收稿日期: 2023-01-27
修回日期: 2023-03-27
网络出版日期: 2023-04-20
基金资助
国家重点研发计划(2021YFC2300800);国家自然科学基金地区项目(2021YFC2300804)
Progress of echinococcosis control in China, 2021
Received date: 2023-01-27
Revised date: 2023-03-27
Online published: 2023-04-20
Supported by
National Key Research and Development Program of China(2021YFC2300800);National Key Research and Development Program of China(2021YFC2300804)
为掌握全国棘球蚴病防治进展,对2021年全国棘球蚴病防治工作数据进行了汇总和分析。截至2021年底,全国共有370个棘球蚴病流行县(市、区、旗)30 421个流行村,流行乡常住人口4 758.41万人。2021年全国流行县(市、区、旗)现有棘球蚴病患者26 773例,平均患病率为0.06%(26 773/47 584 117),其中细粒棘球蚴病16 625例,多房棘球蚴病8 327例,混合感染311例,未分型1 510例;新发现棘球蚴病患者1 346例,其中细粒棘球蚴病1 075例,多房棘球蚴病86例,混合感染7例,未分型178例;< 12岁人群147例,≥ 12岁常住人群1 199例。2021年,全国棘球蚴病流行省(自治区)共开展人群腹部超声筛查447.17万人次,其中,< 12岁人群筛查87.15万人次,≥ 12岁常住人群筛查360.02万人次;血清学检测11 358人次。2021年370个监测点< 12岁人群超声筛查患病检出率为0.02%(72/336 959),其中新发现患者占检出患者数的58.33%(42/72);≥ 12岁常住人群中,Ⅰ、Ⅱ类流行县(市、区、旗)监测点超声筛查患病检出率为0.26%(922/355 006),新发现患者占检出患者数的10.52%(97/922)。2021年开展药物治疗19 552人,肝肾功能检查及不良反应处置14 440人,手术治疗1 792人,其中以细粒棘球蚴病(占71.15%,1 275/1 792)和多房棘球蚴病(占23.66%,424/1 792)为主;2021年随访结果显示,治愈3 063例,治疗有效22 660例,治疗无效2 356例,死亡(死因非棘球蚴病)359例,排除棘球蚴病285例,失访301例,未到随访时间312例,病例外迁他地146例。2021年全国流行乡(镇)共有犬2 626 679条,其中登记管理的犬2 389 828条。35 019个村开展了犬驱虫工作,家犬药物驱虫25 844 226次,野外犬科动物驱虫投药131 315份。采集并检测家犬粪样555 688份,粪棘球绦虫抗原阳性2 614份,阳性率为0.47%;采集并检测野外犬科动物粪样54 266份,粪棘球绦虫抗原阳性422份,阳性率为0.78%。2021年抽查屠宰的家畜222 844头,阳性1 408头,阳性率为0.63%;检查野外啮齿类动物56 124只,阳性599只,阳性率为1.07%。棘球蚴病流行态势得到基本控制,但防治工作还存在诸多困难和挑战,部分流行区传染源控制可能存在漏洞,不排除在野外环境中存在传播链的可能。应继续以棘球蚴病综合干预区为抓手,探索优化防治策略,提高基层疾控机构的棘球蚴病防治能力,开展棘球蚴病野外传播控制试点,强化监测预警体系,进一步遏制棘球蚴病流行。
蒉嫣 , 薛垂召 , 王旭 , 刘白雪 , 王莹 , 王立英 , 杨诗杰 , 韩帅 , 伍卫平 , 肖宁 . 2021年全国棘球蚴病防治进展[J]. 中国寄生虫学与寄生虫病杂志, 2023 , 41(2) : 142 -148 . DOI: 10.12140/j.issn.1000-7423.2023.02.003
In order to understand the work progress in nationwide control of echinococcosis, data related to echinococcosis prevention and control in 2021 were collected and analyzed. As of the end of 2021, echinococcosis was found endemic in 370 counties (city, district, banner) covering 30 421 endemic villages in China. There were 47 584 117 permanent residents living in endemic townships. In 2021, 26 773 echinococcosis cases were documented in endemic counties (cities, districts, banners), with an average prevalence 0.06% (26 773/47 584 117), among them, 16 625 cases were of cystic, and 8 327 cases alveolar echinococcosis, 311 cases mixed infection, 1 510 cases unclassified. A total of 1 346 cases were newly diagnosed in 2021, including 1 075 cases of cystic echinococcosis, 86 cases of alveolar echinococcosis, 7 cases of mixed infection, and 178 cases of unclassified. In 2021, population screening by abdominal ultrasound scanning was performed in all endemic provinces (autonomous regions) for 4.471 7 million person/times, of them, 0.871 5 million person/examinations were for people under age of 12, 3.600 2 million person/times for permanent residents aged ≥ 12; serological examination was carried out for 11 358 person/times. Recorded from 370 surveillance sites in 2021, positive rate of ultrasound detection in people under age of 12 was 0.02% (72/336 959), of which 58.33% (42/72) were newly diagnosed. The positive rate of ultrasound imaging in permanent residents aged ≥ 12 was 0.26% (922/355 006) in type Ⅰ, Ⅱ endemic counties (city, district, banner), and the newly diagnosed patients accounted for 10.52% (97/922) of the detected patients. In 2021, 19 552 people received drug treatment, 14 440 people received liver and kidney function tests or treatment of adverse reactions. A total of 1 792 patients received surgical treatment, among them cystic echinococcosis accounted for 71.15% (1 275/1 792) and alveolar echinococcosis accounted for 23.66% (424/1 792). In 2021, the follow-up results showed that 3 063 cases were cured, 22 660 cases responded to the treatment, 2 356 cases failed in the treatment, 359 cases died (the cause of death was not echinococcosis), 285 cases were excluded, 301 cases were lost in follow-up, 312 cases had not completed the follow-up, and 146 cases migrated to other places. In 2021, there were 2 626 679 dogs in endemic townships (towns) nationwide, of which 2 389 828 were registered and documented. In 35 019 villages, deworming was conducted for dogs, with 25 844 226 deworming for domestic dogs and 131 315 deworming drug sites were distributed for wild canines. A total of 555 688 fecal samples from domestic dogs were collected and tested, of which 2 614 were found Echinococcus coproantigen positive, with a positive rate of 0.47% (2 614/555 688). Of wild canidae, 54 266 field fecal samples were collected and tested, among which, 422 were found Echinococcus coproantigent positive, with a positive rate of 0.78%. A total of 222 844 slaughtered livestock were randomly examined, among which 1 408 were positive, with a positive rate of 0.63% (1 408/222 844); and 56 124 field rodents were examined, of which 599 were found positive, with a positive rate of 1.07% (599/56 124). The epidemic state of echinococcosis has been basically controlled, but there are still many difficulties and challenges in the control and prevention. It is noted that there may be flaws in the control of the source of infection in some endemic areas, and it is likely that there might exist transmission chain in wild environment. It is imperative to continuously advance the comprehensive intervention areas as gripper to explore and optimize the control strategy, enhance the capacity of primary disease control institutions for control of echinococcosis, carry out pilot trial for controlling echinococcosis transmission in wild field, strengthen the surveillance-early warning system to further curb the epidemic of echinococcosis.
Key words: Echinococcosis; Cystic echinococcosis; Alveolar echinococcosis; Epidemiology; China
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