Abstract:

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.

Key words: Soil-transmitted helminth, Poverty and non-poverty areas, Infection analysis, Jiangxi Province