2015年河南省秦巴山地生态区人体肠道寄生虫感染现状调查
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摘要
目的了解河南省秦巴山地生态区人体肠道寄生虫病流行现状,为该地区寄生虫病防治提供科学依据。方法2015年按照《全国人体重点寄生虫病现状调查实施细则》的要求进行抽样,选取河南省秦巴山地生态区8个县(市)的26个调查点进行土源性线虫、带绦虫和肠道原虫感染调查,采用改良加藤厚涂片法(Kato-Katz法)检测肠道蠕虫卵,采用试管滤纸培养法鉴别十二指肠钩虫与美洲钩虫,采用透明胶纸肛拭法检查3~6岁儿童蛲虫卵和带绦虫卵,采用碘液直接涂片法检测肠道原虫滋养体和包囊。分析不同人群肠道寄生虫感染情况及其相关影响因素。结果共检查6 706人,检出8种寄生虫,其中蠕虫3种、原虫5种,肠道寄生虫总感染率为3.39%,蠕虫和原虫感染率分别为2.92%和0.49%,3~6岁儿童肛拭蛲虫感染率为3.93%。查出的3种蠕虫分别为蛔虫、蛲虫和枝双腔吸虫,其中蛲虫感染率最高,为2.68%(χ~2=306.362,P <0.05);5种原虫分别为哈门氏内阿米巴、结肠内阿米巴、微小内蜒阿米巴、蓝氏贾第鞭毛虫和人芽囊原虫,其中微小内蜒阿米巴感染率最高,为0.24%(χ~2=23.842,P <0.05)。8个县(市)中蠕虫感染率最高的地区为汝阳县(13.47%),主要为蛲虫感染;原虫感染率最高的地区为新安县(1.55%),主要为微小内蜒阿米巴感染;各县(市)蠕虫(χ~2=357.525,P <0.05)和原虫感染率(χ~2=38.795,P <0.05)差异均有统计学意义。男、女性蠕虫感染率差异无统计学意义(χ~2=0.034,P> 0.05),但男性肠道原虫感染率高于女性(χ~2=12.946,P <0.05)。0~9岁年龄组人群蠕虫感染率最高(6.60%),以蛲虫感染为主(χ~2=62.600,P <0.05)。肠道寄生虫总感染率在各民族间差异无统计学意义(χ~2=0.212,P>0.05)。蠕虫在学龄前儿童中感染率最高(8.43%),主要为蛲虫感染;蛔虫感染主要发生于农民,感染率为0.31%;不同职业人群蠕虫感染率差异有统计学意义(χ~2=84.333,P <0.05)。文盲人群肠道寄生虫感染率最高(7.63%),不同文化程度人群肠道寄生虫感染率差异有统计学意义(χ~2=72.013,P <0.05)。平原地区人群肠道蠕虫感染率高于丘陵和山区(χ~2=11.690,P <0.05)。低收入人群肠道蠕虫感染率最高,为10.32%(χ~2=244.999,P <0.05);原虫感染率最高的人群为年人均收入6 000~7 999元的中等收入人群(χ~2=24.749,P <0.05)。饮用井水人群蠕虫感染率远高于饮用自来水人群(χ~2=62.255,P <0.05),未进行集体驱虫人群原虫感染率高于驱虫人群(χ~2=5.235,P <0.05)。结论河南省秦巴山地生态区人体肠道寄生虫感染率呈明显下降趋势,儿童蛲虫感染应成为今后该地区寄生虫病防治的重点。
Objective To understand and analyze the epidemic status of human intestinal parasitic diseases in the ecological region of the Qinba Mountains in Henan Province, so as to provide the evidence for the control of the diseases in this region.Methods According to the methods of National Survey Scheme on Major Human Parasitic Diseases, 26 survey spots were selected in 8 counties(cities) in ecological regions of Qinba Mountains in Henan Province in 2015. After collecting the human fecalsamples, the eggs of intestinal helminthes were detected with the modified Kato-Katz thick smear method, the species of Ancylostoma of the hookworm egg-positive samples were identified with the tube fecal culture method, the eggs of Enterobius vermicularis were detected by using the adhesive tape method in children aged 3 to 6 years, and the cyst and trophozoite of intestinal protozoa were examined by iodine staining. The infections of intestinal parasites in different populations and the related influencing factors were analyzed. Results Totally 6 706 residents were recruited in this study, 8 kinds of parasites were found including 3 species of helminthes and 5 species of protozoans. The overall infection rate of intestinal parasites was 3.39%, covering 2.92% for helminthes and 0.49% for protozoans. The infection rate of E. vermicularis in children aged 3 to 6 years was 3.93%. The 3 identified helminthes were Ascaris lumbricoides, E. vermicularis, and Dicrocoelium dendriticum, with the highest infection rate of E. vermicularis(2.68%, χ~2= 306.362, P < 0.05). The 5 identified protozoans were Entamoeba hartmani, E. coli, Endolimax nana, Giardia lamblia, and Blastocystis hominis, and the infection rate of E. nana was the highest(χ~2= 23.842, P < 0.05). Among the 8 counties(cities), the highest infection rate of helminthes, mainly with Enterobius infection, existed in Ruyang County, and the infection rate of protozoans in Xin'an County was the highest, mainly with E. nana infection. There was a significant difference in the infection rates of helminthes and protozoans among the 8 counties(cities)(helminthes: χ~2= 357.525, P < 0.05; protozoans: χ~2=38.795, P < 0.05). There was no significant difference in the helminth infection rate between males and females(χ~2= 0.034, P >0.05), but the protozoan infection rate of the males was higher than that of the females(χ~2= 12.946, P < 0.05). The helminth infection rate of the 0-9 years old group was the highest(χ~2= 62.600, P < 0.05), up to 6.60%, mainly with E. vermicularis infection.There was no significant difference in the infection rate of intestinal parasites among nationalities(χ~2= 0.212, P > 0.05). The helminth infection rate of preschool children was the highest and up to 8.43%, mainly with E. vermicularis infection. The infection of A. lumbricoides was mainly happened among farmers, with the infection rate of 0.31%. There was a significant difference in the helminth infection rate among different occupations(χ~2= 84.333, P < 0.05). The intestinal parasites infection rate of the illiterate population was the highest and up to 7.63%, there was a significant difference among the populations with different educational levels(χ~2= 72.013, P < 0.05). The helminth infection rate of plain areas was higher than that of valley and hill(χ~2= 11.690, P <0.05). The helminth infection rate of people with low-income was the highest and up to 10.32%(χ~2= 244.999, P < 0.05). The protozoan infection rate of people with middle-income was the highest, who had the annual per capita net income of 6 000 to 7 999 Yuan( χ~2= 24.749, P < 0.05). The helminth infection rate of people drinking well water was much higher than that of people drinking tap water(χ~2= 62.255, P < 0.05). The protozoan infection rate of people without insect repellent was higher than that of people with insect repellent(χ~2= 5.235, P < 0.05). Conclusions The infection rates of human intestinal parasites in the ecological region of the Qinba Mountains in Henan Province have decreased sharply. E. vermicularis infection in children should be the main point of prevention and treatment of parasitic diseases in the future.
Objective To understand and analyze the epidemic status of human intestinal parasitic diseases in the ecological region of the Qinba Mountains in Henan Province, so as to provide the evidence for the control of the diseases in this region.Methods According to the methods of National Survey Scheme on Major Human Parasitic Diseases, 26 survey spots were selected in 8 counties(cities) in ecological regions of Qinba Mountains in Henan Province in 2015. After collecting the human fecalsamples, the eggs of intestinal helminthes were detected with the modified Kato-Katz thick smear method, the species of Ancylostoma of the hookworm egg-positive samples were identified with the tube fecal culture method, the eggs of Enterobius vermicularis were detected by using the adhesive tape method in children aged 3 to 6 years, and the cyst and trophozoite of intestinal protozoa were examined by iodine staining. The infections of intestinal parasites in different populations and the related influencing factors were analyzed. Results Totally 6 706 residents were recruited in this study, 8 kinds of parasites were found including 3 species of helminthes and 5 species of protozoans. The overall infection rate of intestinal parasites was 3.39%, covering 2.92% for helminthes and 0.49% for protozoans. The infection rate of E. vermicularis in children aged 3 to 6 years was 3.93%. The 3 identified helminthes were Ascaris lumbricoides, E. vermicularis, and Dicrocoelium dendriticum, with the highest infection rate of E. vermicularis(2.68%, χ~2= 306.362, P < 0.05). The 5 identified protozoans were Entamoeba hartmani, E. coli, Endolimax nana, Giardia lamblia, and Blastocystis hominis, and the infection rate of E. nana was the highest(χ~2= 23.842, P < 0.05). Among the 8 counties(cities), the highest infection rate of helminthes, mainly with Enterobius infection, existed in Ruyang County, and the infection rate of protozoans in Xin'an County was the highest, mainly with E. nana infection. There was a significant difference in the infection rates of helminthes and protozoans among the 8 counties(cities)(helminthes: χ~2= 357.525, P < 0.05; protozoans: χ~2=38.795, P < 0.05). There was no significant difference in the helminth infection rate between males and females(χ~2= 0.034, P >0.05), but the protozoan infection rate of the males was higher than that of the females(χ~2= 12.946, P < 0.05). The helminth infection rate of the 0-9 years old group was the highest(χ~2= 62.600, P < 0.05), up to 6.60%, mainly with E. vermicularis infection.There was no significant difference in the infection rate of intestinal parasites among nationalities(χ~2= 0.212, P > 0.05). The helminth infection rate of preschool children was the highest and up to 8.43%, mainly with E. vermicularis infection. The infection of A. lumbricoides was mainly happened among farmers, with the infection rate of 0.31%. There was a significant difference in the helminth infection rate among different occupations(χ~2= 84.333, P < 0.05). The intestinal parasites infection rate of the illiterate population was the highest and up to 7.63%, there was a significant difference among the populations with different educational levels(χ~2= 72.013, P < 0.05). The helminth infection rate of plain areas was higher than that of valley and hill(χ~2= 11.690, P <0.05). The helminth infection rate of people with low-income was the highest and up to 10.32%(χ~2= 244.999, P < 0.05). The protozoan infection rate of people with middle-income was the highest, who had the annual per capita net income of 6 000 to 7 999 Yuan( χ~2= 24.749, P < 0.05). The helminth infection rate of people drinking well water was much higher than that of people drinking tap water(χ~2= 62.255, P < 0.05). The protozoan infection rate of people without insect repellent was higher than that of people with insect repellent(χ~2= 5.235, P < 0.05). Conclusions The infection rates of human intestinal parasites in the ecological region of the Qinba Mountains in Henan Province have decreased sharply. E. vermicularis infection in children should be the main point of prevention and treatment of parasitic diseases in the future.
引文
[1]常江,尚乐园.河南省人体寄生虫调查分析[M].郑州:世界图书出版公司,1994:18.
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[5]邓艳,陈伟奇,张雅兰,等.2011-2015年河南省淮阳县土源性线虫病监测结果分析[J].中国寄生虫学与寄生虫病杂志,2016,34(6):533-536.
[6]彭金华.河南省许昌市2012年土源性线虫感染调查报告[J].中国寄生虫学与寄生虫病杂志,2015,33(5):395-396,398.
[7]国家卫生计生委疾控局.国家卫生计生委办公厅关于印发全国人体重点寄生虫病现状调查方案的通知[J].首都公共卫生,2014,8(6):241-244.
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[10]买买提江·吾买尔,陈晓英,伊斯拉音·乌斯曼,等.2015年新疆维吾尔自治区人体肠道原虫流行病学调查[J].中国寄生虫学与寄生虫病杂志,2016,34(4):361-365.
[11]张红卫,许汴利,赵旭东,等.河南省肠道寄生虫感染及其社会经济因素调查[J].国际医学寄生虫病杂志,2006,33(4):174-176.
[12]赵旭东,李莹,蔺西萌,等.健康教育全民防治肠道寄生虫病的研究[J].中国热带医学,2002,2(2):249-250.
[13]蔺西萌,崔兆麟,许汴利,等.健康教育为主的肠道寄生虫防治策略研究[J].中国健康教育,2000,16(3):161-163.
[14]蔺西萌,许汴利,李辉,等.全民驱虫模式的探讨[J].中国寄生虫病防治杂志,2004,17(5):插9-插10.
[15]Ngonjo T,Okoyo C,Andove J,et al.Current status of soil-transmitted helminths among school children in Kakamega County,Western Kenya[J].J Parasitol Res,2016,2016:7680124.
[16]Grimes JE,Templeton MW.School water,sanitation,and hygiene to reduce the transmission of schistosomes and soil-transmitted helminths[J].Trends Parasitol,2016,32(9):661-664.
[2]王钊,徐淑惠.序言[J].中国建材科技,2006,12(3):136.
[3]许汴利,赵旭东,苏云普.河南省人体重要寄生虫病现状调查与分析[M].郑州:中原农民出版社,2011:14.
[4]许汴利,赵旭东,苏云普,等.河南省人体重要寄生虫病流行现状调查与分析[J].中国寄生虫病防治杂志,2005,18(6):454-457.
[5]邓艳,陈伟奇,张雅兰,等.2011-2015年河南省淮阳县土源性线虫病监测结果分析[J].中国寄生虫学与寄生虫病杂志,2016,34(6):533-536.
[6]彭金华.河南省许昌市2012年土源性线虫感染调查报告[J].中国寄生虫学与寄生虫病杂志,2015,33(5):395-396,398.
[7]国家卫生计生委疾控局.国家卫生计生委办公厅关于印发全国人体重点寄生虫病现状调查方案的通知[J].首都公共卫生,2014,8(6):241-244.
[8]中国卫生部疾控司.肠道寄生虫病防治手册[M].福州:福建教育出版社,1996:254-255.
[9]全国人体重要寄生虫病现状调查办公室.全国人体重要寄生虫病现状调查报告[J].中国寄生虫学与寄生虫病杂志,2005,23(增刊):332-340.
[10]买买提江·吾买尔,陈晓英,伊斯拉音·乌斯曼,等.2015年新疆维吾尔自治区人体肠道原虫流行病学调查[J].中国寄生虫学与寄生虫病杂志,2016,34(4):361-365.
[11]张红卫,许汴利,赵旭东,等.河南省肠道寄生虫感染及其社会经济因素调查[J].国际医学寄生虫病杂志,2006,33(4):174-176.
[12]赵旭东,李莹,蔺西萌,等.健康教育全民防治肠道寄生虫病的研究[J].中国热带医学,2002,2(2):249-250.
[13]蔺西萌,崔兆麟,许汴利,等.健康教育为主的肠道寄生虫防治策略研究[J].中国健康教育,2000,16(3):161-163.
[14]蔺西萌,许汴利,李辉,等.全民驱虫模式的探讨[J].中国寄生虫病防治杂志,2004,17(5):插9-插10.
[15]Ngonjo T,Okoyo C,Andove J,et al.Current status of soil-transmitted helminths among school children in Kakamega County,Western Kenya[J].J Parasitol Res,2016,2016:7680124.
[16]Grimes JE,Templeton MW.School water,sanitation,and hygiene to reduce the transmission of schistosomes and soil-transmitted helminths[J].Trends Parasitol,2016,32(9):661-664.
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