目的 比较分析江西省贫困和非贫困地区人群土源性线虫感染情况,为精准防控提供科学依据。方法 按照2014年全国第三次人体重点寄生虫病现状调查方案和细则,结合江西省的具体情况,以生态区为基础,按经济条件和地理方位分层整群抽样抽取调查点,每个调查点以自然村为单位随机整群抽取调查250 人,采用改良加藤厚涂片法检查土源性线虫感染情况;每个调查点随机抽取60名参加粪检的居民进行问卷调查。按国家公布的江西省贫困县名单,分别对2014年江西省重点寄生虫病抽样调查的数据和资料进行归类并统计和分析,感染率的比较采用卡方检验。结果 全省共调查32个县92个调查点。贫困地区土源性线虫、蛔虫和鞭虫的平均感染率分别为6.97%（466/6 690）、2.20%（147/6 690）和2.42%（162/6 690）,均高于非贫困地区的6.04%（1 022/16 916）、0.35%（59/16 916）和0.37%（63/16 916）（P < 0.01）。非贫困地区钩虫平均感染率为5.44%（920/16 916）,高于贫困地区的2.71%（181/16 916）（P < 0.01）。贫困和非贫困地区不同年龄组人群土源性线虫、钩虫感染率均随着年龄的增长呈现升高的趋势,≥70岁组最高,分别为9.54%（44/461）、13.13%（184/1 401）;蛔虫感染率贫困地区< 10岁组最高（3.07%,29/946）,非贫困地区20~29岁组最高（0.55%,6/1 088）;鞭虫感染率贫困地区≥70岁组最高（3.69%,17/461）,非贫困地区10~19岁组人群最高（0.60%,9/1 491）。<10、30~39岁组人群土源性线虫感染率贫困地区[（4.97%(47/946）、5.64%(44/780）]高于非贫困地区[1.10%(28/2 534）、2.73%(46/1 685）]（P < 0.01）;40~49岁及以上年龄组人群钩虫感染率非贫困地区[4.67%（140/2 999）、7.40%（237/3 203）、10.66%（268/2 515）、13.13%（184/1 401）]高于贫困地区[2.70%（30/1 111）、3.34%（40/1 199）、4.72%（43/911）、9.54%（44/461）]（P < 0.01）;蛔虫除20~29岁组外、鞭虫除10~19岁组外,其余各年龄组人群蛔虫、鞭虫的感染率贫困地区均高于非贫困地区（P < 0.01）。贫困和非贫困地区女性土源性线虫、钩虫和鞭虫感染率分别为8.66%（290/3 348）、6.66%（581/8 720）,3.58%（120/3 348）、6.06%（528/8 720）和2.63%（88/3 348）、0.42%（37/8 720）,均高于男性的5.27%（176/3 342）、5.38%（441/8 196）,1.83%（61/3 342）、4.78%（392/8 196）和2.21%（74/3 342）、0.32%（26/8 196）（P < 0.01）;贫困地区女性蛔虫感染率(2.75%,92/3 348）高于男性（1.65%,55/3 342）（P < 0.01）。土源性线虫女性感染率贫困地区高于非贫困地区（P < 0.01）,蛔虫、鞭虫感染率贫困地区女性和男性均高于非贫困地区（P < 0.01）,钩虫感染率非贫困地区女性和男性均高于贫困地区（P < 0.01）。非贫困地区改厕率为52.06%,低于贫困地区的61.23%（P < 0.01）,非贫困地区用新鲜粪便施肥的比例（36.31%）与贫困地区（33.72%）差异无统计学意义（P > 0.05）,非贫困和贫困地区分别有55.20%、63.62%的人有赤脚下地习惯。结论 非贫困地区钩虫和贫困地区蛔虫、钩虫、鞭虫是不同地区重点防控的虫种。40~49岁及以上人群是钩虫防治的重点对象,40~49岁以下人群是蛔虫、鞭虫防治的重点对象。

Objective To compare and analyze the status of soil-transmitted helminth (STH) infection between poverty and non-poverty areas in Jiangxi Province, in order to provide scientific basis for precise parasitic diseases control. Methods According to the protocol of the 3rd National Human Parasitic Diseases Survey in 2014, the survey sites for current study were sampled using the stratified cluster sampling method based on the economic and geographical characteristics of Jiangxi Province. From each sampled natural village, 250 villagers were randomly selected for fecal examination by modified Kato-Katz thick smear method to estimate the prevalence of STH infection. Meanwhile, 60 villagers who participated in fecal examinationin each survey site were randomly selected for the questionnaire survey. According to the list of poverty counties in Jiangxi Province issued by the government, the survey data and information of major parasitic diseases in Jiangxi Province in 2014 were sorted and analyzed. The comparison of infection rate between the poverty areas and the non-poverty areas was made by the Chi-square test. Results A total of 92 survey sites of 32 counties in Jiangxi Province were surveyed. The average infection rates of STH, Ascaris lumbricoides and Trichuris trichiura in the poverty areas were 6.97% (466/6 690), 2.20% (147/6 6690) and 2.42% (162/6 690), respectively, which were significantly higher than those of the non-poverty areas [6.04% (1 022/16 916), 0.35% (59/16 916) and 0.37% (63/16 916), respectively] (P < 0.01). The average infection rate of hookworm in non-poverty areas was 5.44% (920/16 916), which was significantly higher than the 2.71% (181/16 916) in poverty areas (P < 0.01). The infection rates of STH and hookworm in both poverty and non-poverty areas showed a trend of increase with age, which peaked in the age group of ≥70 (9.54%, 44/461; 13.13%, 184/1 401; respectively). The infection rates of A. lumbricoides peaked in the age group of <10 in the poverty areas (3.07%, 29/946) and in the age group of 20-29 years in the non-poverty areas (0.55%, 6/1 088). The infection rates of T. trichiura peaked in the age group of ≥70 in the poverty areas (3.69%, 17/461) and in the age group of 10-19 years in the non-poverty areas (0.60%, 9/1 491). The infection rates of STH in the age group of <10 and in the age group of 30-39 years in the poverty areas [4.97% (47/946), 5.64% (44/780)] were higher than those in the non-poverty areas [1.10% (28/2 534), 2.73% (46/1 685)], respectively (P < 0.01). The infection rates of hookworm in the age groups of 40-49 years and above in the non-poverty areas [4.67% (140/2 999), 7.40% (237/3 203), 10.66% (268/2 515), 13.13% (184/1 401)] were higher than those in the poverty areas [2.70% (30/1 111), 3.34% (40/1 999), 4.72% (43/911), 9.54% (44/461)], respectively (P < 0.01). The infection rates of A. lumbricoides in all age groups except the age group of 20-29 years in the poverty areas were higher than those in the non-poverty areas, and the infection rates of T. trichiura in all age groups except the group aged 10-19 years in the poverty areas were higher than those in the non-poverty areas. In both the poverty and non-poverty areas, the infection rates of STH [8.66% (290/3 348), 6.66% (581/8 720)], hookworm [3.58% (120/3 348), 6.06% (528/8 720)] and T. trichiura [2.63% (88/3 348), 0.42% (37/8 720)] in females, were higher than those in males [5.27% (176/3 342), 5.38% (441/8 196); 1.83% (61/3 342), 4.78(392/8 196) and 2.21% (74/3 342), 0.32%(26/8 196), respetively] (P < 0.01). In the poverty areas, the infection rate of A. lumbricoides in females (2.75%, (93/3 348) was higher than that in males (1.65%, 55/3 342) (P < 0.01). In females, the infection rate of STH in the poverty areas was higher than that in the non-poverty areas (P < 0.01). The infection rates of A. lumbricoides and T. trichiura both in female and males in the poverty areas were higher than those in the non-poverty areas (P < 0.01); and the infection rates of hookworm both in female and males were higher in the non-poverty areas than in the poverty areas (P < 0.01). The proportion of safe toilets in the non-poverty areas was 52.06%, significantly lower than that in the poverty areas(61.23%, P < 0.01). The rate of fertilization with fresh feces was 36.31% in the non-poverty areas, which did not differ significantly from the 33.72% in the poverty areas (P > 0.05); in addition, 55.20% and 63.62% of residents in the non-poverty and poverty areas respectively had the habit of working barefoot in field. Conclusion The survey data indicates that the key target parasites for control are hookworm in non-poverty areas, while A. lumbricoides, hookworm and T. trichiura in poverty areas, and the population at the age of 40-49 years and above is the main target for hookworm control and populations at the age of 40-49 years and below is the main target for control of A. lumbricoides and T. trichiura.