Prevalence and influencing factors of hydatid disease among children in Tibet Autonomous Region

Abstract

Abstract:

Objective To understand the prevalence of hydatid disease in children in Tibet Autonomous Region and analyze the influencing factors of the disease. Methods A stratified cluster sampling method was used to select 364 villages in 70 counties (distict) from August to October, 2016. In each village, 200 residents including children were randomly selected for B ultrasound examination, accompanied by a serological test for those suspected. In each village, 20 local residents were selected using a random number table method, and in each county, a primary school was selected, from which 50 students of grades 4-6 were selected. Their knowledge and behaviors on hydatid disease control were surveyed by face-to-face Q & A. In each village, 20 dog-raising households were selected randomly and in each household, fecal sample (1-3 g) was collected from only one dog. Statistical analysis was carried out using SPSS 19.0 statistical software. Results A total of 13 651 children were examined, with a prevalence of 0.40% (55/13 651) for hydatid disease. In the 70 counties (district) surveyed, child cases were found in only 25 counties(district), of which 23 had children with cystic hydatid disease and 5 had children with alveolar hydatid disease. The top 5 counties with regard to the prevalence were Zuogong County in Changdu City (11.84%, 9/76), Cuoqin County in Ali Prefecture (1.84%, 4/218), Zhongba County in Shigatse City (1.59%, 3/189), Langkazi County in Shannan City (1.50%, 2/133), and Gaize County in Ali Prefecture (1.37%). Among 6 660 girls examined, 32 were detected with hydatid disease (0.48%), and among 6 991 boys examined, 23 were detected with hydatid disease (0.33%). Among 6 770 children under 6 years, 13 were found with hydatid disease (0.19%)(13/6 770), and among 6 881 children aged 7-12 years, 42 were found with hydatid disease (0.61%)(42/6 881)(χ² = 13.86, P < 0.05). By setting 3 years as an age subgroup, each subgroup had cases of hydatid disease, and the prevalence showed a trend of increase with age (χ² = 17.69, P < 0.05). The antigen positive rate of dog feces was a leading risk factor （OR = 3250.2,P < 0.05）, followed by age and the rate of dog-raising, and the qualified rate of questionnairing was the protective factor. Conclusion Hydatid disease in children is related to age, dog-raising and daily hygienic habits.

Key words: Hydatid disease, Tibet Autonomous Region, Children, Influencing factors

CLC Number:

R532.32

Chui-zhao XUE, Wei-ping WU, Shuai HAN, Can-jun ZHENG, Ying WANG, Li-ying WANG, Qing YU, Shan-shan ZHANG, Xiao-nong ZHOU, Ning XIAO, Jian-ping CAO, Qu-zhen GONGSANG, Chun-li CAO, Tian TIAN, Wei-qi CHEN, Xin-liu YAN. Prevalence and influencing factors of hydatid disease among children in Tibet Autonomous Region[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2018, 36(1): 20-25.

Figures/Tables 4

Table 1

Prevalence of hydatid disease among children in 70 counties of Tibet Autonomous Region in 2016

地（市） City（Prefecture)	县（区） County(District)	检查人数 No. exam′d	多房棘球蚴病 Alveolar hydatid disease		细粒棘球蚴病 Cystic hydatid disease		合计Total
地（市） City（Prefecture)	县（区） County(District)	检查人数 No. exam′d	检出患病人数 No. patients	检出率/%Prevalence/%	检出患病人数 No. patients	检出率/%Prevalence/%	检出患病人数 No. patients	检出率/%Prevalence/%
拉萨市 Lhasa	当雄县Dangxiong	204	1	0.49	0	0	1	0.49
拉萨市 Lhasa	曲水县Qushui	294	0	0	1	0.34	1	0.34
	其他几个县Others	840	0	0	0	0	0	0
	小计Subtotal	1 338	1	0.07	1	0.07	2	0.15
昌都市 Changdu	左贡县Zuogong	76	1	1.32	8	10.53	9	11.84
昌都市 Changdu	丁青县Dingqing	411	1	0.24	1	0.24	2	0.49
	芒康县Mangkang	305	0	0	2	0.66	2	0.66
	其他几个县Others	1 744	0	0	0	0	0	0
	小计Subtotal	2 536	2	0.08	11	0.43	13	0.51
山南市 Shannan	浪卡子县Langkazi	133	0	0	2	1.50	2	1.50
山南市 Shannan	其他几个县Others	1 048	0	0	0	0	0	0
	小计Subtotal	1 181	0	0	2	0.17	2	0.17
日喀则市 Shigatse	仲巴县Zhongba	189	0	0	3	1.59	3	1.59
日喀则市 Shigatse	吉隆县Jilong	276	0	0	3	1.09	3	1.09
	定结县Dingjie	147	0	0	1	0.68	1	0.68
	定日县Dingri	505	0	0	2	0.40	2	0.40
	萨迦县Sajia	172	0	0	1	0.58	1	0.58
	昂仁县Angren	488	0	0	2	0.41	2	0.41
	南木林县Nanmulin	498	0	0	2	0.40	2	0.40
	桑珠孜区Sangzhuzi	737	0	0	2	0.27	2	0.27
	江孜县Jiangzi	393	1	0.25	0	0	1	0.25
	其他几个县Others	1 099	0	0	0	0	0	0
	小计Subtotal	4 504	1	0.02	16	0.36	17	0.38
那曲地区 Nagqu	申扎县Shenzha	158	0	0	2	1.27	2	1.27
那曲地区 Nagqu	那曲县Naqu	596	0	0	4	0.67	4	0.67
	比如县Biru	401	0	0	1	0.25	1	0.25
	其他几个县Others	889	0	0	0	0	0	0
	小计Subtotal	2 044	0	0	7	0.34	7	0.34
阿里地区Ali	措勤县Cuoqin	218	2	0.92	2	0.92	4	1.83
	改则县Gaize	293	0	0	4	1.37	4	1.37
	普兰县Pulan	77	0	0	1	1.30	1	1.30
	日土县Ritu	95	0	0	1	1.05	1	1.05
	噶尔县Gaer	203	0	0	2	0.99	2	0.99
	革吉县Geji	177	0	0	1	0.56	1	0.56
	其他几个县Others	95	0	0	0	0	0	0
	小计Subtotal	1 158	2	0.17	11	0.95	13	1.12
林芝市Nyingchi	工布江达县 Gongbujiangda	108	0	0	1	0.93	1	0.93
其他几个县Others	工布江达县 Gongbujiangda	108	0	0	1	0.93	1	0.93	782	0	0	0	0	0	0
	小计Subtotal	890	0	0	1	0.11	1	0.11
合计Total		13 651	6	0.04	49	0.36	55	0.40

Table 1

Table 2

Table 3

Table 4

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地（市） City (Prefecture)	调查县数/个 No. counties surveyed	患病率分级（县数）/个 Grading statistics of the hydatid disease detection rate (No. counties)
地（市） City (Prefecture)	调查县数/个 No. counties surveyed	< 0.1%	0.1%~	1.0%~	≥ 2.0%	总计Total
拉萨市Lhasa	8	6	2	0	0	8
昌都市Changdu	11	8	2	0	1	11
山南市Shannan	11	10	0	1	0	11
日喀则市Shigatse	17	8	7	2	0	17
那曲地区Nagqu	10	7	2	1	0	10
阿里地区Ali	7	1	2	4	0	7
林芝市Nyingchi	6	5	1	0	0	6
总计Total	70	45	16	8	1	70

年龄组 Age group	检查人数 No. exam′d	检出患病人数 No. patients	检出率/% Prevalence/%
1~3	2 324	2	0.09
4~6	4 446	11	0.25
7~9	3 528	18	0.51
10~12	3 353	24	0.72
合计Total	13 651	55	0.40

指标Index	系数 B	标准误 S.E.	wald卡方值 Wals	P值 P value	比值比 EXP(B)	95%可信区间 95% Confidence interval
年龄Age	0.202	0.049	16.80	0.000	1.224	(1.111, 1.349)
养犬率Dog raising rate	0.010	0.004	5.03	0.025	1.010	(1.001, 1.019)
犬粪抗原阳性率Antigen positive rate in dog feces	8.086	0.992	66.39	0.000	3 250.177	(464.657, 22 734.293)
问卷合格率Qualified rate of questionnairing	-1.670	0.797	4.39	0.036	0.188	(0.039, 0.898)
常数Constant	-8.372	0.609	188.81	0.000	0.000