2014年江西省人体肠道原虫感染现状调查
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摘要
目的了解江西省人体肠道原虫感染现状,为制订防控措施提供参考依据。方法根据2014年全国第3次人体重点寄生虫感染现状调查方案,结合江西省具体情况,以生态区为基础,根据地理方位进行分层整群随机抽样,选择江西省28个县(市、区) 84个调查点。调查对象为各调查点常住居民(12岁以下儿童不超过1/3),每个调查点最终受检人数不少于250人。采集调查对象粪样,采用卢戈氏碘液染色法(一粪一检)检查粪样原虫包囊,生理盐水直接涂片法(一粪一检)检查滋养体。应用IBM SPSS Statistics 20软件进行统计学分析,感染率通过χ2检验进行比较。结果共调查21 569人,肠道原虫感染率为1.4%(307/21 569)。共发现8种原虫,感染率分别为溶组织内阿米巴0.2%(45/21 569)、结肠内阿米巴0.5%(104/21 569)、蓝氏贾第鞭毛虫0.1%(26/21 569)、人芽囊原虫0.3%(68/21 569)、哈门氏内阿米巴0.1%(28/21 569)、微小内蜒阿米巴0.2%(46/21 569)、布氏嗜碘阿米巴3例和结肠小袋纤毛虫1例。南岭山地丘陵地区肠道原虫感染率最高,为2.8%(132/4 742),以人芽囊原虫和微小内蜒阿米巴感染为主;浙闽山地丘陵地区感染率最低,为0.3%(18/5 887),不同生态区肠道原虫感染率差异有统计学意义(P <0.01)。九江市溶组织内阿米巴感染病例数最多,占全省病例数的93.3%(42/45);宜春市结肠内阿米巴、蓝氏贾第鞭毛虫感染病例数较多,分别占全省病例数的65.4%(68/104)和46.2%(12/26),仅有的1例结肠小袋纤毛虫感染病例也发现于宜春市;赣州市人芽囊原虫、哈门氏内阿米巴、微小内蜒阿米巴感染病例数较多,分别占全省病例数的69.1%(47/68)、 82.1%(23/28)和97.8%(45/46)。全省存在12例混合感染病例。男、女肠道原虫感染率分别为1.4%(148/10 582)和1.5%(159/10 987),差异无统计学意义(P> 0.05)。0～9岁人群肠道原虫感染率最高,为2.0%(64/3 243); 70≥岁人群感染率最低,为0.9%(16/1 710),不同年龄组人群肠道原虫感染率差异无统计学意义(P> 0.05)。工、商人员肠道原虫感染率最高,为1.8%(6/329);教师及离退休人员感染率最低,为0.8%(2/248),不同职业间肠道原虫感染率差异无统计学意义(P> 0.05)。文盲人群肠道原虫感染率最高,为1.5%(56/3 635),大专、大学以上人群感染率最低,为0.2%(1/219),不同文化程度人群肠道原虫感染率差异无统计学意义(P> 0.05)。经济水平较高地区人群的肠道原虫感染率为1.3%(102/7 837),以结肠内阿米巴感染为主;经济水平中等地区人群的感染率为0.9%(50/5 456),以溶组织内阿米巴和蓝氏贾第鞭毛虫感染为主;经济水平较低地区人群的感染率为1.9%(155/8 276),以人芽囊原虫和其他原虫感染为主,不同经济水平地区间肠道原虫感染率差异有统计学意义(P <0.01)。结论江西省人体肠道原虫总感染率较低,但经济水平较低的南岭山地丘陵地区人群感染情况较严重,是未来原虫防治工作的重点。
Objective To investigate the current status of human intestinal protozoa infections in Jiangxi Province, so as to provide the evidence for the formulation of prevention and control measures. Methods A survey was performed in 2014 according to the Protocol of the 3 rd National Survey on the Status of Human Key Parasitic Infections combining with the specific economic and geographic situation in Jiangxi Province. Total 84 survey sites were chosen from 28 counties(cities and districts) using stratified cluster sampling method based on the different geographic zones. No less than 250 permanent residents with no more than 1/3 of children with age less than 12 years old were recruited in the survey in each site. The fecal samples were collected from each participant. The infected protozoan cysts were examined using iodine staining and the trophozoites were examined using direct saline smear under microscope. Each fecal sample was examined once and the statistical analysis was performed using IBM SPSS Statistics 20 and chi-square test. Results A total of 21 569 people were participated in this survey. The overall prevalence of protozoa infections was 1.4%(307/21 569) with eight species of intestinal protozoa identified.Specifically the prevalence of Entamoeba histolytica was 0.2%(45/21 569), E. coli 0.5%(104/21 569), Gardia lamblia 0.1%(26/21 569), Blastocystis hominis 0.3%(68/21 569), E. hartmani 0.1%(28/21 569) and Endolimax nana0.2%(46/21 569). Three cases of Iodamoeba butschlii and 1 case of Balantidium coli were identified. The prevalence of protozoa infections was highest in Nanling hilly areas(2.8%, 132/4 742) with B. hominis and E. nana as dominant infected species. The lowest prevalence of protozoa infections was identified in Zhejiang/Fujian hilly areas(0.3%, 18/5 887). There was significant difference in the prevalence of intestinal protozoa infections among different ecological areas(P < 0.01). The largest number of cases of E. histolytica infection was found in Jiujiang City,accounting for 93.3%(42/45) of the total cases in the province. E. coli and G. lamblia infections were common in Yichun City, accounting for 65.4%(68/104) and 46.2%(12/26) of the total cases in the province, respectively. The1 case of B. coli infection was also found in Yichun City. The infections of B. hominis, E. hartmani and E. nana were mostly found in Ganzhou City, accounting for 69.1%(47/68), 82.1%(23/28) and 97.8%(45/46) of the total cases in the province, respectively. There were 12 cases of mixed protozoa infections identified province-wide. There was no significant difference in the prevalence of intestinal protozoa infections between male(1.4%, 148/10 582) and female(1.5%, 159/10 987)(P > 0.05). The highest prevalence of intestinal protozoa was observed in children with age 0-9 years old(2.0%, 64/3 243), and the lowest in the elders with age above 70(0.9%, 16/1 710), however,there was no statistical significance among different age groups( P > 0.05). In different occupation groups, the highest prevalence of intestinal protozoa infections was found in workers and businessmen(1.8%, 6/329) and the lowest in teachers and retirees(0.8%, 2/248). There was no significant difference in the prevalence among different occupations(P > 0.05) though. In different level of education, the highest prevalence was identified in population with low education(illiterate, 1.5%, 56/3 635) and the lowest in people with high education(college and above,0.2%, 1/219), but without statistical difference in people with different educational levels( P > 0.05). The prevalence of intestinal protozoa infections in the high income areas was 1.3%(102/7 837) with E. coli as a dominant infected species. The protozoa infection in people with medium income was 0.9%(50/5 456) mainly with E. histolytica and G. lamblia infected. The infection rate in people with low income was 1.9%(155/8 276), mainly with B. hominis and other protozoans. The prevalence of intestinal protozoa infections was significant difference between people with different economic level(P < 0.01). Conclusion The overall prevalence of human intestinal protozoa infections in Jiangxi Province is low, but more serious in the population in Nanling hilly areas with lower economic level. More control measures should be performed in this part of population.
Objective To investigate the current status of human intestinal protozoa infections in Jiangxi Province, so as to provide the evidence for the formulation of prevention and control measures. Methods A survey was performed in 2014 according to the Protocol of the 3 rd National Survey on the Status of Human Key Parasitic Infections combining with the specific economic and geographic situation in Jiangxi Province. Total 84 survey sites were chosen from 28 counties(cities and districts) using stratified cluster sampling method based on the different geographic zones. No less than 250 permanent residents with no more than 1/3 of children with age less than 12 years old were recruited in the survey in each site. The fecal samples were collected from each participant. The infected protozoan cysts were examined using iodine staining and the trophozoites were examined using direct saline smear under microscope. Each fecal sample was examined once and the statistical analysis was performed using IBM SPSS Statistics 20 and chi-square test. Results A total of 21 569 people were participated in this survey. The overall prevalence of protozoa infections was 1.4%(307/21 569) with eight species of intestinal protozoa identified.Specifically the prevalence of Entamoeba histolytica was 0.2%(45/21 569), E. coli 0.5%(104/21 569), Gardia lamblia 0.1%(26/21 569), Blastocystis hominis 0.3%(68/21 569), E. hartmani 0.1%(28/21 569) and Endolimax nana0.2%(46/21 569). Three cases of Iodamoeba butschlii and 1 case of Balantidium coli were identified. The prevalence of protozoa infections was highest in Nanling hilly areas(2.8%, 132/4 742) with B. hominis and E. nana as dominant infected species. The lowest prevalence of protozoa infections was identified in Zhejiang/Fujian hilly areas(0.3%, 18/5 887). There was significant difference in the prevalence of intestinal protozoa infections among different ecological areas(P < 0.01). The largest number of cases of E. histolytica infection was found in Jiujiang City,accounting for 93.3%(42/45) of the total cases in the province. E. coli and G. lamblia infections were common in Yichun City, accounting for 65.4%(68/104) and 46.2%(12/26) of the total cases in the province, respectively. The1 case of B. coli infection was also found in Yichun City. The infections of B. hominis, E. hartmani and E. nana were mostly found in Ganzhou City, accounting for 69.1%(47/68), 82.1%(23/28) and 97.8%(45/46) of the total cases in the province, respectively. There were 12 cases of mixed protozoa infections identified province-wide. There was no significant difference in the prevalence of intestinal protozoa infections between male(1.4%, 148/10 582) and female(1.5%, 159/10 987)(P > 0.05). The highest prevalence of intestinal protozoa was observed in children with age 0-9 years old(2.0%, 64/3 243), and the lowest in the elders with age above 70(0.9%, 16/1 710), however,there was no statistical significance among different age groups( P > 0.05). In different occupation groups, the highest prevalence of intestinal protozoa infections was found in workers and businessmen(1.8%, 6/329) and the lowest in teachers and retirees(0.8%, 2/248). There was no significant difference in the prevalence among different occupations(P > 0.05) though. In different level of education, the highest prevalence was identified in population with low education(illiterate, 1.5%, 56/3 635) and the lowest in people with high education(college and above,0.2%, 1/219), but without statistical difference in people with different educational levels( P > 0.05). The prevalence of intestinal protozoa infections in the high income areas was 1.3%(102/7 837) with E. coli as a dominant infected species. The protozoa infection in people with medium income was 0.9%(50/5 456) mainly with E. histolytica and G. lamblia infected. The infection rate in people with low income was 1.9%(155/8 276), mainly with B. hominis and other protozoans. The prevalence of intestinal protozoa infections was significant difference between people with different economic level(P < 0.01). Conclusion The overall prevalence of human intestinal protozoa infections in Jiangxi Province is low, but more serious in the population in Nanling hilly areas with lower economic level. More control measures should be performed in this part of population.
引文
[1]姜唯声,陈红根,曾小军,等.江西省土源性线虫流行状况的变化[J].江西医药,2004,39(增刊):10-13.
[2]许隆祺,余森海,徐淑惠,等.中国人体寄生虫分布与危害[M].北京:人民卫生出版社,2000.
[3]魏庆宽,徐凤全,黄炳成,等.济宁市1981-2000年儿童肠道原虫感染情况分析[J].中国热带医学,2003,3(6):758-760.
[4]余森海,许隆棋,蒋则孝,等.首次全国人体寄生虫分布调查的报告I.虫种的地区分布[J].中国寄生虫学与寄生虫病杂志,1994,12(4):241-247.
[5]周宪民,吴忠道,汪维周,等.江西景德镇市人体寄生虫分布调查报告[J].中国寄生虫学与寄生虫病杂志,1994,12(S1):216-218.
[6]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):264-268.
[7]黄文长,石焕焕,宾正凤,等.南昌市肠寄生虫感染情况调查[J].江西医学院学报,1987,27(3):70-73.
[8]廖红群,邱伟,王玲,等.反复腹痛儿童肠道原虫的检测及临床研究[J].赣南医学院学报,2010,30(6):876-878.
[9]田利光,周晓农.艾滋病患者几种易被忽视的肠道寄生虫感染[J].中国寄生虫学与寄生虫病杂志,2008,26(5):376-381.
[10]国家卫计委办公厅.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.
[11]杨树森.溶组织内阿米巴的致病作用[J].生物学通报,1996,31(8):8-10.
[12]胡缨,李艳文.常见人体肠道原虫感染的临床概述[J].蛇志,2013,25(1):54-57.
[13]卢思奇.国内蓝氏贾第鞭毛虫研究[J].寄生虫与医学昆虫学报,1999,6(4):193-200.
[14]滕雪娇,陈家旭,田利光. HIV/AIDS患者合并肠道原虫感染状况[J].中国寄生虫学与寄生虫病杂志,2017,35(6):607-614.
[15]刘颖,李素华,张雅兰,等.河南省人体肠道原虫感染现状分析[J].中国寄生虫学与寄生虫病杂志,2018,36(3):280-285.
[16]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.
[17]陈宝建,谢汉国,张榕燕,等.福建省人体肠道原虫病调查分析[J].中国人兽共患病学报,2018,34(6):542-545,549.
[18]李顺平,袁方曙,李连信.寄生虫病的社会经济学研究[J].中国寄生虫病防治杂志,1995,8(2):143-145.
[19]胡缨,黎学铭,张鸿满,等.南宁市城区人群人芽囊原虫感染情况调查[J].中国病原生物学杂志,2013,8(6):547-548,555.
[20]李玉民,赵宝福,李文,等.人群感染肠道寄生虫影响因素分析[J].中国初级卫生保健,2001,15(5):20-21.
[2]许隆祺,余森海,徐淑惠,等.中国人体寄生虫分布与危害[M].北京:人民卫生出版社,2000.
[3]魏庆宽,徐凤全,黄炳成,等.济宁市1981-2000年儿童肠道原虫感染情况分析[J].中国热带医学,2003,3(6):758-760.
[4]余森海,许隆棋,蒋则孝,等.首次全国人体寄生虫分布调查的报告I.虫种的地区分布[J].中国寄生虫学与寄生虫病杂志,1994,12(4):241-247.
[5]周宪民,吴忠道,汪维周,等.江西景德镇市人体寄生虫分布调查报告[J].中国寄生虫学与寄生虫病杂志,1994,12(S1):216-218.
[6]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):264-268.
[7]黄文长,石焕焕,宾正凤,等.南昌市肠寄生虫感染情况调查[J].江西医学院学报,1987,27(3):70-73.
[8]廖红群,邱伟,王玲,等.反复腹痛儿童肠道原虫的检测及临床研究[J].赣南医学院学报,2010,30(6):876-878.
[9]田利光,周晓农.艾滋病患者几种易被忽视的肠道寄生虫感染[J].中国寄生虫学与寄生虫病杂志,2008,26(5):376-381.
[10]国家卫计委办公厅.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.
[11]杨树森.溶组织内阿米巴的致病作用[J].生物学通报,1996,31(8):8-10.
[12]胡缨,李艳文.常见人体肠道原虫感染的临床概述[J].蛇志,2013,25(1):54-57.
[13]卢思奇.国内蓝氏贾第鞭毛虫研究[J].寄生虫与医学昆虫学报,1999,6(4):193-200.
[14]滕雪娇,陈家旭,田利光. HIV/AIDS患者合并肠道原虫感染状况[J].中国寄生虫学与寄生虫病杂志,2017,35(6):607-614.
[15]刘颖,李素华,张雅兰,等.河南省人体肠道原虫感染现状分析[J].中国寄生虫学与寄生虫病杂志,2018,36(3):280-285.
[16]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.
[17]陈宝建,谢汉国,张榕燕,等.福建省人体肠道原虫病调查分析[J].中国人兽共患病学报,2018,34(6):542-545,549.
[18]李顺平,袁方曙,李连信.寄生虫病的社会经济学研究[J].中国寄生虫病防治杂志,1995,8(2):143-145.
[19]胡缨,黎学铭,张鸿满,等.南宁市城区人群人芽囊原虫感染情况调查[J].中国病原生物学杂志,2013,8(6):547-548,555.
[20]李玉民,赵宝福,李文,等.人群感染肠道寄生虫影响因素分析[J].中国初级卫生保健,2001,15(5):20-21.
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