乌鲁木齐县板房沟乡包虫病流行状况和传播因素探讨

The Prevalence and Epidemiological Factors of Cystic Hydatidosis in Banfanggou,Urumqi,Xinjiang

1992年3月我们在乌鲁木齐县板房沟乡进行了一次包虫病流行病学调查,采用 X 线、B 超体检和测定血清抗体的方法(ELISA)对当地580名居民进行检查,发现包囊携带者20人,患病率为3.45%(20/580)。ELISA 检测抗体阳性151人、阳性率为26.77%(151/564)。用氢溴酸槟榔碱泻下法检查了32条狗,28条狗有反应,其中8条狗体内检到细粒棘球绦虫,感染率为28.57%,提示当地包虫病流行严重。不同年龄组人群比较,发现儿童病例最多(5～14岁年龄组7例病人),B 超观察发现儿童体内寄生的包囊均具有包虫的典型影像特征,表明儿童体内寄生的细粒棘球蚴处于十分活跃时期。作者认为在农牧区儿童是主要的高危人群,应在儿童中做好健康教育,普及预防包虫病的基本知识是十分必要的。调查中发现的病例几乎没有自觉症状,提示病人绝大部分是早期病例。同时对居民的某些行为也进行了调查,接受调查的人中71.5%人回答家中有犬,主要用于护院(88.95%),几乎不栓养。询问是否有家庭屠宰的行为,82.24%的回答是肯定的。60.93%的人回答将牲畜病变脏器乱扔,35.79%的人回答将牲畜病变脏器喂狗,只有2.46%的回答将病变脏器深埋处理。人们的不当行为造成了当地包虫病的严重流行。作者认为与板房沟相似的地区是北疆地区包虫病高发区,应加强此类地区的防治工作。本文还对当地包虫病流行现状和一些可能的原因进行了讨论。

An epidemiological survey of cystic hydatidosis was made on 580 local inhabitants using X-ray examination,B-mode ultrasonography and serological test(ELISA)in Banfanggou vil- lage of Urumqi county in March 1992.Twenty(20/580,3.45%)subjects were found to be cyst-carriers and 151(151/564,26.77%)to be positive for antihydatid antibodies.Thirty- two dogs were detected with arecoline hydrobromide 28 of these dogs were reactors,and in 8 (28.57%)of these 28 dogs were detected Echinococcus granulosus,suggesting the high prevalence of hydatid disease in the area.The comparison of different age groups showed more cases in children(7 patients in the age group of 5—14 years),B-mode ultrasonography showed typical cyst image in children affected by the disease,indicating that hydatid cysts in children were in highly active stage.Children were found to be the high-risk group of hydati- dosis in agricultural and pastoral areas and should receive health education on prevention of hydatid disease.Patients found in this survey had almost no subjective symptoms,suggest- ing that the majority of the patients were in early stages of the disease.Dogs were kept in 71.5% of households,mainly as guard dogs(88.95%),and rarely tied.Home slaughtering was common in this village(82.24%).There were 60.93% of the local residents who admit- ted the practice of throwing away casually diseased organs of animals,35.79% who ac- knowledged feeding dogs on diseased offal of animal,and only 2.46% who buried diseased or- gans deeply in earth.These improper conducts of the local residents were responsible for the high prevalence of hydatid disease in the very place.Hydatid control efforsts should be strengthened in such areas.Other factors contributing to the high prevalence of hydatidosis are discussed in detail.