摘要
目的了解拉萨市棘球蚴病流行现状。方法于2016年8-12月,采取分层整群随机抽样法,在拉萨市当雄、林周、尼木、墨竹工卡、达孜、曲水、堆龙德庆、城关8个县(区)抽取调查村。根据生产类型,将各县划分成牧区、半农半牧区、农区和城镇,按比例随机抽取调查村数。以行政村(居委会)为单位,每村至少检查200人,人数不足时由邻近村补足,对居民进行腹部B超检查。每个行政村(居委会)随机抽取20名居民,每个县抽1所完全小学,4～6年级每个年级抽不少于50名学生,以问卷形式对居民和学生进行棘球蚴病防治知识与行为调查。每个行政村(居委会)抽取20个养犬户,每户采集1份犬粪,ELISA检测犬粪棘球绦虫抗原。每个行政村(居委会)抽取当地繁育、宰杀的羊(猪)10只或牛5头,检查肝、肺等脏器的包囊情况。利用χ~2检验比较不同组间检出率的差异。结果2016年拉萨市人群棘球蚴病检出率为1.38%(151/10 917),分型以细粒棘球蚴病为主(82.12%,124/151),不同县(区)间居民棘球蚴病检出率的差异无统计学意义(χ~2=13.322,P>0.05)。男、女性棘球蚴病检出率分别为1.12%(48/4 267)和1.55%(103/6 650),两者差异无统计学意义(χ~2=3.425,P>0.05)。各年龄组均有棘球蚴病检出,检出率随年龄的增加呈上升趋势,≥70岁人群棘球蚴病检出率最高,为2.99%(19/635),不同年龄组人群棘球蚴病检出率的差异有统计学意义(χ~2=39.544,P<0.01)。牧民、半农半牧民和家务工作者的棘球蚴病检出率较高,依次为3.16%(38/1 263)、1.93%(15/777)和1.59%(8/504),不同职业类型人群棘球蚴病检出率的差异有统计学意义(χ~2=53.199,P<0.01)。文盲人群的棘球蚴病检出率最高,为2.08%(99/4 755),高中及以上文化程度人群的棘球蚴病检出率最低,为0.47%(3/638),不同文化程度人群棘球蚴病检出率的差异有统计学意义(χ~2=34.138,P<0.01)。非定居人群和定居人群棘球蚴病检出率分别为3.03%(8/264)和1.34%(143/10 653),两者差异有统计学意义(χ~2=4.215,P<0.05)。牧区人群棘球蚴病检出率最高,为2.63%(40/1 995),城镇人群检出率最低,为0.84%(21/2 512),不同生产类型地区人群棘球蚴病检出率的差异有统计学意义(χ~2=11.206,P<0.05)。人群棘球蚴病防治知识认知合格率为40.20%(907/2 256)。犬粪棘球绦虫抗原阳性率为6.30%(66/1 047),家畜(猪、牛、羊)棘球蚴感染检出率为15.68%(29/185)。结论拉萨市人群棘球蚴病检出率较高,牧区是棘球蚴病的重度流行区。
Objective To investigate the prevalence of echinococcosis in Lhasa. Methods A stratified cluster sampling method was used to select 8 counties （Damxung, Lhünzhub, Nyêmo, Maizhokunggar, Dagzê, Qüxü,Doilungdegen and Chengguan） in Lhasa City to investigate the prevalence of echinococcosis, and they were divided into pastoral area, semi-agricultural and semi-pastoral area, agricultural area and towns based on the type of production. Villages for investigation were assigned into the 8 counties with an appropriate proportion. In each village, at least 200 residents were examined by B ultrasound. When there were fewer than 200 people in a village, residents from its neighbor village would be enrolled. Twenty villagers were randomly selected in each village, and no less than 50 students were selected from each of grades 4-6 in primary schools（one primary school from each county） for survey on the knowledge of and behaviors in relation to echinococcosis prevention by questionnairing. Twenty dog-raising households were selected from each village, and Echinococcus antigen in dog feces was detected by ELISA. In each village, 10 sheep/pigs or 5 cattle were selected to examine internal organs including liver and lung. The number of cysts found were recorded. Difference in prevalence among groups was analyzed by χ2 test. Results In 2016, the prevalence of echinococcosis in Lhasa was 1.38% （151/10 917）, dominated by cystic echinococcosis （82.12%, 124/151）. There was no significant difference in prevalence among the counties （χ2 = 13.322, P 〉 0.05） and between males （1.12%, 48/4 267） and females （1.55%, 103/6 650） （χ2 = 3.425, P 〉 0.05）. All age groups were found with hydatid disease, with the ≥ 70 years group having the highest prevalence （2.99%, 19/635）. The prevalence showed a trend of increase with age （χ2 = 39.544, P 〈 0.01）. The prevalence was higher in herdsmen （3.16%, 38/1 263）, semi-farmer-and-herdsmen （1.93%, 15/777）, and houseworkers （1.59%, 8/504） , with a significant difference among occupations （χ2 = 53.199, P 〈 0.01）. There was a significant difference in prevalence among educational levels （χ2 = 34.138, P 〈 0.01）, highest in the illiterates （2.08%, 99/4 755） and lowest in those with a high school level or above （0.47%, 3/638）. There was also a significant difference in prevalence between the settled-down residents （3.03%, 8/264） and the nomadic population （1.34%, 143/10 653） （χ2 = 4.215, P 〈 0.05）. In addition, the prevalence was highest in pastoral area （2.63%, 40/1 995） and lowest in town （0.84%, 21/2 512） （χ2 = 11.206, P 〈 0.05）. The qualified rate on knowledge of echinococcosis prevention in selected residents was 40.20% （907/2 256）. The positive rate of Echinococcus antigen in dog fecal samples was 6.30% （66/1 047）. The prevalence of hydatid infection was 16.36% （29/185） in livestock. Conclusion There is a high prevalence of hydatid disease in Lhasa, especially in pastoral area.
出处
《中国寄生虫学与寄生虫病杂志》
CAS
CSCD
北大核心
2018年第1期58-62,74,共6页
Chinese Journal of Parasitology and Parasitic Diseases
基金
国家卫生和计划生育委员会的大力支持
中国疾病预防控制中心
中国疾病预防控制中心传染病防治处
寄生虫病预防控制所的大量帮助和支持
关键词
棘球蚴病
拉萨市
流行
Echinococcosis
Lhasa City
Prevalence
