目的 分析云南大理地区人群带绦虫感染和囊尾蚴抗体的流行特征及影响因素，为带绦虫和囊尾蚴病的防控提供科学依据。 方法 2023年10—11月，在大理州带绦虫病和囊尾蚴病历史流行区选择大把关村、伙山村、金刚村和清水沟村开展调查，采用整群随机抽样的方法，抽取调查村3周岁以上常住居民为调查对象。通过问卷调查收集是否有排节片史、皮下结节、癫痫和剧烈头痛等症状以及饮食习惯、卫生行为和居住环境等信息；采集究对象粪样进行改良加藤厚涂片法（Kato-Katz法，一粪两检）检测，对粪检阳性或近一年有排节片史者采用槟榔南瓜子法进行药物诊断性驱虫。以粪检阳性或驱出虫体者为阳性感染者，计算带绦虫感染率。用囊尾蚴（猪带绦虫）IgG抗体检测试剂盒检测血清囊尾蚴特异性抗体。采用卡方检验、Fisher确切概率法和logistic回归分析对人群带绦虫感染和血清囊尾蚴抗体阳性的影响因素进行统计学分析。 结果 4个村共1 842人参与问卷调查，近一年排节片者39人（占2.1%）。粪检1 533人，粪检阳性者25人（占1.6%）。共38人接受诊断性驱虫，33人驱出完整虫体（1名粪检阳性者未驱出虫体），人群带绦虫感染率为1.8%（34/1 842）。金刚、伙山、大把关和清水沟村人群带绦虫感染率分别为2.1%（10/475）、1.3%（6/450）、2.7%（12/450）、1.3%（6/467），差异无统计学意义（χ² = 3.31，P > 0.05）。男性感染率为2.6%（22/848），女性为1.2%（12/994）（χ² = 4.90，P < 0.05）；30~59岁年龄组（2.8%，24/862）、苗族（1/2）和农牧民（3.0%，28/944）等人群的感染率在各组中均为最高（χ² = 10.10，P < 0.01；Fisher = 26.04，P < 0.01；χ² = 13.47，P < 0.01）。人群血清囊尾蚴抗体阳性率为9.2%（82/887）。清水沟、大把关、伙山和金刚村的血清抗体阳性率分别为12.7%（20/157）、4.7%（11/236）、10.4%（26/251）、10.3%（25/243），差异有统计学意义（χ² = 8.88，P < 0.05）。男性阳性率为9.2%（36/393），女性为9.3%（46/494）（χ² = 0.01，P > 0.05）。60岁以上年龄组（2.8%，24/862）、农牧民（11.2%，61/546）和文盲（15.0%，35/234）等人群的血清抗体阳性率在各组内均为最高（χ² = 8.66、12.37、6.47，P < 0.05 或 0.01）。单因素分析结果显示，不同性别、年龄、民族、职业和食用生猪制品（生猪皮、猪肉、猪肝）是带绦虫感染的影响因素（χ² = 4.86、10.10、26.04、13.48、5.72，均为P < 0.05）。每月食用生猪制品的次数与带绦虫感染率之间存在正相关关系[OR = 1.135，95% CI：（1.023，1.259）]；不同年龄、文化程度、职业、是否使用自来水及食用生猪制品是血清囊尾蚴抗体阳性率的影响因素（χ² = 8.66、12.37、6.47、3.58、2.20，均为P < 0.05）。多因素分析结果显示，男性[OR = 2.047，95% CI：（1.001，4.189）]、食用生猪制品[OR = 4.986，95% CI：（1.166，21.321）]是人群感染带绦虫的危险因素，低文化程度[OR = 2.051，95% CI：（1.183，3.557）]是人群血清囊尾蚴抗体阳性的危险因素，使用自来水[OR = 0.320，95% CI：（0.124，0.824）]是人群血清囊尾蚴抗体阳性的保护因素。 结论 云南大理地区人群带绦虫感染率和血清囊尾蚴抗体阳性率较高，食用生猪制品和男性是带绦虫感染的危险因素；自来水的使用和高文化程度是血清囊尾蚴抗体阳性的保护因素。

Objective To analyze the epidemic characteristics and influencing factors of Taenia infection and cysticercus antibody in the residents of Dali, Yunnan, to provide a scientific basis for prevention and control of taeniasis and cysticercosis. Methods From October to November 2023, a survey was conducted in Dabaguan Village, Huoshan Village, Jingang Village and Qingshuigou Village in the historical endemic area of taeniasis and cysticercosis in Dali Prefecture. Permanent residents aged over 3 years were enrolled in the survey using the method of cluster random sampling. A questionnaire survey was conducted to collect information including whether there was a history of proglottid excreted, subcutaneous nodules, symptoms of epilepsy and severe headache, as well as the dietary habits, hygiene behaviors and living environment. Fecal samples were collected, and examined by the modified Kato-Katz method (two slide-reading for each sample). For residents with positive fecal test results or with a history of excreting proglottids in the past year, pharmacological diagnostic deworming was conducted using the areca-pumpkin seed method. Those positives in fecal examination and found expelled worms were considered as the infected persons and used to calculate the infection rate. Serum cysticercus specific antibodies were detected using cysticercus (Taenia solium) IgG antibody detection kit. The chi-square test, Fisher’s exact probability method and logistic regression analysis were used to analyze the influencing factors of Taenia infection and serum cysticercus antibody positivity in the population. Results A total of 1 842 people from the 4 villages participated in the questionnaire survey, and 39 people (2.1%) had excreted proglottids in the past year. Fecal examination was performed on 1 533 people, and 25 people (1.6%) were found positive. A total of 39 people received diagnostic deworming, and 33 people expelled complete worms (1 person positive in fecal examination did not expel the parasite), and the infection rate was 1.8% (34/1 842). The infection rates in the Jingang, Huoshan, Dabaguan and Qingshuigou villages were 2.1% (10/475), 1.3% (6/450), 2.7% (12/450) and 1.3% (6/467), respectively, with no significant difference (χ² = 3.31, P > 0.05). The infection rate was 2.6% (22/848) in males and 1.2% (12/994) in females (χ² = 4.90, P < 0.05). The infection rates of the 30-59 age group (2.8%, 24/862), Miao (1/2), and farmers and herdsmen (3.0%, 28/944) were the highest in each group (χ² = 10.10, P < 0.01; Fisher = 26.04, P < 0.01; χ² = 13.47, P < 0.01). The positive rate of serum cysticercus antibody was 9.2% (82/887). Positive rates of serum antibodies in Qingshuigou, Dabaguan, Huoshan and Jingang villages were 12.7% (20/157), 4.7% (11/236), 10.4% (26/251) and 10.3% (25/243), respectively, with significant differences (χ² = 8.88, P < 0.05). The positive rates in males were 9.2% (36/393) and 9.3% (46/494) in females (χ² = 0.01, P > 0.05). The serum antibody positive rates in the groups aged 60 years and above (2.8%, 24/862), farmers and herdsmen (11.2%, 61/546) and illiterate people (15.0%, 35/234) were the highest in each group (χ² = 8.66, 12.37, 6.47, P < 0.05 or 0.01). The results of univariate analysis showed that gender, age, nationality, occupation and consuming raw pork products (raw pig skin, pork and liver) were the influencing factors of Taenia infection (χ² = 4.86, 10.10, 26.04, 13.48, 5.72, all P < 0.05). There was a positive correlation between the frequency of consuming raw pork products per month and Taenia infection rate[OR = 1.135, 95% CI: (1.023, 1.259)]. The age, education level, occupation, use of tap water and consuming raw pork products were influencing factors for the positive rate of serum cysticercus antibody (χ² = 8.66, 12.37, 6.47, 3.58, 2.20, all P < 0.05). The results of multivariate analysis showed that males [OR = 2.047, 95% CI: (1.001, 4.189) ] and eating raw pork products [OR = 4.986, 95% CI: (1.166, 21.321) ] were the risk factors for Taenia infection. The low education level [OR = 2.051, 95% CI: (1.183, 3.557)] was a risk factor for positive serum cysticercus antibody, while using tap water [OR = 0.320, 95% CI: (0.124, 0.824) ] was a protective factor for positive serum cysticercus antibody. Conclusion Considerably high Taenia infection rate and positive rate of serum cysticercus antibody are observed in the residents of Dali, Yunnan. Eating raw pork products and male gender are the risk factors for Taenia infection; using tap water and high education level are the protective factors for positive serum cysticercus antibody.