中国寄生虫学与寄生虫病杂志

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2009-2014年新疆温泉县棘球蚴病流行病学调查分析

甫拉提·伊明江1,夏木西丁1,刘鸣涛1,伊斯拉音·乌斯曼2*   

  1. 1 新疆维吾尔自治区博尔塔拉蒙古自治州温泉县疾病预防控制中心,温泉 833500;2 新疆维吾尔自治区疾病预防控制中心,乌鲁木齐 830002
  • 出版日期:2016-08-30 发布日期:2016-11-07

Epidemiological Survey on Echinococcosis in Wenquan County of Xinjiang in 2009-2014

Polat IMINJIAN1, Xamixidin1, LIU Ming-tao1, Yisilayin OSMAN2*   

  1. 1 The Center for Disease Control and Prevention of Wenquan County, Boertala Mongolian Autonomous Prefecture of Xinjiang Uygur Autonomous Region, Wenquan 833500, China;2 The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi 830002, China
  • Online:2016-08-30 Published:2016-11-07

摘要:

目的 了解新疆温泉县棘球蚴病的流行程度和分布特点,为防治工作提供依据。 方法 于2009-2014年,以温泉县的2镇4乡共74个村为调查点,随机选择全年龄组部分人群采用B超常规腹部扫描检查棘球蚴感染情况;ELISA检测6~12岁学生血清棘球蚴IgG抗体;内脏剖检法调查屠宰家畜的棘球蚴感染情况;采集犬粪,ELISA检测棘球绦虫抗原。 结果 B超共检查49 627人,年龄最小5岁,最大89岁,平均36岁。查出棘球蚴病患者192人,均为细粒棘球蚴病,患病率为0.39%。几年间的患病率呈下降趋势,2009年最高,为1.22%(72/5 919),2011年最低,为0.17%(15/9 011)(P<0.05)。男性和女性患病率分别为0.34%(72/21 226)和0.42%(120/28 401),两者差异无统计学意义(P>0.05)。患者年龄分布主要集中在20~59岁人群,占总患病人数的91.67%(176/192);农业区、牧业区和城区人群的患病率分别为0.43%(130/30 492)、0.33%(49/14 649)和0.29%(13/4 486),差异无统计学意义(P>0.05)。牧民患病率最高,为0.34%(86/24 963),与其他各职业人群差异有统计学意义(P<0.05)。蒙古族和哈萨克族患病率较高,分别为0.51%(45/8 696)和0.42%(49/11 434)。文盲患病率最高,为1.92%(63/3 285),与其他学历人群差异有统计学意义(P<0.05)。ELISA共检测6~12岁学生7 369人,血清棘球蚴抗体阳性率为3.60%(265/7 369),阳性率从2009年的6.06%(37/611)降至2014年的2.59%(22/850);农业区学生的阳性率为3.99%(207/5 193),高于牧业区的2.89%(43/1 487)和城区内的2.18%(15/689)(P<0.05);汉族学生的阳性率最高,为4.06%(177/4 361)。共检查家畜4 677只,家畜棘球蚴感染率为13.04%(610/4 677),也呈逐年下降趋势,由2009年的25.05%(127/507)降至2014年的8.80%(44/500),其中2013年最低,为7.90%(79/1 000)(P<0.05)。家犬全粪棘球绦虫抗原阳性率为5.18%(365/7 049),由2009年的16.98%(81/477)逐步降至2014年的2.56%(41/1 600)(P<0.05)。 结论 温泉县棘球蚴病流行程度逐年降低,患者以青壮年为主。棘球蚴病患病率、6~12岁学生血清棘球蚴抗体阳性率、家畜棘球蚴感染率和犬棘球绦虫抗原阳性率仍较高。

关键词: 棘球蚴病, 流行病学, 调查, 温泉县, 新疆

Abstract:

Objective To understand the prevalence and distribution of echinococcosis in Wenquan County of Xinjiang, and provide evidence for control of this disease. Methods In 2009-2014, B ultrasound scan of the abdomen was conducted to examine hydatid cyst infection in populations randomly selected in 74 villages in Wenquan County. ELISA was performed to detect serum IgG antibody against hydatid cyst in 6-12-year-old students. Visceral necropsy was performed to examine hydatid cyst infection in livestocks at slaughter house. Dog feces were collected, and hydatid cyst antigen was examined by ELISA. Results A total of 49 627 people were examined, with an average age of 36 years (5-89 years). Among them, 192 (0.39%) were determined to be positive for cystic echinococcosis. The morbidity showed a trend of decrease during 2009-2014, highest in 2009(1.22%, 72/5 919) and lowest in 2014 (0.17%, 15/9 011). There was no significant difference in morbidity between males (0.34%, 72/21 226) and females(0.42%, 120/28 401). The disease was mainly distributed in age range of 20-59 years (91.67%, 176/192). There was no significant difference on morbidity in agricultural areas(0.43%, 130/30 492), pastoral areas (0.33%, 49/14 649) and towns (0.29%, 13/4 486). The morbidity in herdsmen (0.34%, 86/24 963) was significantly higher than that in those with other occupations. The morbidity was higher in Mongolian(0.51%, 45/8 696) and Kazak (0.42%, 49/11 434) than that in other ethnic groups, and highest in the illiterates (1.92%, 63/3 285). ELISA showed that the positive rate for serum antibody against hydatid cyst was 3.60% (265/7 369) in 7 369 students examined, and showed a trend of decrease from 2009 (6.06%, 37/611) to 2014(2.59%, 22/850); the positive rate was higher in agricultural areas (3.99%, 207/5 193) than that in pastoral areas (2.89%, 3/1 487) and towns (2.18%, 15/689)(P<0.05), and highest in Han students (4.06%, 177/4 361). The hydatid cyst infection rate in 4 677 livestocks was 13.04% (610/4 677), decreased from 25.05% (127/507) in 2009 to 8.80% (44/500) in 2014. The positive rate of hydatid cyst antigen in dog feces was 5.18% (365/7 049), decreased from 16.98% (81/477) in 2009 to 2.56% (41/1 600) in 2014. Conclusion The morbidity of echinococcosis showed a trend of decrease in Wenquan County, and most of the patients are young adults. There remains a high level of echinococcosis morbidity, positive rate of serum echinococcosis antibody in 6-12-year-old students, infection rate in livestocks, and existence of hydatid cyst antigen in dog feces.

Key words: Echinococcosis, Epidemiology, Investigation, Wenquan County, Xinjiang