云南省腾冲市住院病人溶组织内阿米巴感染情况及影响因素分析
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摘要
目的了解云南省腾冲市住院病人溶组织内阿米巴感染情况及其影响因素。方法 2016-07-01–2017-03-31,采用横断面调查方法对云南省腾冲市人民医院住院病例进行问卷调查。无菌采集其粪便样本,通过巢氏PCR检测溶组织内阿米巴感染情况。采用χ~2检验和多因素logistic回归模型分析溶组织内阿米巴感染的影响因素。结果共调查507名住院患者,其中10名患者感染溶组织内阿米巴,感染率为1.97%(95%CI:1.07%~3.59%)。溶组织内阿米巴感染者和非感染者身高(Z=-0.40,P=0.69)、体重(Z=-0.34,P=0.73)、体重指数(Z=-0.40,P=0.69)和年龄(Z=-1.48,P=0.14)差异无统计学意义。慢性腹泻(OR=21.43,95%CI:5.04~91.23)和日常饮用水(OR=11.28,95%CI:2.79~45.56)是人感染溶组织内阿米巴的影响因素。溶组织内阿米巴感染和腹胀(OR=0.70,95%CI:0.09~5.56)、食欲不振(OR=0.50,95%CI:0.06~4.02)、皮肤瘙痒(OR=0.79,95%CI:0.10~6.38)、肛周瘙痒(OR=1.74,95%CI:0.21~14.07)及便秘(OR=0.91,95%CI:0.13~7.33)无统计学关联。结论云南省腾冲市住院病人溶组织内阿米巴感染率较高,慢性腹泻和饮用未煮沸的水与溶组织内阿米巴感染呈高度相关。
Objective To understand the infection status and risk factors of Entamoeba histolytica in inpatients in Tengchong City, Yunnan Province. Methods A cross-sectional study was conducted in the inpatients in Tengchong People's Hospital,Yunnan Province. After obtaining the informed consent from the subjects, the stool samples were collected from 2016-07-01 to2017-03-31, and nested polymerase chain reaction(PCR) was used to detect E. histolytica in the stool samples. Meanwhile, a structured questionnaire was used to record the demographic information and clinical symptoms for the patients. Results Totally 507 cases were recruited, and the detection rate of E. histolytica was 1.97%(10/507, 95% CI: 1.07%-3.59%) in all subjects.There were no significant differences between the inpatients with and without E. histolytica infection in the height(Z =-0.40,P = 0.69), weight(Z =-0.34, P = 0.73), body mass index(Z =-0.40, P = 0.69) and age(Z =-1.48, P = 0.14). Chronic diarrhea(OR = 21.43, 95% CI: 5.04-91.23) and daily drinking water(OR = 11.28, 95% CI: 2.79-45.56) were relevant to E. histolytica infection. No significant association was observed between E. histolytica infection and the clinical symptoms, such as abdominal distension(OR = 0.70, 95% CI: 0.09-5.56), inappetence(OR = 0.50, 95% CI: 0.06-4.02), itchy skin(OR = 0.79, 95% CI: 0.10-6.38), perianal pruritus(OR = 1.74, 95% CI: 0.21-14.07), and constipation(OR = 0.91, 95% CI: 0.13-7.33). Conclusion E. his-tolytica infection is high in inpatients in Tengchong City, Yunnan Province, and chronic diarrhea and drinking unboiled water were highly correlated with E. histolytica infection.
Objective To understand the infection status and risk factors of Entamoeba histolytica in inpatients in Tengchong City, Yunnan Province. Methods A cross-sectional study was conducted in the inpatients in Tengchong People's Hospital,Yunnan Province. After obtaining the informed consent from the subjects, the stool samples were collected from 2016-07-01 to2017-03-31, and nested polymerase chain reaction(PCR) was used to detect E. histolytica in the stool samples. Meanwhile, a structured questionnaire was used to record the demographic information and clinical symptoms for the patients. Results Totally 507 cases were recruited, and the detection rate of E. histolytica was 1.97%(10/507, 95% CI: 1.07%-3.59%) in all subjects.There were no significant differences between the inpatients with and without E. histolytica infection in the height(Z =-0.40,P = 0.69), weight(Z =-0.34, P = 0.73), body mass index(Z =-0.40, P = 0.69) and age(Z =-1.48, P = 0.14). Chronic diarrhea(OR = 21.43, 95% CI: 5.04-91.23) and daily drinking water(OR = 11.28, 95% CI: 2.79-45.56) were relevant to E. histolytica infection. No significant association was observed between E. histolytica infection and the clinical symptoms, such as abdominal distension(OR = 0.70, 95% CI: 0.09-5.56), inappetence(OR = 0.50, 95% CI: 0.06-4.02), itchy skin(OR = 0.79, 95% CI: 0.10-6.38), perianal pruritus(OR = 1.74, 95% CI: 0.21-14.07), and constipation(OR = 0.91, 95% CI: 0.13-7.33). Conclusion E. his-tolytica infection is high in inpatients in Tengchong City, Yunnan Province, and chronic diarrhea and drinking unboiled water were highly correlated with E. histolytica infection.
引文
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[11]卢艳,陈家旭,张永年,等.FTA-巢式PCR方法鉴定溶组织内阿米巴原虫的初步研究[J].中国人兽共患病学报,2016,32(2):128-132.
[12]董海聚,王荣军,张龙现.内阿米巴属原虫分子检测及基因分型方法研究进展[J].中国人兽共患病学报,2014,30(7):747-752.
[2]Shirley DT,Farr L,Watanabe K,et al.A review of the global bur-147den,new diagnostics,and current therapeutics for amebiasis[J].Open Forum Infect Dis,2018,5(7):161.
[3]Lozano R,Naghavi M,Foreman K,et al.Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010:a systematic analysis for the Global Burden of Disease Study 2010[J].Lancet,2012,380(9859):2095-2128.
[4]Haghighi A,Riahi SM,Taghipour A,et al.Amoebiasis in Iran:a systematic review and meta-analysis[J].Epidemiol Infect,2018,146(15):1880-1890.
[5]Murray CJ,Vos T,Lozano R,et al.Disability-adjusted Life years(DALYs)for 291 diseases and injuries in 21 regions,1990-2010:a systematic analysis for the Global Burden of Disease Study 2010[J].Lancet,2012,380(9859):2197-2223.
[6]Liu J,Platts-Mills JA,Juma J,et al.Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children:a reanalysis of the GEMS case-control study[J].Lancet,2016,388(151):1291-1301.
[7]Alvarado-Esquivel C,Sanchez-Anguiano LF,Hernandez-Tinoco J,142et al.Entamoeba histolytica infection in female sex workers:Amatched case-control study in Durango,Mexico[J].J Clin Med Res,2017,9(7):624-629.
[8]齐唐凯.上海等地HIV感染者溶组织内阿米巴感染的流行病学调查[D].上海:复旦大学,2006.
[9]蒋则孝,许隆祺,余森海,等.中国溶组织内阿米巴感染的状况[J].中国寄生虫病防治杂志,1997,10(4):26-30.
[10]张小萍,何艳燕,王真瑜,等.上海市综合性医院腹泻患者中溶组织内阿米巴感染现状调查[J].中国血吸虫病防治杂志,2015,27(6):600-603.
[11]卢艳,陈家旭,张永年,等.FTA-巢式PCR方法鉴定溶组织内阿米巴原虫的初步研究[J].中国人兽共患病学报,2016,32(2):128-132.
[12]董海聚,王荣军,张龙现.内阿米巴属原虫分子检测及基因分型方法研究进展[J].中国人兽共患病学报,2014,30(7):747-752.