2016—2021年云南省贡山县人群土源性线虫感染监测结果分析

doi:10.12140/j.issn.1000-7423.2023.06.016

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (6): 766-771.doi: 10.12140/j.issn.1000-7423.2023.06.016

2016—2021年云南省贡山县人群土源性线虫感染监测结果分析

段承丽¹(), 何冬梅¹, 杨舒², 张妍黎³, 罗自荣³, 雄碧才³, 字金荣⁴, 彭佳⁴, 吴方伟⁴^,^*()

1 怒江傈僳族自治州疾病预防控制中心，云南泸水 673199
2 怒江傈僳族自治州人民医院，云南泸水 673199
3 贡山独龙族怒族自治县疾病预防控制中心，云南贡山 673599
4 云南省寄生虫病防治所，普洱 665000

收稿日期:2023-05-12 修回日期:2023-07-03 出版日期:2023-12-30 发布日期:2023-12-13
通讯作者: * 吴方伟（1984-），男，本科，副主任技师，从事寄生虫病防治工作。E-mail：wufangwei-03@163.com
作者简介:段承丽（1984-），女，本科，主管护师，从事寄生虫病防治工作。E-mail：502787598@qq.com

Surveillance on soil-transmitted helminth infections in Gongshan County of Yunnan Province from 2016 to 2021

DUAN Chenli¹(), HE Dongmei¹, YANG Shu², ZHANG Yanli³, LUO Zirong³, XIONG Bicai³, ZI Jinrong⁴, PENG Jia⁴, WU Fangwei⁴^,^*()

1 Nujiang Center for Disease Control and Prevention, Lushui 673199, Yunnan, China
2 Nujiang People’s Hospital, Lushui 673199, Yunnan, China
3 Gongshan Center for Disease Control and Prevention, Gongshan 673599, Yunnan, China
4 Yunnan Institute of Parasitic Diseases, Pu’er 665000, China

Received:2023-05-12 Revised:2023-07-03 Online:2023-12-30 Published:2023-12-13
Contact: * E-mail: wufangwei-03@163.com

摘要/Abstract

摘要：

为了解贡山县人群土源性线虫感染现状及流行趋势，2016—2021年，根据《全国肝吸虫病和土源性线虫病监测方案（试行）》要求，按照地理方位将贡山县划分为东、西、南、北、中5个片区，每年在每个片区随机抽取1个乡（镇）的1个行政村为调查村，调查对象为调查村3岁及以上本地常住人口。收集调查对象的粪样，采用改良加藤厚涂片法检查土源性线虫虫卵并计数，采用试管滤纸培养法鉴别钩虫虫种，3~9岁儿童加做透明胶纸肛拭法检查蛲虫卵。记录感染虫种和人数，计算感染率，感染率间比较采用卡方检验。共粪检6 175人，土源性线虫感染928例，总感染率为15.03%（928/6 175），其中蛔虫、鞭虫、钩虫和蛲虫的感染率分别为7.92%（489/6 175）、8.87%（548/6 175）、3.27%（202/6 175）和0.19%（12/6 175）。透明胶纸肛拭法检查3~9岁儿童823人，检出蛲虫感染6例。对202例钩虫感染者采用试管滤纸培养法进行钩虫虫种鉴别，其中美洲钩虫感染89例，十二指肠钩虫感染72例，两者混合感染1例，分别占44.06%（89/202）、35.64%（72/202）和0.50%（1/202）。钩虫、蛔虫和鞭虫轻度感染者分别占81.19%（164/201）、69.33%（339/489）和78.29%（429/548）。2016—2021年贡山县各年度人群土源性线虫感染率分别为38.78%（389/1 003）、14.76%（156/1 057）、6.53%（68/1 042）、13.15%（134/1 019）、11.89%（121/1 018）和5.79%（60/1 036），各年度间感染率差异有统计学意义（χ² = 581.98，P < 0.01）。调查的5个乡（镇）中，独龙江乡人群土源性线虫感染率最高，为32.07%（398/1 241），茨开镇最低，为9.09%（112/1 232），不同乡（镇）间人群土源性线虫感染率差异有统计学意义（χ² = 359.24，P < 0.01）。女性感染率17.81%（637/3 577）高于男性感染率11.20%（291/2 598）（χ² = 51.49，P < 0.01）。各年龄组均有感染者，以3~9岁年龄组土源性线虫感染率最高（28.21%，244/865）；民族分布以独龙族人群土源性线虫感染率最高（30.39%，392/1290）；职业分布以儿童土源性线虫感染率最高（27.78%，170/612）；文化程度分布以学龄前儿童土源性线虫感染率最高（27.48%，169/615）。不同年龄、民族、职业和文化程度间人群土源性线虫感染率差异均有统计学意义（χ² = 172.16、310.89、195.59、197.59，均P < 0.05）。监测结果显示，2016—2021年贡山县人群土源性线虫感染率呈下降趋势，但仍维持在较高水平，应继续加强对独龙族、儿童、老年人等重点人群的土源性线虫病综合防治工作。

关键词: 土源性线虫, 感染率, 监测, 贡山县

Abstract:

To understand the prevalence and transmission of soil-transmitted helminth (STH) infection in Gongshan County. From 2016 to 2021, according to the National Surveillance Program for Liver Fluke Diseases and Soil-transmitted Nematodes (Pilot). The Gongshan County were selected from five areas (east, west, south, north and central). From each of the areas, a township was randomly selected, and then an administrative village was selected from each township as the surveillance site every year. Over 200 permanent residents above 3 years old were cluster sampled from each administrative village and no less than 1 000 residents were included every year. Fecal samples were collected from the participants for examining and counting STH eggs using the modified Kato-Katz thick smear method to calculate the infection rate. Hookworm egg-positive samples were further identified for species by test tube-filter paper culture method. The eggs of Enterobius vermicularis were detected by the cellophane tape method in children aged 3-9 years. The species and number of infected were recorded, and the infection rate was calculated. The infection rate between groups was compared by the Chi-square test. The fecal samples from 6 175 residents were examined with 928 samples infected with STH. The total infection rate was 15.03% (928/6 175). The infection rates of hookworm, Ascaris lumbricoides, whipworm and Enterobius vermicularis were 3.27% (202/6 175), 7.92% (489/6 175), 8.87% (548/6 175) and 0.19% (12/6 175) respectively. The E. vermicularis eggs were detected by the cellophane tape method in children aged 3-9 years. A total of 823 children were examined and 6 were infected. A total of 202 cases of hookworm infection were identified by the test tube filter method. Among them, 89 cases were infected with Necator americanus, 72 cases were infected with Ancylostoma duodenale and 1 case was infected with both, accounting for 44.06% (89/202), 35.64% (72/202) and 0.50% (1/202), respectively. Minor with hookworm, A. lumbricoides and whipworm infections accounted for 81.19% (164/201, 69.33% (339/489) and 78.29% (429/548) respectively. From 2016 to 2021, the infection rate of STH in Gongshan County was 38.78% (389/1 003), 14.76% (156/1 057), 6.53% (68/1 042), 13.15% (134/1 019), 11.89% (121/1 018) and 5.79% (60/1 036), respectively. There was significant difference in the infection rate among different years (χ² = 581.98, P < 0.01). Among the five townshipssurveyed, the infection rate of STH was the highest in Dulong River township (32.07%, 398/1 241), and the lowest in Cikai town (9.09%, 112/1 232).The infection rate of STH was statistically significant among different village (χ² = 359.24, P < 0.01). The infection rate of STH was 11.20% (291/2 598) in male and 17.81% （637/3 577) in female, with significant difference (χ² = 51.49, P < 0.01). The STH infections were found in all age groups with the highest infection rate in the age group 3 to 9 years old (28.21%, 244/865). People of the Dulong ethnic group had the higher STH infection rate of 30.39% (392/1 290) than people with other ethnic groups. Children possessed the highest infection rate of 27.78% (170/612) compared with people with other occupations. In terms of education, the STH infection rate was highest among preschool child 27.48% (169/615). The infection rate of STH was statistically significant among different agegroups, nationalities, occupations and educational levels (χ² = 172.16, 310.89, 195.59, 197.59; P < 0.05). The results showed that the infection rate of STH in Gongshan County decreased significantly from 2016 to 2021, but remained at a high level. Combined with the rural revitalization project, the comprehensive control of STH should be continued to strengthen among key populations such as Dulong nationality, children and the elderly.

Key words: Soil-transmitted helminth, Infection rate, Surveillance, Gongshan County

中图分类号:

R532.1

段承丽, 何冬梅, 杨舒, 张妍黎, 罗自荣, 雄碧才, 字金荣, 彭佳, 吴方伟. 2016—2021年云南省贡山县人群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, 2023, 41(6): 766-771.

DUAN Chenli, HE Dongmei, YANG Shu, ZHANG Yanli, LUO Zirong, XIONG Bicai, ZI Jinrong, PENG Jia, WU Fangwei. Surveillance on soil-transmitted helminth infections in Gongshan County of Yunnan Province from 2016 to 2021[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(6): 766-771.

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参考文献 18

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乡（镇）	调查人数	土源性线虫^a		钩虫		蛔虫		鞭虫
乡（镇）	调查人数	总感染人数	总感染率/%	感染人数	感染率/%	感染人数	感染率/%	感染人数	感染率/%
丙中洛镇	1 234	129	10.45	31	2.51	62	5.02	68	5.51
茨开镇	1 232	112	9.09	33	2.68	52	4.22	65	5.28
独龙江乡	1 241	398	32.07	71	5.72	219	17.65	256	20.63
捧当乡	1 209	152	12.57	28	2.32	78	6.45	86	7.11
普拉底乡	1 259	137	10.88	39	3.10	78	6.20	73	5.80
合计	6 175	928	15.03	202	3.27	489	7.92	548	8.87

特征	调查人数	土源性线虫^a		钩虫		蛔虫		鞭虫
特征	调查人数	总感染人数	总感染率/%	感染人数	感染率/%	感染人数	感染率/%	感染人数	感染率/%
性别
男	2 598	291	11.20	70	2.69	155	5.97	163	6.27
女	3 577	637	17.81	132	3.69	334	9.34	385	10.76
年龄/岁
3~9	865	244	28.21	66	7.63	172	19.88	124	14.34
10~19	535	74	13.83	10	1.87	48	8.97	43	8.04
20~29	898	77	8.57	13	1.45	38	4.23	50	5.57
30~39	1 442	175	12.14	32	2.22	81	5.62	107	7.42
40~49	1 098	149	13.57	31	2.82	65	5.92	92	8.38
50~59	738	92	12.47	16	2.17	42	5.69	54	7.32
≥ 60	599	117	19.53	34	5.68	43	7.18	78	13.02
民族
藏族	427	60	14.05	6	1.41	37	8.67	28	6.56
独龙族	1 290	392	30.39	71	5.50	212	16.43	253	19.61
汉族	148	10	6.76	0	0	7	4.73	4	2.70
傈僳族	3 156	329	10.42	99	3.14	170	5.39	189	5.99
怒族	1 056	131	12.41	24	2.27	61	5.78	71	6.72
其他	98	6	6.12	2	2.04	2	2.04	3	3.06
职业
干部	62	1	1.61	0	0	0	0	1	1.61
农民	4 636	600	12.94	127	2.74	267	5.76	373	8.05
散居和幼托儿童	612	170	27.78	48	7.84	124	20.26	87	14.22
学生	714	144	20.17	27	3.78	93	13.03	79	11.06
其他	151	13	8.61	0	0	5	3.31	8	5.30
文化程度
文盲或半文盲	881	199	22.59	52	5.90	94	10.67	133	15.10
学龄前儿童	615	169	27.48	48	7.80	125	20.33	85	13.82
小学	2 475	375	15.15	71	2.87	183	7.39	228	9.21
初中	1 671	160	9.58	27	1.62	73	4.37	88	5.27
高中及以上	533	25	4.69	4	0.75	14	2.63	14	2.63

2016—2021年云南省贡山县人群土源性线虫感染监测结果分析

Surveillance on soil-transmitted helminth infections in Gongshan County of Yunnan Province from 2016 to 2021

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年份	调查人数	土源性线虫^a		钩虫		蛔虫		鞭虫
年份	调查人数	总感染人数	总感染率/%	感染人数	感染率/%	感染人数	感染率/%	感染人数	感染率/%
2016	1 003	389	38.78	86	8.57	214	21.34	231	23.03
2017	1 057	156	14.76	65	6.15	112	10.60	84	7.95
2018	1 042	68	6.53	20	1.92	27	2.59	34	3.26
2019	1 019	134	13.15	15	1.47	55	5.40	83	8.15
2020	1 018	121	11.89	15	1.47	66	6.48	68	6.68
2021	1 036	60	5.79	1	0.10	15	1.45	48	4.63
合计	6 175	928	15.03	202	3.27	489	7.92	548	8.87

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