2016—2021年江西省人群土源性线虫感染率总体逐年下降，呈低度流行态势，其中41个县土源性线虫感染率连续3年降至1.0%以下。

关键词: 土源性线虫, 监测, 钩虫, 蛔虫, 鞭虫, 江西省

Abstract:

Objective To understand and analyze the endemic status and transmission trends of soil-transmitted helminth (STH) infection in Jiangxi Province during 2015—2020 to provide scientific basis for formulating strategy of transmission control and interruption, and evaluate the control effect. Methods From 2015 to 2021, 13, 86, 86, 86, 86, 24 and 24 counties (cities and districts) in Jiangxi Province were selected as national surveillance sites and provincial surveillance sites. The surveillance sites were randomly selected from five geographical sections in the east, west, south, north and center, from each section, one administrative village in one township (town) was randomly selected as surveillance site. Fecal samples were collected from each enrolled participant and examined for STH eggs (two slide-reading each sample) using the modified Kato-Katz thick smear method. The infection rate and intensity of different worm species were calculated, and the infection prevalence in different eco-region was analyzed. The disposable income data of rural residents in Jiangxi Province were collected from Jiangxi Statistical Yearbook from 2015 to 2021. A questionnaire based survey was conducted to collect information on the construction of sanitary toilets in each surveillance site from the village committee from 2016 to 2021. The infection rate and constituent ratio were compared by the Chi-square test. The correlation study was conducted using Pearson correlation analysis. Results From 2015 to 2021, the infection rates of STH were 1.8% (126/7 137), 1.3% (947/71 766), 1.1% (803/70 547), 0.9% (604/69 507), 0.9% (628/69 620), 0.7% (151/21 884) and 0.9% (202/21 757) respectively, showing a decreasing trend year by year, with statistically significant differences in infection rates between years (χ² = 158.639, P < 0.01). From 2015 to 2021, the infection rates of hookworm were 1.1% (82/7 137), 0.6% (466/71 766), 0.6% (450/70 547), 0.5% (336/69 507), 0.5% (362/69 620), 0.4% (98/21 884) and 0.7% (148/21 757) respectively. From 2015 to 2021, the infection rates of Ascaris lumbricoides were 0.3% (24/7 137), 0.5% (393/71 766), 0.4% (287/70 547), 0.3% (221/69 507), 0.3% (225/69 620), 0.2% (40/21 884) and 0.2% (42/21 757) respectively. From 2015 to 2021, the infection rates of Trichuris trichiura were 0.3% (21/7 137), 0.2% (125/71 766), 0.1% (74/70 547), 0.1% (57/69 507), 0.1% (49/69 620), 0.1% (13/21 884) and 0.1% (14/21 757) respectively. The infection rates of hookworm, A. lumbricoides and T. trichiura were significantly different between years (χ² = 75.456, 112.506, 75.383, all P < 0.01). From 2015 to 2021, the infection rates were 2.0% (73/3 623), 1.3% (469/35 788), 1.1% (378/35 207), 0.8% (273/34 703), 0.9% (295/34 801), 0.6% (65/11 110) and 0.8% (88/10 620) in males and 1.5% (53/3 514), 1.3% (478/35 978), 1.2% (425/35 340), 1.0% (331/34 804), 1.0% (333/34 819), 0.8% (86/10 774) and 1.0% (114/11 137) in females. The infection rates of male and female were significantly different between years (χ² = 122.146, 49.615, P < 0.01). The infection rates of female were statistically higher than that of males in 2018 (χ² = 5.450, P < 0.05). From 2015 to 2021, the infection rates of soil-transmitted nematodes were the highest in the over-70-year-old age group, which were 3.4% (19/554), 2.3% (129/5 559), 2.1% (127/5 965), 2.0% (129/6 507), 1.7% (119/7 105), 1.3% (36/2 811) and 2.1% (68/3 177) respectively, with statistically significant differences in infection rates among the different age groups (χ² = 39.763, 150.459, 212.140, 219.129, 132.674, 43.997, 115.627, P < 0.01). From 2015 to 2021, the severely infected accounted for 1.2% (1/82), 3.9% (18/466), 1.3% (6/450), 1.5% (5/336), 0.3% (1/362), 2.0% (2/98) and 5.4% (8/148) of the total hookworm infected villagers, respectively. The differences of constituent ratio in each year were statistically significant （χ² = 22.853, P < 0.01）. Severe A. lumbricoides infection was only detected in 2016, accounting for 1.0% (4/393) of the total A. lumbricoides infection cases. T.trichiura severe infection were only detected in 2015, accounting for 4.8% (1/21) of the total T. trichiura infection cases. The infection rates of STH in 2016—2017 and 2019—2021 were the highest in Zhejiang-Fujian mountain and hill ecological regions. They were 2.3% (316/13 852), 1.5% (217/14 402), 1.4% (194/14 063), 1.2% (69/5 527) and 1.1% (60/5 535) respectively. In 2015 and 2018, the highest infection rates were 2.5% (63/2 471) and 1.2% (234/18 883) in Hunan-Jiangxi hill and mountain and Yangtze River basin ecological region, respectively. The differences in infection rates among different ecological regions in each year were statistically significant (χ² = 21.112, 156.920, 67.104, 73.315, 73.493, 37.022, 9.351, P < 0.01 or P < 0.05). From 2015 to 2021, the disposable income of rural residents in Jiangxi Province were 10 117, 11 139, 12 138, 13 242, 14 460, 15 796 and 16 981 yuan and the coverage rates of sanitary latrines in surveillance villages were 82.7% (200 994/243 000), 85.7% (256 437/299 398), 87.3% (257 553/294 951), 88.9% (250 381/281 699), 92.1% (69 428/75) and 93.8% (77 259/82 376), respectively. The infection rates of soil-transmitted nematodes in Jiangxi Province were negatively correlated with the disposable income data among the rural residents (r = -0.834, P < 0.05) while were no correlation with the coverage rate of sanitary latrines in surveillance villages (r = -0.799, P > 0.05) in Jiangxi Province during 2016—2021. Conclusion The infection rate of STH in Jiangxi Province in 2016—2021 shows an overall decline year by year, suggesting a low transmission trend. The infection rate in 41 counties has reduced to below 1.0% for 3 consecutive years.

Key words: Soil-transmitted helminth, Surveillance, Hookworm, Ascaris lumbricoides, Trichuris trichiura, Jiangxi Province

中图分类号:

R532.1

陈喆, 葛军, 姜唯声, 邱婷婷, 温琪, 曾小军. 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.

CHEN Zhe, GE Jun, JIANG Weisheng, QIU Tingting, WEN Qi, ZENG Xiaojun. Epidemiological trends of soil-transmitted nematode infections in Jiangxi Province, 2015—2021[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(1): 59-67.

图/表 3

表1

表2

表3

2015—2021年江西省监测点人群土源性线虫感染的年龄分布

年份 Year	年龄组/岁 Age group/Year	检查人数 No. examined	土源性线虫 Soil-transmitted helminth		钩虫 Hookworm		蛔虫 A. lumbricoides		鞭虫 T. trichiura
年份 Year	年龄组/岁 Age group/Year	检查人数 No. examined	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/%
2015	3~9	1 188	11	0.9	4	0.3	6	0.5	1	0.1
	10~19	723	2	0.3	0	0.0	0	0.0	2	0.3
	20~29	602	10	1.7	4	0.7	3	0.5	3	0.5
	30~39	841	6	0.7	3	0.4	2	0.2	1	0.1
	40~49	1 166	24	2.1	18	1.5	4	0.3	2	0.2
	50~59	1 125	25	2.2	14	1.2	5	0.4	6	0.5
	60~69	938	29	3.1	23	2.5	3	0.3	4	0.4
	≥ 70	554	19	3.4	16	2.9	1	0.2	2	0.4
	小计Subtotal	7 137	126	1.8	82	1.1	24	0.3	21	0.3
2016	3~9	12 431	108	0.9	26	0.2	71	0.6	16	0.1
	10~19	8 112	74	0.9	13	0.2	55	0.7	10	0.1
	20~29	5 263	52	1.0	19	0.4	30	0.6	6	0.1
	30~39	7 703	80	1.0	38	0.5	32	0.4	11	0.1
	40~49	11 127	122	1.1	58	0.5	55	0.5	16	0.1
	50~59	12 095	168	1.4	89	0.7	61	0.5	25	0.2
	60~69	9 476	214	2.3	140	1.5	53	0.6	26	0.3
	≥ 70	5 559	129	2.3	83	1.5	36	0.7	15	0.3
	小计Subtotal	71 766	947	1.3	466	0.7	393	0.6	125	0.2
2017	3~9	12 210	72	0.6	11	0.1	52	0.4	10	0.1
	10~19	7 718	50	0.7	16	0.2	24	0.3	11	0.1
	20~29	4 936	22	0.5	4	0.1	17	0.3	1	0.0
	30~39	7 221	59	0.8	24	0.3	30	0.4	5	0.1
	40~49	10 337	100	1.0	62	0.6	31	0.3	8	0.1
	50~59	12 060	166	1.4	104	0.9	44	0.4	18	0.2
	60~69	10 100	207	2.1	142	1.4	52	0.5	15	0.2
	≥ 70	5 965	127	2.1	87	1.5	37	0.6	6	0.1
	小计 Subtotal	70 547	803	1.1	450	0.6	287	0.4	74	0.1
2018	3~9	11 097	44	0.4	10	0.1	24	0.2	12	0.1
	10~19	8 338	44	0.5	9	0.1	30	0.4	5	0.1
	20~29	4 583	18	0.4	8	0.2	9	0.2	1	0.0
	30~39	6 819	28	0.4	14	0.2	12	0.2	2	0.0
	40~49	9 844	65	0.7	36	0.4	25	0.3	5	0.1
	50~59	11 992	120	1.0	66	0.6	43	0.4	14	0.1
	60~69	10 327	156	1.5	105	1.0	43	0.4	9	0.1
	≥ 70	6 507	129	2.0	88	1.4	35	0.5	9	0.1
	小计 Subtotal	69 507	604	0.9	336	0.5	221	0.3	57	0.1
2019	3~9	11 429	61	0.5	14	0.1	43	0.4	4	0.0
	10~19	7 834	45	0.6	14	0.2	28	0.4	3	0.0
	20~29	4 440	22	0.5	13	0.3	9	0.2	2	0.1
	30~39	6 866	38	0.6	22	0.3	13	0.2	3	0.0
	40~49	9 634	72	0.8	41	0.4	26	0.3	6	0.1
	50~59	12 125	121	1.0	69	0.6	40	0.3	13	0.1
	60~69	10 187	150	1.5	102	1.0	40	0.4	10	0.1
	≥ 70	7 105	119	1.7	87	1.2	26	0.4	8	0.1
	小计 Subtotal	69 620	628	0.9	362	0.5	225	0.3	49	0.1
2020	3~9	2 870	5	0.2	3	0.1	1	0.0	1	0.0
	10~19	2 245	10	0.5	5	0.2	2	0.1	3	0.1
	20~29	1 178	3	0.3	2	0.2	1	0.1	0	0.0
	30~39	2 119	12	0.6	9	0.4	2	0.1	1	0.1
	40~49	2 932	15	0.5	8	0.3	5	0.2	2	0.1
	50~59	4 202	29	0.7	18	0.4	11	0.3	0	0.0
	60~69	3 527	41	1.2	25	0.7	11	0.3	5	0.1
	≥ 70	2 811	36	1.3	28	1.0	7	0.3	1	0.0
	小计 Subtotal	21 884	151	0.7	98	0.5	40	0.2	13	0.1
2021	3~9	2 601	3	0.1	0	0.0	3	0.1	0	0.0
	10~19	1 984	7	0.4	5	0.3	0	0.0	2	0.1
	20~29	801	2	0.2	0	0.0	0	0.0	2	0.2
	30~39	1 868	6	0.3	2	0.1	2	0.1	2	0.1
	40~49	2 753	16	0.6	14	0.5	1	0.0	1	0.0
	50~59	4 556	34	0.7	21	0.5	11	0.2	2	0.0
	60~69	4 017	66	1.6	53	1.3	10	0.2	3	0.1
	≥ 70	3 177	68	2.1	53	1.7	15	0.5	2	0.1
	小计 Subtotal	21 757	202	0.9	148	0.7	42	0.2	14	0.1

表3

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2015—2021年江西省人群土源性线虫感染流行趋势分析

Epidemiological trends of soil-transmitted nematode infections in Jiangxi Province, 2015—2021

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性别 Gender	年份 Year	检查人数 No. examined	土源性线虫 Soil-transmitted helminth		钩虫 Hookworm		蛔虫 A. lumbricoides		鞭虫 T. trichiura
性别 Gender	年份 Year	检查人数 No. examined	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/%
男性 Male	2015	3 623	73	2.0	46	1.3	16	0.4	11	0.3
男性 Male	2016	35 788	469	1.3	235	0.7	189	0.5	58	0.2
	2017	35 207	378	1.1	203	0.6	149	0.4	28	0.1
	2018	34 703	273	0.8	148	0.4	103	0.3	24	0.1
	2019	34 801	295	0.9	155	0.5	118	0.3	25	0.1
	2020	11 110	65	0.6	38	0.3	19	0.2	8	0.1
	2021	10 620	88	0.8	66	0.6	18	0.2	5	0.0
女性 Female	2015	3 514	53	1.5	36	1.0	8	0.2	10	0.3
女性 Female	2016	35 978	478	1.3	231	0.6	204	0.6	67	0.2
	2017	35 340	425	1.2	247	0.7	138	0.4	46	0.1
	2018	34 804	331	1.0	188	0.5	118	0.3	33	0.1
	2019	34 819	333	1.0	207	0.6	107	0.3	24	0.1
	2020	10 774	86	0.8	60	0.6	21	0.2	5	0.1
	2021	11 137	114	1.0	82	0.7	24	0.2	9	0.1

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