2014年江西省人体肠道原虫感染现状调查

doi:10.12140/j.issn.1000-7423.2019.03.005

摘要/Abstract

摘要：

目的了解江西省人体肠道原虫感染现状,为制订防控措施提供参考依据。方法根据2014年全国第3次人体重点寄生虫感染现状调查方案,结合江西省具体情况,以生态区为基础,根据地理方位进行分层整群随机抽样,选择江西省28个县（市、区）84个调查点。调查对象为各调查点常住居民（12岁以下儿童不超过1/3）,每个调查点最终受检人数不少于250人。采集调查对象粪样,采用卢戈氏碘液染色法（一粪一检）检查粪样原虫包囊,生理盐水直接涂片法（一粪一检）检查滋养体。应用IBM SPSS Statistics 20软件进行统计学分析,感染率通过χ² 检验进行比较。结果共调查21 569人,肠道原虫感染率为1.4%（307/21 569）。共发现8种原虫,感染率分别为溶组织内阿米巴0.2%（45/21 569）、结肠内阿米巴0.5%（104/21 569）、蓝氏贾第鞭毛虫0.1%（26/21 569）、人芽囊原虫0.3%（68/21 569）、哈门氏内阿米巴0.1%（28/21 569）、微小内蜒阿米巴0.2%（46/21 569）、布氏嗜碘阿米巴3例和结肠小袋纤毛虫1例。南岭山地丘陵地区肠道原虫感染率最高,为2.8%（132/4 742）,以人芽囊原虫和微小内蜒阿米巴感染为主;浙闽山地丘陵地区感染率最低,为0.3%（18/5 887）,不同生态区肠道原虫感染率差异有统计学意义（P < 0.01）。九江市溶组织内阿米巴感染病例数最多,占全省病例数的93.3%（42/45）;宜春市结肠内阿米巴、蓝氏贾第鞭毛虫感染病例数较多,分别占全省病例数的65.4%（68/104）和46.2%（12/26）,仅有的1例结肠小袋纤毛虫感染病例也发现于宜春市;赣州市人芽囊原虫、哈门氏内阿米巴、微小内蜒阿米巴感染病例数较多,分别占全省病例数的69.1%（47/68）、82.1%（23/28）和97.8%（45/46）。全省存在12例混合感染病例。男、女肠道原虫感染率分别为1.4%（148/10 582）和1.5%（159/10 987）,差异无统计学意义（P > 0.05）。0~9岁人群肠道原虫感染率最高,为2.0%（64/3 243）;70≥岁人群感染率最低,为0.9%（16/1 710）,不同年龄组人群肠道原虫感染率差异无统计学意义（P > 0.05）。工、商人员肠道原虫感染率最高,为1.8%（6/329）;教师及离退休人员感染率最低,为0.8%（2/248）,不同职业间肠道原虫感染率差异无统计学意义（P > 0.05）。文盲人群肠道原虫感染率最高,为1.5%（56/3 635）,大专、大学以上人群感染率最低,为0.2%（1/219）,不同文化程度人群肠道原虫感染率差异无统计学意义（P > 0.05）。经济水平较高地区人群的肠道原虫感染率为1.3%（102/7 837）,以结肠内阿米巴感染为主;经济水平中等地区人群的感染率为0.9%（50/5 456）,以溶组织内阿米巴和蓝氏贾第鞭毛虫感染为主;经济水平较低地区人群的感染率为1.9%（155/8 276）,以人芽囊原虫和其他原虫感染为主,不同经济水平地区间肠道原虫感染率差异有统计学意义（P < 0.01）。结论江西省人体肠道原虫总感染率较低,但经济水平较低的南岭山地丘陵地区人群感染情况较严重,是未来原虫防治工作的重点。

关键词: 肠道原虫, 感染现状, 江西省

Abstract:

Objective To investigate the current status of human intestinal protozoa infections in Jiangxi Province, so as to provide the evidence for the formulation of prevention and control measures. Methods A survey was performed in 2014 according to the Protocol of the 3rd National Survey on the Status of Human Key Parasitic Infections combining with the specific economic and geographic situation in Jiangxi Province. Total 84 survey sites were chosen from 28 counties (cities and districts) using stratified cluster sampling method based on the different geographic zones. No less than 250 permanent residents with no more than 1/3 of children with age less than 12 years old were recruited in the survey in each site. The fecal samples were collected from each participant. The infected protozoan cysts were examined using iodine staining and the trophozoites were examined using direct saline smear under microscope. Each fecal sample was examined once and the statistical analysis was performed using IBM SPSS Statistics 20 and chi-square test. Results A total of 21 569 people were participated in this survey. The overall prevalence of protozoa infections was 1.4% (307/21 569) with eight species of intestinal protozoa identified. Specifically the prevalence of Entamoeba histolytica was 0.2% (45/21 569), E. coli 0.5% (104/21 569), Gardia lamblia 0.1% (26/21 569), Blastocystis hominis 0.3% (68/21 569), E. hartmani 0.1% (28/21 569) and Endolimax nana 0.2% (46/21 569). Three cases of Iodamoeba butschlii and 1 case of Balantidium coli were identified. The prevalence of protozoa infections was highest in Nanling hilly areas (2.8%, 132/4 742) with B. hominis and E. nana as dominant infected species. The lowest prevalence of protozoa infections was identified in Zhejiang/Fujian hilly areas(0.3%, 18/5 887). There was significant difference in the prevalence of intestinal protozoa infections among different ecological areas(P < 0.01). The largest number of cases of E. histolytica infection was found in Jiujiang City, accounting for 93.3% (42/45) of the total cases in the province. E. coli and G. lamblia infections were common in Yichun City, accounting for 65.4% (68/104) and 46.2% (12/26) of the total cases in the province, respectively. The 1 case of B. coli infection was also found in Yichun City. The infections of B. hominis, E. hartmani and E. nana were mostly found in Ganzhou City, accounting for 69.1% (47/68), 82.1% (23/28) and 97.8% (45/46) of the total cases in the province, respectively. There were 12 cases of mixed protozoa infections identified province-wide. There was no significant difference in the prevalence of intestinal protozoa infections between male (1.4%, 148/10 582) and female (1.5%, 159/10 987) (P > 0.05). The highest prevalence of intestinal protozoa was observed in children with age 0-9 years old (2.0%, 64/3 243), and the lowest in the elders with age above 70 (0.9%, 16/1 710), however, there was no statistical significance among different age groups (P > 0.05). In different occupation groups, the highest prevalence of intestinal protozoa infections was found in workers and businessmen(1.8%, 6/329) and the lowest in teachers and retirees (0.8%, 2/248). There was no significant difference in the prevalence among different occupations (P > 0.05) though. In different level of education, the highest prevalence was identified in population with low education (illiterate, 1.5%, 56/3 635) and the lowest in people with high education (college and above, 0.2%, 1/219), but without statistical difference in people with different educational levels (P > 0.05). The prevalence of intestinal protozoa infections in the high income areas was 1.3% (102/7 837) with E. coli as a dominant infected species. The protozoa infection in people with medium income was 0.9% (50/5 456) mainly with E. histolytica and G. lamblia infected. The infection rate in people with low income was 1.9% (155/8 276), mainly with B. hominis and other protozoans. The prevalence of intestinal protozoa infections was significant difference between people with different economic level (P < 0.01). Conclusion The overall prevalence of human intestinal protozoa infections in Jiangxi Province is low, but more serious in the population in Nanling hilly areas with lower economic level. More control measures should be performed in this part of population.

Key words: Intestinal protozoa, Infection status, Jiangxi Province

中图分类号:

R532.1

兰炜明, 葛军, 姜唯声, 谢曙英, 杭春琴, 李召军, 刘红云, 张晶, 黄成坚, 曾小军. 2014年江西省人体肠道原虫感染现状调查[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(3): 266-271.

Wei-ming LAN, Jun GE, Wei-sheng JIANG, Shu-ying XIE, Chun-qin HANG, Zhao-jun LI, Hong-yun LIU, Jing ZHANG, Cheng-jian HUANG, Xiao-jun ZENG. Current status of human intestinal protozoa infections in Jiangxi Province, China in 2014[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2019, 37(3): 266-271.

图/表 2

表1

2014年江西省4个生态区28个县（市、区）人群肠道原虫感染情况

生态区 Ecological region	市City	县（市、区） County (city and district)	检查人数 No. exam′d	感染人数 No. infected	感染率/%Prevalence/%	8种肠道原虫感染例数No. infected cases with 8 intestinal protozoa
生态区 Ecological region	市City	县（市、区） County (city and district)	检查人数 No. exam′d	感染人数 No. infected	感染率/%Prevalence/%	溶组织内阿米巴Entamoeba histolytica	结肠内阿米巴 E. coli	蓝氏贾第鞭毛虫 Gardia lamblia	人芽囊原虫Blastocystis hominis	结肠小袋纤毛虫 Balantidium coli	哈门氏内阿米巴 E. hartmani	微小内蜒阿米巴 Endolimax nana	布氏嗜碘阿米巴 Iodamoeba butschlii
南岭山地丘陵 Nanling hilly	赣州 Ganzhou	信丰县 Xinfeng	870	1	0.1	0	1	0	0	0	0	0	0
		于都县 Yudu	785	8	1.0	0	1	1	5	0	0	1	0
		寻乌县 Xunwu	785	26	3.3	0	3	1	12	0	7	4	0
		定南县 Dingnan	767	28	3.7	0	5	0	8	0	9	10	1
		石城县 Shicheng	776	41	5.3	0	14	0	14	0	4	14	0
		会昌县 Huichang	759	28	3.7	0	1	1	8	0	3	16	0
	小计 Subtotal		4 742	132	2.8	0	25	3	47	0	23	45	1
湘赣丘陵山地 Hunan-Jiangxi hilly	宜春 Yichun	上高县 Shanggao	758	5	0.7	2	2	0	0	1	0	1	0
		奉新县 Fengxin	771	68	8.8	1	66	0	1	0	0	0	0
		万载县 Wanzai	754	12	1.6	0	0	12	0	0	0	0	0
	吉安 Ji′an	万安县 Wan’an	800	1	0.1	0	0	0	1	0	0	0	0
		遂川县 Suichuan	750	0	0	0	0	0	0	0	0	0	0
	萍乡 Pingxiang	芦溪县 Luxi	861	4	0.5	0	1	2	1	0	0	0	0
	新余 Xinyu	渝水区 Yushui	749	0	0	0	0	0	0	0	0	0	0
	九江 Jiujiang	瑞昌市 Ruichang	786	20	2.5	15	3	1	0	0	0	0	1
	小计 Subtotal		6 229	110	1.8	18	72	15	3	1	0	1	1
长江中下游平原Yang-tze river basin	南昌 Nanchang	进贤县 Jinxian	1 040	1	0.1	0	0	1	1	0	0	0	0
		安义县 Anyi	833	3	0.4	0	0	1	2	0	0	0	0
	九江 Jiujiang	彭泽县 Pengze	769	10	1.3	6	3	0	0	0	1	0	0
		都昌县 Duchang	531	12	2.3	10	1	0	0	0	0	0	1
		星子县 Xingzi	760	11	1.5	11	0	0	0	0	0	0	0
	上饶 Shangrao	余干县 Yugan	778	10	1.3	0	0	6	4	0	0	0	0
	小计 Subtotal		4 711	47	1.0	27	4	8	7	0	1	0	1
浙闽山地丘陵 Zhejiang-Fujian hilly	上饶 Shangrao	玉山县 Yushan	775	5	0.7	0	2	0	3	0	0	0	0
		德兴市 Dexing	524	8	1.5	0	0	0	4	0	4	0	0
		上饶县 Shangrao	1 002	0	0	0	0	0	0	0	0	0	0
		广丰区 Guangfeng	773	1	0.1	0	0	0	1	0	0	0	0
	抚州 Fuzhou	资溪县 Zixi	762	1	0.1	0	1	0	0	0	0	0	0
		南丰县 Nanfeng	738	1	0.1	0	0	0	1	0	0	0	0
	鹰潭 Yingtan	贵溪市 Guixi	770	1	0.1	0	0	0	1	0	0	0	0
	景德镇 Jing Dezhen	浮梁县 Fuliang	543	1	0.2	0	0	0	1	0	0	0	0
	小计 Subtotal		5 887	18	0.3	0	3	0	11	0	4	0	0
	合计 Total		21 569	307	1.4	45	104	26	68	1	28	46	3

表1

表2

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