Prevalence and influencing factors of Enterobius vermicularis infection among kindergarten children in Jiangsu Province from 2019 to 2022

doi:10.12140/j.issn.1000-7423.2023.06.007

Abstract

Abstract:

Objective To investigate the current status, trend of changes and influencing factors of Enterobius vermicularis infection in kindergarten children in Jiangsu Province, in order to provide the scientific basis for adjustment and improvement of enterobiasis control strategy. Methods From 2019 to 2022, at least one county (city, district) was selected from the southern, central and northern parts of the Province as survey sites, from each of which two kindergartens (one rural type and one urban type) with a size over 200 children each were selected for cluster sampling the participants. In each kindergarten, no less than 200 chidren separately from senior, middle, and junior classes participated in the suvey. Anal swab method was used to detect E. vermicularis eggs by microscopy. Children’s parents underwent questionnaire survey on basic information of children, hygienic habits related to E. vermicularis infection, family background, and knowledge awareness of enterobiasis. Results A total of 15 669 children were examined in 21 counties (districts, cities), and the overall prevalence rate of pinworm infection was 0.7% in Jiangsu Province from 2019 to 2022. The annual prevalence was 1.2% (44/3 678), 0.5% (13/2 568), 0.7% (27/3 802) and 0.4% (22/5 621), with a significant decrease detected among the years (χ² = 14.46，P < 0.05). The annual prevalence of rural kindergarten was 2.1% (41/1 981), 0.2% (2/833), 1.0% (8/824) and 0.6% (19/3 271), with a significant decrease detected among the years (χ² = 17.34，P < 0.05). The annual prevalence of urban kindergarten was 0.2% (4/1 697), 0.6% (10/1 635), 0.7% (20/2 987) and 0.2% (6/2 650), with no significant difference detected among years (χ² = 0.04, P > 0.05). The overall prevalence of South Jiangsu, Central Jiangsu, and North Jiangsu from 2019 to 2022 was 1.0% (56/5 698), 0.5% (32/6 135), and 0.5% (22/4 136). The prevalence among children of the senior class was 1.8% (23/1 266), 0.8% (8/998), 1.4% (16/1 167), and 0.6% (10/1 796) from 2019 to 2022, respectively, with a significant decrease detected among years (χ² = 8.01, P < 0.05), which were higher than that among children of the middle and junior class. The prevalence among children of middle class was 1.0% (13/1 325), 0.5% (4/871), 0.5% (9/1 687), and 0.5% (10/2 063) from 2019 to 2022, respectively. The prevalence among children of junior class was 0.8% (9/1 087), 0 (0/699), 0.3% (3/948), and 0.3% (5/1 762) from 2019 to 2022, respectively. The sucking-finger habit accounted for 20.8%, 17.4%, 20.5%, and 19.4% from 2019 to 2022, respectively. The habit of sucking toys/pens accounted for 12.5%, 9.3%, 10.1%, and 12.6% from 2019 to 2022, respectively. A total of 61.9%, 76.0%, 78.5%, and 70.3% (from 2019 to 2022, respectively) parents reported that they knew enterobiasis, with a significant increase detected among the years (χ² = 202.86, P < 0.05). Being older (OR = 1.447, 95% CI = 1.186-1.764, P < 0.05), a low frequency of laundry (OR = 1.121, 95% CI = 1.002-1.225, P < 0.05), and rural precshool (OR = 0.509, 95% CI = 0.333-0.776, P < 0.05) were risk factors for pinworm infection. Conclusion The prevalence of E. vermicularis infection remained comparatively low in kindergarten children in Jiangsu Province from 2019 to 2022, with a prevalence decreasing trend. However, there exist inadequate hygienic habits in children, and parents showed low knowledge awarness rate on enterobiasis. It is suggested that the factors influencing pinworm infection in kindergarten may include children age, the frequency of washing and sunshining exposure of beddings, and the type of kindergartens.

Key words: Enterobius vermicularis infection, Risk factor, Preschool, Children, Jiangsu Province

CLC Number:

R383.12

MAO Fanzhen, LI Xuecheng, XU Xiangzhen, DAI Yang, LIU Yaobao, CAO Jun. Prevalence and influencing factors of Enterobius vermicularis infection among kindergarten children in Jiangsu Province from 2019 to 2022[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2023, 41(6): 708-717.

Figures/Tables 6

Table 1

Table 2

Enterobius vermicularis infections among kindergarten children in Jiangsu Province from 2019 to 2022

特征 Feature	2019			2020			2021			2022
特征 Feature	调查人数（占比/%） No. investigations (Proportion/%)	感染率/% Infection rate/%	χ²	调查人数（占比/%） No. investigations (Proportion/%)	感染率/% Infection rate/%	χ²	调查人数（占比/%） No. investigations (Proportion/%)	感染率/% Infection rate/%	χ²	调查人数（占比/%） No. investigations (Proportion/%)	感染率/% Infection rate/%	χ²
地区 Area			25.44^a			2.02			0.79			5.39^a
农村 Rural area	1 982(53.9)	2.1		933(36.6)	0.2		824(21.7)	1.0		2 972(52.9)	0.6
城区 Urban area	1 697(46.1)	0.2		1 635(63.7)	0.6		2 978(78.3)	0.7		2 649(47.1)	0.2
性别 Gender			0.02			4.60^a			0.04			0.05
男 Male	2 000(54.4)	1.2		1 348(52.5)	0.7		1 973(51.9)	0.7		2 817(50.1)	0.4
女 Female	1 678(45.6)	1.3		1 220(47.5)	0.2		1 829(48.1)	0.8		2 804(49.9)	0.5
年龄/岁 Age/Year			17.66^a			7.45			6.27			5.23
2	15(0.4)	0		6(0.2)	0		2(0.1)	0		11(0.2)	0
3	763(20.7)	1.2		296(11.6)	0		702(18.5)	0.4		1 264(22.5)	0.3
4	1 142(31.1)	0.3		635(24.7)	0.3		1 313(34.5)	0.5		1 648(29.3)	0.2
5	1 243(33.8)	1.6		827(32.2)	0.2		1 300(34.1)	0.9		1 793(31.9)	0.7
6	515(14.0)	2.5		804(31.3)	1.0		485(12.8)	1.4		905(16.1)	0.4
班级 Class			5.74			5.68			9.67^a			1.62
大班 Senior	1 266(34.4)	1.8		998(38.9)	0.8		1 167(30.7)	1.4		1 796(32.0)	0.6
中班 Middle	1 325(36.0)	1.0		871(33.9)	0.5		1 687(44.4)	0.5		2 063(36.7)	0.5
小班 Junior	1 087(29.6)	0.8		699(27.2)	0		948(24.9)	0.3		1 762(31.3)	0.3
父亲受教育程度 Father’s education level			4.90			1.40			2.62			2.28
小学及以下 Primaryschool&below	106(2.9)	1.9		93(3.6)	0		60(1.6)	1.7		227(4.0)	0.4
中学或大专 Highschool	2 973(80.8)	1.4		2 000(77.9)	0.5		2 911(76.5)	0.8		3 992(71.1)	0.5
大学及以上 College&above	599(16.3)	0.3		475(18.5)	0.2		831(21.9)	0.4		1 402(24.9)	0.2
母亲受教育程度 Mother’s education level			7.28^a			2.05			2.48			4.03
小学及以下 Primaryschool&below	134(3.7)	2.2		116(4.5)	0		101(2.7)	2.0		274(4.9)	0
中学或大专 Highschool	2 828(76.9)	1.4		1 897(73.9)	0.6		2 669(70.2)	0.7		3 948(70.2)	0.6
大学及以上 College&above	716(19.4)	0.3		555(21.6)	0.2		1 032(27.1)	0.6		1 399(24.9)	0.2
家中地面材料 Flooring material			20.21^a			4.12			1.82			0.05
砖地或木地面 Brick/Wood	3 092(84.1)	0.9		2 134(83.1)	0.5		3 448(90.7)	0.8		4 997(88.9)	0.4
水泥地 Cement	549(14.9)	2.6		398(15.5)	0.5		337(8.9)	0.3		572(10.2)	0.9
土地面 Soil	37(1.0)	5.4		36(1.4)	0		17(0.4)	0		52(0.9)	1.9
家庭收入水平 Family income			5.85^a			0.83			4.78			1.32
低 Low	785(21.3)	2.8		597(23.2)	0.7		786(20.7)	0.6		1 202(21.4)	0.6
中 Medium	2 861(77.8)	0.8		1 945(75.8)	0.4		2 974(78.2)	0.8		4 344(77.3)	0.4
高 High	32(0.9)	3.1		26(1.0)	0		42(1.1)	0		75(1.3)	1.3
合计 Total	3 678	1.2		2 568	0.5		3 802	0.7		5 621	0.4	—

Table 2

Table 3

Enterobius vermicularis infections among kindergarten children in different areas of Jiangsu Province from 2019 to 2022

地区分类 Area	调查点 Study site	感染率/%（感染人数/调查人数） Infection rate/% (No. infections/no. investigations)
地区分类 Area	调查点 Study site	2019	2020	2021	2022
苏南 Southern Jiangsu
南京市鼓楼区 Gulou District, Nanjing Municipal		4.1（25/607）	1.1（7/612）	1.2（5/419）	1.0（4/402）
无锡市锡山区 Xishan District, Wuxi Municipal		-	-	1.8（7/400）	0.3（1/400）
常州市钟楼区 Zhonglou District, Changzhou Municipal		-	-	0.4（2/443）	0.5（2/405）
常州市武进区 Wujin District, Changzhou Municipal		-	-	-	0.5（2/401）
常州市经开区 Jingkai District, Changzhou Municipal		-	-	-	0 （0/404）
苏州市相城区 Xiangcheng District, Suzhou Municipal		-	-	0 （0/400）	-
镇江市润州区 Runzhou District, Zhenjiang Municipal		-	-	0.2（1/413）	-
镇江市丹徒区 Dantu District, Zhenjiang Municipal		-	-	-	0 （0/392）
小计 Total		4.1（25/607）	1.1（7/612）	0.7（15/2 075）	0.4（9/2404）
苏中Central Jiangsu
南通市海门区 Haimen District, Nantong Municipal		1.1（7/661）	0.4（2/441）	-	-
南通市港闸区 Gangzha District, Nantong Municipal		1.7（10/600）	0.2（1/400）	0.2（1/420）	-
泰州市海陵区 Hailing District, Taizhou Municipal		-	-	0.9（4/424）	-
泰州市高港区 Gaogang District, Taizhou Municipal		-	-	-	0.4（3/729）
扬州市广陵区 Guangling District, Yangzhou Municipal		0.2（1/493）	0（0/420）	-	0.3（2/611）
扬州市仪征市 Yizheng City, Yangzhou Municipal		0.2（1/636）	-	-	-
小计 Total		0.8（19/2390）	0.2（3/1261）	0.6（5/844）	0.3（5/1340）
苏北Northern Jiangsu
徐州市云龙区 Yunlong District, Xuzhou Municipal		-	-	-	0.2（1/500）
连云港市海州区 Haizhou District, Lianyungang Municipal		-	-	0.9（4/443）	-
淮安市淮安区 Huaian District, Huaian Municipal		-	0.4（3/695）	-	0.4（2/500）
盐城市盐都区 Yandu District, Yancheng Municipal		0.1（1/681）	-	-	-
盐城市响水县 Xiangshui County, Yancheng Municipal		-	-	-	1.1（5/450）
宿迁市宿城区 Sucheng District, Suqian Municipal		-	-	0.9（4/440）	-
宿迁市泗阳县 Siyang County, Suqian Municipal		-	-	-	0.7（3/427）
小计 Total		0.1（1/681）	0.4（3/695）	0.9（8/883）	0.6（11/1877）

Table 3

Fig. 1

Fig. 2

Table 4

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变量Variable	赋值Assignment
性别 Gender	0 = 男 Male，1 = 女 Female
年龄 Age	实际年龄 Actual age
洗手行为 Hand washing	主成分分析标准化得分 Standardized score of principal component analysis
吸咬行为 Sucking	主成分分析标准化得分 Standardized score of principal component analysis
洗晒频率 Washing & Sunning	主成分分析标准化得分 Standardized score of principal component analysis
幼儿园性质 Type of preschool	0 = 农村幼儿园 Rural preschool， 1 = 城区幼儿园 Urban preschool
家庭居住地 Residence	1 = 城镇 Urban，2 = 农村 Rural
家中地面材料 Flooring material	1 = 地砖等其他 Floor tiles and other，2 = 水泥地 Cement，3 = 土地 Soil
家庭收入水平 Family income	1 = 低收入 Low income，2 = 中等收入 Moderate income，3 = 高收入 High income
母亲受教育程度 Mother’s education level	0 = 小学及以下 Primary school & below，1 = 中学或大专 High school，2 = 大学及以上 College & above

特征 Feature	OR	95% CI	P值 P value
男性 Male	1.109	0.760~1.619	> 0.05
年龄 Age	1.447	1.186~1.764	< 0.05
洗手行为 Hand washing	0.918	0.780~1.080	> 0.05
吸咬行为 Sucking	1.048	0.882~1.245	> 0.05
洗晒频率 Washing & Sunning	1.121	1.002~1.225	< 0.05
城区幼儿园 Urban preschool	0.509	0.333~0.776	< 0.05
家庭居住地（农村为对照） Residence(Ref=Rural)
城镇Urban	1.11	0.731~1.687	> 0.05
家中地面材料（土地为对照） Flooring material(Ref=Soil)
地砖等其他 Brick/Wood	0.494	0.148~1.647	> 0.05
水泥地 Cement	0.635	0.184~2.190	> 0.05
家庭收入水平 Family income	0.711	0.472~1.071	> 0.05
母亲受教育程度 Mother’s education level	0.906	0.769~1.067	> 0.05
家长的主观知晓情况 Subjective awareness rate of parents	1.361	0.921~2.011	> 0.05