西藏自治区4种生产类型地区人群棘球蚴病流行情况

摘要/Abstract

摘要：

目的了解西藏自治区4种生产类型地区棘球蚴病流行现状。方法于2016年8-12月采用分层随机抽样和整群抽样方法抽取西藏牧区、农区、半农半牧区、城镇等4种不同生产类型地区共7个地（市）（拉萨市、林芝市、山南市、昌都市、日喀则市、那曲地区、阿里地区）70个县（区）的调查村,对1岁以上常住居民进行B超检查。结果共B超检查77 049人,检出棘球蚴病患者1 230例,检出率为1.60%,其中细粒棘球蚴病占87.64%（1 078/1 230）。4种生产类型地区人群棘球蚴病检出率以牧区人群的最高,为2.48%（572/23 038）,农区最低,为0.78%（29/3 719）,半农半牧区和城镇分别为1.46%（470/32 173）和0.94%（159/16 899）;4种生产类型地区人群棘球蚴病检出率差异有统计学意义（χ² = 171.670,P < 0.05）。男性和女性棘球蚴病检出率均以牧区最高,分别为2.05%（220/10 756）和2.74%（352/12 854）;牧区（2.74%）和半农半牧区（1.66%,310/18 632）的女性棘球蚴病检出率均高于男性（2.05%;1.14%,160/14 011）（χ² = 11.899,P < 0.01;χ² = 15.347,P < 0.05）。不同年龄组的人群棘球蚴病检出率以牧区的60~岁年龄组最高,为5.56%（130/2 338）,城镇< 15岁年龄组未检出;农区、牧区和半农半牧区的人群棘球蚴病检出率均随年龄组增高呈上升趋势,且差异均有统计学意义（χ²_趋势 = 39.057,179.698,100.914;P < 0.05）。不同文化程度的人群棘球蚴病检出率以牧区的文盲人群最高,为3.21%（438/13 633）,城镇的学龄前儿童未检出;不同生产类型地区的文盲、小学、初中、高中及以上人群棘球蚴病检出率差异均有统计学意义（χ² = 99.676,16.683,16.650,11.222;P < 0.05）。不同居住方式人群的棘球蚴病检出率以半农半牧区的夏季游牧冬季定居人群最高,为4.09%（73/1 783）,牧区和农区的其他居住方式人群未检出;4种生产类型地区的不同居住方式人群棘球蚴病检出率差异有统计学意义（χ² = 503.452,P < 0.01）。结论西藏4种生产类型地区人群棘球蚴病检出率以牧区最高,其中高年龄组人群、文盲人群、女性人群应列为重点防治对象。

关键词: 棘球蚴病, 检出率, 生产类型, 西藏自治区

Abstract:

Objective To investigate the prevalence of echinococcosis in regions of four production types in Tibet Autonomous Region. Methods Seventy villages were selected using the stratified cluster sampling method in 7 cities/districts of four types of production (pastoral area, semi-agricultural and semi-pastoral area, agricultural area, and town), from August to October, 2016. B ultrasound examination was performed in residents aged > 1 year. Results Among the 77 049 persons receiving B ultrasound examination, 1 230 were detected to have hydatid disease (1.60%), dominated by cystic echinococcosis (87.64%, 1 078/77 049). The prevalence was highest in pastoral area (2.48%, 572/23 038), lowest in agricultural area (0.78%, 29/3 719), and 1.46%（470/32 173）and 0.94%（159/16 899）in semi-agricultural and semi-pastoral area and town, respectively, and was significantly different among the regions of four types of production (χ² = 171.670, P < 0.05). The prevalence in males and females was both highest in pastoral area (2.05%, 220/10 756 and 2.74%, 352/12 854). In females, it was higher than that in males in pastoral area (2.74%, 352/12 854 versus 2.05%, 220/10 756; χ² = 11.899, P < 0.01) as well as in semi-agricultural and semi-pastoral area (1.66%, 310/18 632 versus 1.14%, 160/14 011; χ² = 15.347, P < 0.05). Among different age groups, the prevalence was highest in the population group of > 60 years in pastoral area (5.56%, 130/2 338) and lowest in the group of < 15 year in town; the prevalence showed a trend of increase with increased age in agricultural areas, pastoral area, and semi-agricultural and semi-pastoral area, with a significant difference (χ²_trend = 39.057, 179.698, 100.914; P < 0.05). Among different educational levels, the prevalence was highest in illiteracy population in pastoral area (3.21%, 438/13 633) and no case was found in the preschool children in the town. There was a significant difference in prevalence among different education groups in regions of each type of production (χ² = 99.676, 16.683, 16.650, 11.222; P < 0.05). The prevalence was highest in populations with settlement type of summer nomads and winter settlers in semi-agricultural and semi-pastoral area (4.09%, 73/1 783) and no case was found in populations with other settlement types in pastoral area and agricultural area (χ² = 178.608, P < 0.01). There was a significant difference in prevalence among different settlement types in regions of each type of production (χ² = 503.452,P < 0.01). Conclusion The prevalence of echinococcosis in human population is highest in pastoral area in Tibet. In particular, specific attention of disease prevention should be paid to the older population, the illiteracy, and females.

Key words: Echinococcosis, Prevalence, Type of production, Tibet Autonomous Region

中图分类号:

R532.32

白玛央金, 韩帅, 何瑞峰, 贡桑曲珍, 索郎旺杰. 西藏自治区4种生产类型地区人群棘球蚴病流行情况[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(1): 26-30.

Yang-jin BAIMA, Shuai HAN, Rui-feng HE, Qu-zhen GONGSANG, Wang-jie SUOLANG. Prevalence of hydatid disease in regions of four production types in Tibet Autonomous Region[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(1): 26-30.

图/表 1

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特征Features		牧区 Pastoral area			农区 Agricaltural area			半农半牧区 Semi-agricultural and semi-pastoral area			城镇 Town
特征Features		检查人数 No. exam′d	检出患病人数 No. patients	检出率 /%Prevalence/%	检查人数 No. exam′d	检出患病人数 No. patients	检出率 /%Prevalence/%	检查人数 No. exam′d	检出患病人数 No. patients	检出率 /%Prevalence/%	检查人数 No. exam′d	检出患病人数 No. patients	检出率/%Prevalence/%
性别 Gender	男性Male	10 756	220	2.05	7 062	60	0.85	14 011	160	1.14	1 291	7	0.54
性别 Gender	女性Female	12 854	352	2.74	2 457	22	0.90	18 632	310	1.66	9 986	99	0.99
年龄组 Age group	1~14	5 358	34	0.63	3 203	8	0.25	6 289	27	0.43	384	0	0
	15~29	5 007	91	1.82	2 243	13	0.58	4 991	66	1.32	480	6	1.25
	30~44	6 428	173	2.69	4 175	36	0.86	9 032	113	1.25	1 046	4	0.38
	45~59	4 479	144	3.22	4 841	58	1.20	8 168	143	1.75	1 231	13	1.06
	≥ 60	2 338	130	5.56	2 586	44	1.70	4 163	121	2.91	607	6	0.99
文化程度 Education level	高中及以上 High school and above	568	15	2.64	513	3	0.58	928	8	0.86	401	3	0.75
	初中 Junior middle school	1 376	27	1.96	1 053	11	1.04	2 167	13	0.60	357	1	0.28
	小学Primary school	5 758	84	1.46	6 860	53	0.77	11 470	120	1.05	1 166	7	0.60
	学龄前Preschool	2 275	8	0.35	1 463	1	0.07	2 467	4	0.16	125	0	0
	文盲Illiteracy	13 633	438	3.21	7 159	91	1.27	15 611	325	2.08	1 699	18	1.06
居住方式 Settlement type	定居settled	15 953	405	2.54	16 437	158	0.96	30 647	389	1.27	3 740	27	0.72
	游牧Nomadic	3 619	83	3.21	370	0	0	190	6	3.16	5	1
	夏季游牧冬季定居 Summer nomads and winter settlers	212	1	0.47	0	0	0	1 783	73	4.09	3 993	84	2.10
	其他Others	45	0	0	29	0	0	23	2	8.70	3	1	1/3