| 许汴利,张红卫,邓艳,陈正利,陈伟奇,鲁德领,张雅兰,赵玉玲,蔺西萌,黄倩,杨成运,刘颖,周瑞敏,李蓬,陈建设,贺丽君,钱丹.河南省人体重点寄生虫病分层抽样调查结果及影响因素分析[J].中华流行病学杂志,2018,39(3):322-328 |
| 河南省人体重点寄生虫病分层抽样调查结果及影响因素分析 |
| Stratified sampling survey of major human parasitic diseases in Henan province |
| 收稿日期:2017-07-17 出版日期:2018-03-21 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.03.014 |
| 中文关键词: 人体重点寄生虫病 现状调查 影响因素 河南省 |
| 英文关键词: Human parasitic diseases Cross sectional survey Influencing factor Henan province |
| 基金项目: |
| 作者 | 单位 | E-mail | | 许汴利 | 450016 郑州, 河南省疾病预防控制中心 | bianlixu@163.com | | 张红卫 | 450016 郑州, 河南省疾病预防控制中心 | | | 邓艳 | 450016 郑州, 河南省疾病预防控制中心 | | | 陈正利 | 450016 郑州, 河南省疾病预防控制中心 | | | 陈伟奇 | 450016 郑州, 河南省疾病预防控制中心 | | | 鲁德领 | 450016 郑州, 河南省疾病预防控制中心 | | | 张雅兰 | 450016 郑州, 河南省疾病预防控制中心 | | | 赵玉玲 | 450016 郑州, 河南省疾病预防控制中心 | | | 蔺西萌 | 450016 郑州, 河南省疾病预防控制中心 | | | 黄倩 | 450016 郑州, 河南省疾病预防控制中心 | | | 杨成运 | 450016 郑州, 河南省疾病预防控制中心 | | | 刘颖 | 450016 郑州, 河南省疾病预防控制中心 | | | 周瑞敏 | 450016 郑州, 河南省疾病预防控制中心 | | | 李蓬 | 450016 郑州, 河南省疾病预防控制中心 | | | 陈建设 | 450016 郑州, 河南省疾病预防控制中心 | | | 贺丽君 | 450016 郑州, 河南省疾病预防控制中心 | | | 钱丹 | 450016 郑州, 河南省疾病预防控制中心 | |
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| 中文摘要: |
| 目的 了解河南省人体重点寄生虫病流行现状及影响因素。方法 2014－2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求选取35个县的104个点农村人群开展土源性线虫病、带绦虫病和肠道原虫病调查，每个点调查250人，共调查26 866人；选取37县（区）的62个点城镇人群开展华支睾吸虫病调查，每个点调查250人，共调查15 893人。采用改良加藤厚涂片法（Kato-Katz法）检查肠道蠕虫卵，试管滤纸钩蚴培养法鉴别美洲钩虫与十二指肠钩虫，透明胶纸肛拭法检查蛲虫卵和带绦虫卵，生理盐水和碘液直接涂片法查肠道原虫滋养体和包囊。结果 河南省农村人群肠道寄生虫总感染率为2.02%，蠕虫感染率（1.48%）高于原虫感染率（0.56%），查出虫种14种，其中肠道线虫5种、吸虫2种、肠道原虫7种，所有检出虫种中蛲虫感染率最高，全省4个生态区中秦巴山地生态区肠道寄生虫感染率最高。男女性间肠道寄生虫感染率差异无统计学意义（χ2=3.630，P=0.057）；不同年龄组间感染率差异有统计学意义（χ2=124.783，P=0.000 1），0～9岁年龄组感染率最高且以蛲虫感染为主；不同文化程度人群间肠道寄生虫感染率差异有统计学意义（χ2=120.118，P=0.000 1）且感染率随文化程度升高呈下降趋势（χ2=70.969，P=0.000 1）；不同职业人群中学龄前儿童肠道寄生虫感染率最高，肠道蠕虫以轻度感染为主，仅钩虫出现2例重度感染。河南省城镇人群华支睾吸虫感染率仅为0.006%。logistic回归分析结果显示学龄前儿童（χ2=15.765，P=0.000 1）、饮用井水（χ2=45.589，P=0.000 1）是感染肠道寄生虫的危险因素，农民人均年收入是感染肠道寄生虫的保护因素。本研究人群肠道寄生虫总感染率、原虫感染率与前两次调查相比均有大幅下降，肠道蠕虫感染率与第二次寄生虫病调查相比也有大幅下降，检出的原虫、蠕虫、总虫种数均少于第一次和第二次寄生虫病调查。结论 对比河南省三次的寄生虫病调查结果，河南省农村人群肠道寄生虫病感染率及肠道原虫感染率呈明显下降趋势，儿童的蛲虫感染应成为今后寄生虫病防治重点。 |
| 英文摘要: |
| Objective To understand the prevalence of major human parasitic diseases and related factors in Henan province. Methods This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases, 2014-2015. The prevalence of soil-transmitted helminths infection, taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships. In each survey spot, 250 persons were surveyed. A total of 26 866 persons and 15 893 persons were surveyed. Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes. Tube fecal culture was used to identify the species of hookworm. The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape. The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method. Results The overall infestation rate of intestinal parasites was 2.02% in Henan, and the worm infection rate was higher than protozoa infection rate. Fourteen kinds of intestinal parasites were found, including nematode (5 species), trematode (2 species), and protozoan (7 species). The infection rate of Enterobius vermicularis was highest, and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan. There was no significant difference in intestinal parasite infection rate between males and females (χ2=3.630, P=0.057), and the differences in intestinal parasite infection rate among different age groups had significance (χ2=124.783, P=0.000 1). The infection rate reached the peak in age group ≤ 9 years and the major parasite was Enterobius vermicularis. Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (χ2=70.969, P=0.000 1), the differences had significance (χ2=120.118, P=0.000 1). For different populations, the infection rate of intestinal parasites was highest among preschool children. The infection of intestinal helminth was mainly mild, only 2 severe cases were detected. The infection rate of Clonorchis sinensis in urban residents was only 0.006%. Logistic regression analysis showed that being preschool children (χ2=15.765, P=0.000 1) and drinking well water (χ2=45.589, P=0.000 1) were the risk factors for intestinal parasite infection, and annual income per capita of farmers was the protective factor against intestinal parasite infection. The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys, and the rate of intestinal helminth infection also dropped sharply compared with the second survey. The numbers of protozoa, helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys. Conclusions Compared the results of three surveys in Henan, the infection rate of protozoa and intestinal parasites showed a downward trend. The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future. |
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