2017—2023年云南省棘球蚴病综合防治措施实施效果分析

doi:10.12140/j.issn.1000-7423.2025.01.004

中国寄生虫学与寄生虫病杂志 ›› 2025, Vol. 43 ›› Issue (1): 20-25.doi: 10.12140/j.issn.1000-7423.2025.01.004

2017—2023年云南省棘球蚴病综合防治措施实施效果分析

李奔福(), 吴方伟, 字金荣, 严信留, 彭佳, 王正青, 李建雄, 徐倩, 李永飞, 杨亚明^*()

云南省寄生虫病防治所，云南省疟疾研究中心，云南公共卫生与疾病防控协同创新中心，大理学大学病原与媒介生物研究所（普洱分部），云南普洱 665000

收稿日期:2024-07-05 修回日期:2025-01-08 出版日期:2025-02-28 发布日期:2025-03-26
通讯作者: *杨亚明，男，硕士，主任医师，从事寄生虫病防治与研究。E-mail：yangymsm@126.com
作者简介:李奔福，男，本科，副主任技师，从事重点寄生虫病防治与研究。E-mail：libefu@163.com
基金资助:
国家卫生健康委员会棘球蚴病防治研究重点实验室开放课题(2021WZK1001)

Effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023

LI Benfu(), WU Fangwei, ZI Jinrong, YAN Xinliu, PENG Jia, WANG Zhengqing, LI Jianxiong, XU Qian, LI Yongfei, YANG Yaming^*()

Yunnan Institute of Parasitic Diseases; Yunnan Provincial Center of Malaria Research; Yunnan Provincial Collaborative Innovation Center for Public Health and Disease Prevention and Control; Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Pu’er 665000, Yunnan, China

Received:2024-07-05 Revised:2025-01-08 Online:2025-02-28 Published:2025-03-26
Contact: *E-mail: yangymsm@126.com
Supported by:
Open Project of National Health Commission Key Laboratory of Echinococcosis Control and Research(2021WZK1001)

摘要/Abstract

摘要：

目的分析2017—2023年云南省棘球蚴病综合防治措施实施效果，为云南省制定棘球蚴病防控措施提供参考依据。方法 2017年在云南省9个州（市）24个县（市、区）实施中央重大疾病棘球蚴病防控项目，在流行区建立棘球蚴病监测和实验室检测体系、实行病例规范管理、进行病例个案流行病学调查、对疫点进行调查处置、防控传染源犬、防控中间宿主动物、健康科普。收集2016—2023年云南省棘球蚴病综合防治措施、防治和监测报表数据，以人群棘球蚴病患病率、犬棘球绦虫粪抗原阳性率、家畜棘球蚴病患病率、人群棘球蚴病防治知识知晓率为评价指标，采用SPSS 21.0统计学软件进行分析，应用χ²检验进行趋势性分析，以2016年度调查数据为基线，计算各年度的相对风险度，评价云南省棘球蚴病综合防治措施实施效果。结果 2017—2023年云南省建立了1个棘球蚴病防控工作站、2个省级棘球蚴病检测参比实验室，人群棘球蚴病B超筛查183万人次、病例随访365次和病例个案流行病学调查254次、病例规范管理率为100%、疫点调查处置5个。2023年人群棘球蚴病患病率（1.42/10万，11/774 609）与基线（38.17/10万，24/62 874）相比下降了96.28%，人群患病率差异有统计学意义（χ² = 187.881，P < 0.05）。居民棘球蚴病防治知识知晓率从基线的43.50%（5 075/11 668）提高至2023年89.20%（6 680/7 489）（χ² = 922.835，P < 0.05），小学生棘球蚴病防治知识知晓率从2019年77.86%（2 687/3 451）提高至2023年95.21%（7 097/7 454）（χ² = 44.170，P < 0.05）。犬棘球绦虫粪抗原阳性率从2017的4.38%（186/4 246）下降至2023年1.68%（141/8 392）（χ² = 367.928，P < 0.05），家畜动物患病率从基线的0.23%（8/3 472）下降至2023年0.12%（7/5 663）（χ² = 1.492，P > 0.05）。相对危险度分析显示，2023年较2017年人群棘球蚴病患病风险下降了97.99%，2023年传染源犬传播风险度与2018年相比下降了90.76%。各年度家畜动物棘球蚴病患病风险比差异无统计学意义（P > 0.05）。结论 2017—2023年云南省棘球蚴病综合防治措施取得了显著成效，传染源动物之间仍然存在传播流行，需继续强化传染源动物控制，有效阻断传播链。

关键词: 棘球蚴病, 综合防治, 措施, 效果, 云南省

Abstract:

Objective To evaluate the effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023, so as to provide insights into formulation of the echinococcosis control strategy in the province in the future. Methods The central government fiscal transfer payment program for echinococcosis prevention and control was implemented across 24 counties (cities, districts) in 9 prefectures (cities) of Yunnan Province in 2017, and establishment of the echinococcosis surveillance and laboratory testing system, standardized management of echinococcosis patients, case investigation, investigation and disposal of foci, management of dogs and intermediate host animals and health education were performed in echinococcosis-endemic areas. The comprehensive echinococcosis control measures, echinococcosis control reports and echinococcosis surveillance reports were collected in Yunnan Province from 2016 to 2023, and the prevalence of human echinococcosis, positive rate of Echinococcus coproantigen in dogs, prevalence of echinococcosis in livestock, and awareness of echinococcosis control knowledge among residents were estimated. All analyses were performed with the statistical software SPSS 21.0, and the trends were tested with chi-square test. In addition, the relative risk was calculated from 2017 to 2023 based on the 2016 data, in order to evaluate the effectiveness of comprehensive echinococcosis control measures in Yunnan Province. Results An echinococcosis control workstation and 2 province-level echinococcosis testing reference laboratories were built in Yunnan Province during the period between 2017 and 2023, when B-mode ultrasonography screening for human echinococcosis among 1.83 million person-times, 365 times of follow-up of echinococcosis patients, 254 case investigations, a 100% proportion of standardized case management and investigation and disposal of 5 foci were conducted. The prevalence of human echinococcosis reduced from 38.17/105 (24/62 874) at baseline to 1.42/105 (11/774 609) in 2023, with a reduction of 96.28% (χ² = 187.881, P < 0.05). The awareness of echinococcosis control knowledge increased from 43.50% (5 075/11 668) among residents at baseline to 89.20% (6 680/7 489) in 2023 (χ² = 922.835，P < 0.05), while the awareness of echinococcosis control knowledge increased from 77.86% (2 687/3 451) among primary school students in 2019 to 95.21% (7 097/7 454) in 2023 (χ² = 44.170，P < 0.05). The positive rate of Echinococcus coproantigen reduced from 4.38% (186/4 246) in dogs in 2017 to 1.68% (141/8 392) in 2023 (χ² = 367.928，P < 0.05), and the prevalence of echinococcosis reduced from 0.23% (8/3 472) in livestock at baseline to 0.12% (7/5 663) in 2023 (χ² = 1.492，P > 0.05). In addition, the risk of human echinococcosis reduced by 97.99% in 2023 relative to in 2017, and the risk of dog-associated transmission of echinococcosis reduced by 90.76% in 2023 relative to in 2018. Nevertheless, there was no significant difference in the risk ratio of the prevalence of echinococcosis in livestock among years (P > 0.05). Conclusion Remarkable achievements had been obtained in the comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023; however, transmission of echinococcosis remained among animal sources of infections. Intensified management of animal sources of infections is required to effective block the transmission chain of echinococcosis.

Key words: Echinococcosis, Comprehensive control, Measure, Effectiveness, Yunnan Province

中图分类号:

R523.32

李奔福, 吴方伟, 字金荣, 严信留, 彭佳, 王正青, 李建雄, 徐倩, 李永飞, 杨亚明. 2017—2023年云南省棘球蚴病综合防治措施实施效果分析[J]. 中国寄生虫学与寄生虫病杂志, 2025, 43(1): 20-25.

LI Benfu, WU Fangwei, ZI Jinrong, YAN Xinliu, PENG Jia, WANG Zhengqing, LI Jianxiong, XU Qian, LI Yongfei, YANG Yaming. Effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2025, 43(1): 20-25.

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参考文献 21

[1]	吐尔洪江•吐逊, 邵英梅, 吐尔干艾力•阿吉, 等. 棘球蚴病临床领域相关中文专业术语专家共识[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(1): 76-84. doi: 10.12140/j.issn.1000-7423.2021.01.011
	Tuerhongjiang TX, Shao YM, Tuerganaili AJ, et al. Consensus on Chinese terminology in the clinical field of echinococcosis[J]. Chin J Parasitol Parasit Dis, 2021, 39(1): 76-84. (in Chinese)
[2]	Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: Advances in the 21st century[J]. Clin Microbiol Rev, 2019, 32(2): e00075-e00093.
[3]	中国医师协会外科医师分会包虫病外科专业委员会. 肝两型包虫病诊断与治疗专家共识(2019版)[J]. 中华消化外科杂志, 2019, 18(8): 711-721.
	Chinese Doctor Association, Chinese College of Surgeons (CCS). Expert consensus on diagnosis and treatment of hepatic cystic and alveolar echinococcosis (2019 edition)[J]. Chin J Dig Surg, 2019, 18(8): 711-721. (in Chinese)
[4]	四川省包虫病临床医学研究中心, 四川省医师协会包虫病专业委员会. 复杂肝多房棘球蚴病诊疗专家共识(2020版)[J]. 中国普外基础与临床杂志, 2020, 27(1): 18-23.
	Sichuan Provincial Hydatid Disease Clinical Medical Research Center, Sichuan Provincial Medical Doctors Association Hydatid Disease Professional Committee. Expert consensus on the diagnosis and treatment of complex hepatic multilocular echinococcosis (2020 edition)[J]. Chin J Bases Clin Gen Surg, 2020, 27(1): 18-23. (in Chinese)
[5]	Cadavid Restrepo AM, Yang YR, McManus DP, et al. The landscape epidemiology of echinococcoses[J]. Infect Dis Poverty, 2016, 5: 13. doi: 10.1186/s40249-016-0109-x pmid: 26895758
[6]	Budke CM, Deplazes P, Torgerson PR. Global socioeconomic impact of cystic echinococcosis[J]. Emerg Infect Dis, 2006, 12(2): 296-303. doi: 10.3201/eid1202.050499 pmid: 16494758
[7]	张梦媛, 伍卫平. 国内外包虫病疾病负担研究进展[J]. 中国病原生物学杂志, 2017, 12(5): 473-475.
	Zhang MY, Wu WP. Advances in study the burden of echinococcosis in China and elsewhere around the world[J]. J Pathog Biol, 2017, 12(5): 473-475. (in Chinese)
[8]	McManus DP, Zhang WB, Li J, et al. Echinococcosis[J]. Lancet, 2003, 362(9392): 1295-1304. doi: 10.1016/S0140-6736(03)14573-4 pmid: 14575976
[9]	Moro P, Schantz PM. Echinococcosis: A review[J]. Int J Infect Dis, 2009, 13(2): 125-133. doi: 10.1016/j.ijid.2008.03.037 pmid: 18938096
[10]	李奔福, 吴方伟, 严信留, 等. 2012—2017年云南省棘球蚴病流行病学分析[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(5): 576-582. doi: 10.12140/j.issn.1000-7423.2019.05.012
	Li BF, Wu FW, Yan XL, et al. Epidemiological analysis of echinococcosis in Yunnan Province from 2012 to 2017[J]. Chin J Parasitol Parasit Dis, 2019, 37(5): 576-582. (in Chinese)
[11]	Zi JR, Xiao D, Peng J, et al. Epidemiological survey of cystic echinococcosis in southwest China: From the Qinghai-Tibet plateau to the area of Yunnan[J]. World J Hepatol, 2024, 16(2): 229-240.
[12]	李奔福, 史帅, 和文胜, 等. 2016—2020年云南省迪庆藏族自治州棘球蚴病流行病学分析[J]. 中国病原生物学杂志, 2023, 18(7): 812-815.
	Li BF, Shi S, He WS, et al. Epidemiological analysis of echinococcosis in Diqing Tibetan Autonomous Prefecture of Yunnan Province from 2016 to 2020[J]. J Pathog Biol, 2023, 18(7): 812-815. (in Chinese)
[13]	李奔福, 杨敬, 杨金玉, 等. 云南省大理州棘球蚴病流行病学调查和病例回顾性分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 573-578. doi: 10.12140/j.issn.1000-7423.2023.05.008
	Li BF, Yang J, Yang JY, et al. Epidemiological investigation and case retrospective analysis of echinococcosis in Dali Prefecture, Yunnan Province[J]. Chin J Parasitiol Parasit Dis, 2023, 41(5): 573-578. (in Chinese)
[14]	李奔福, 王正青, 徐倩, 等. 云南省细粒棘球绦虫线粒体co1和nd1基因序列分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 306-311. doi: 10.12140/j.issn.1000-7423.2023.03.007
	Li BF, Wang ZQ, Xu Q, et al. Sequence analysis of mitochondrial co1 and nd1 genes in Echinococcus granulosus in Yunnan Province[J]. Chin J Parasitol Parasit Dis, 2023, 41(3): 306-311. (in Chinese)
[15]	韩帅, 蒉嫣, 薛垂召, 等. 2004—2020年全国棘球蚴病疫情分析[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(4): 475-480. doi: 10.12140/j.issn.1000-7423.2022.04.009
	Han S, Kui Y, Xue CZ, et al. The endemic status of echinococcosis in China from 2004 to 2020[J]. Chin J Parasitol Parasit Dis, 2022, 40(4): 475-480. (in Chinese)
[16]	严俊, 胡桃, 雷正龙. 全国重点寄生虫病的防控形势与挑战[J]. 中国寄生虫学与寄生虫病杂志, 2015, 33(6): 412-417.
	Yan J, Hu T, Lei ZL. The endemic situation and challenges of major parasitic diseases in China[J]. Chin J Parasitol Parasit Dis, 2015, 33(6): 412-417. (in Chinese)
[17]	郑灿军, 杨柳, 张光葭, 等. 《棘球蚴病防治技(案(版2019年)》解读[J]. 热带病与寄生虫学, 2020, 18(4): 193-196, 201.
	Zheng CJ, Yang L, Zhang GJ, et al. Interpretation of technical scheme for echinococcosis control (edition 2019)[J]. J Trop Dis Parasitol, 2020, 18(4): 193-196, 201. (in Chinese)
[18]	李奔福, 和文胜, 字金荣, 等. 云南省香格里拉市棘球蚴病流行状况调查及防控措施分析[J]. 中国病原生物学杂志, 2020, 15(12): 1436-1441.
	Li BF, He WS, Zi JR, et al. Analysis of the prevalence of and control measures for echinococcosis in Shangrila, Yunnan Province[J]. J Pathog Biol, 2020, 15(12): 1436-1441.
[19]	肖宁. 理念与机制创新为我国棘球蚴病防治提供持续动力[J]. 中国血吸虫病防治杂志, 2021, 33(4): 329-333.
	Xiao N. Concept and mechanism innovations provide a sustainable driver for echinococcosis control in China[J]. Chin J Schisto Control, 2021, 33(4): 329-333. (in Chinese)
[20]	喻文杰, 王谦, 杨毅, 等. 2019年四川省色达县棘球蚴病流行病学调查[J]. 中国血吸虫病防治杂志, 2021, 33(6): 623-625, 642.
	Yu WJ, Wang Q, Yang Y, et al. Epidemiology of echinococcosis in Serthar County of Sichuan Province in 2019[J]. Chin J Schisto Control, 2021, 33(6): 623-625, 642. (in Chinese)
[21]	吴向林, 段红菊, 齐蓉婷, 等. 2011—2018年宁夏回族自治区棘球蚴病综合防治效果[J]. 中国血吸虫病防治杂志, 2020, 32(6): 598-604.
	Wu XL, Duan HJ, Qi RT, et al. Evaluation of the effect of the integrated echinococcosis control program in Ningxia Hui Autonomous Region from 2011 to 2018[J]. Chin J Schisto Control, 2020, 32(6): 598-604. (in Chinese)

年份 Year	居民 Resident			小学生 Primary school students
年份 Year	调查人数 No. surveyed	合格人数 No. qualified	知晓率/% Awareness rate/%	调查人数 No. surveyed	合格人数 No. qualified	知晓率/% Awareness rate/%
2016	11 668	5 075	43.5	-	-	-
2017	2 675	2 182	81.57	-	-	-
2018	5 372	4 310	80.23	-	-	-
2019	3 699	3 191	86.27	3 451	2 687	77.86
2020	6 458	5 511	85.34	8 096	6 811	84.13
2021	7 721	6 924	89.68	7 418	6 791	91.55
2022	7 236	6 479	89.54	7 246	6 681	92.20
2023	7 489	6 680	89.2	7 454	7 097	95.21

年份Year	家犬Domestic dog			家畜Livestock
年份Year	调查数 No. examined	阳性数 No. positive	阳性率% Prevalence/%	调查数 No. examined	患病数 No. positive	患病率% Prevalence/%
2016	6 587	105	1.59	3 472	8	0.23
2017	4 246	186	4.38	21 054	21	0.10
2018	5 347	299	5.59	21 725	55	0.25
2019	6 986	152	2.18	11 419	20	0.18
2020	8 022	107	1.33	6 758	9	0.13
2021	6 969	146	2.10	4 991	4	0.08
2022	7 936	157	1.98	5 077	13	0.26
2023	8 392	141	1.68	5 663	7	0.12
合计Total	54 485	1 293	2.37	80 159	137	0.17

年份Year	人群^a Human population^a		犬^b Domestic dog^b		家畜^c Livestock^c
年份Year	风险比/% Risk ratio/%	95% CI	风险比/% Risk ratio/%	95% CI	风险比/% Risk ratio/%	95% CI
2017	1.844	1.064~3.195	2.267	2.112~3.387	0.433	0.192~0.978
2018	1.538	0.891~2.652	3.375	2.710~4.204	1.098	0.524~2.307
2019	0.402	0.332~0.487	1.357	1.061~1.736	0.761	0.335~1.725
2020	0.353	0.206~0.603	0.244	0.200~0.309	0.579	0.233~1.498
2021	0.197	0.105~0.371	0.387	0.319~0.471	0.348	0.105~1.156
2022	0.295	0.125~0.404	0.366	0.303~0.443	0.111	0.461~2.678
2023	0.037	0.018~0.076	0.312	0.256~0.380	0.537	0.195~1.480

2017—2023年云南省棘球蚴病综合防治措施实施效果分析

Effectiveness of comprehensive echinococcosis control measures in Yunnan Province from 2017 to 2023

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[8]	吴向林, 刘煊, 马国良, 段红菊, 马天宝, 田慧芳, 王志平, 齐蓉婷, 闫芳. 宁夏多房棘球蚴病流行区流浪犬和野外犬科动物驱虫方法的探索与效果评估[J]. 中国寄生虫学与寄生虫病杂志, 2025, 43(1): 30-36.
[9]	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.
[10]	雷家希, 贡桑曲珍, 王立英, 杨频, 程茜茜, 王芝依, 姜明哲. 2015—2022年西藏棘球蚴病人群筛查和患者治疗成本效果分析[J]. 中国寄生虫学与寄生虫病杂志, 2025, 43(1): 44-51.
[11]	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.
[12]	邓冰清, 阿迪莱·多力坤, 李寅时, 阿比旦·艾尼瓦尔, 孙胜, 肖雯颖, 葛聪蕙, 唐娜, 姜涛, 王慧, 张传山, 李静. 多房棘球蚴感染小鼠腹膜腔免疫细胞迁移及其功能变化[J]. 中国寄生虫学与寄生虫病杂志, 2025, 43(1): 76-83.
[13]	邵宏莉, 冯美娟, 黄丽, 史临爱, 梁红云, 张建, 张重辉. 2013—2022年临汾市内脏利什曼病流行特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(6): 721-725.
[14]	李振伟, 王成, 王志鑫, 刘津铭, 赵乾, 王海久, 谢智. 基于三维可视化技术指导肝多房棘球蚴病手术方案的应用研究[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(6): 737-743.
[15]	祖力皮喀尔·图孙尼亚孜, 蒋铁民, 温浩. 肝多房棘球蚴病的手术治疗进展[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(6): 783-789.