云南省防治亚洲无钩绦虫病试点研究

STUDY ON THE CONTROL OF TAENIASIS SAGINATA ASIATICA IN PILOT OF YUNAN

目的了解亚洲无钩绦虫病流行因素及流行环节,掌握流行特征,探索综合防治方法. 方法选择带绦虫病流行区兰坪县河西乡箐花村和三界村为防治试点,开展亚洲无钩绦虫流行病学调查.采用药物驱虫及健康教育(箐花村)等措施控制亚洲无钩绦虫病. 结果病史访问2 214人, 查到近期排亚洲无钩绦虫节片者886人,感染率分别为箐花村42.12%(489/1161),三界37.70%(397/1053).未发现有癫痫病史者和皮下结节者.人群感染率,男性38.55%,女性41.44%,差异无显著性;最小感染年龄为9个月,最大90岁;30～50岁组感染率最高,在55.99%～60.66%之间;普米族居民感染率为46.69%,高于其他民族;农民感染率为51.77%,高于其他职业人群.饮食习惯调查,生食猪肝者占调查人数的95.12%,感染率为41.55%,显著高于不生食猪肝者(6.48%).不同牲畜饲养户亚洲无钩绦虫感染率差异有显著性(χ2=299.266,P<0.01).3年累计复查7 771人次,驱虫3 285人次,药物驱虫治愈率分别为驱绦胶囊82.50%(509/617),吡喹酮75.00%(150/200).采取综合性防治措施后,箐花村居民生食猪肝者所占比例从防治前的95.95%下降至36.32%,厕所普及率从1.48%上升至39.41%,亚洲无钩绦虫人群感染率从42.12%下降至17.67%.三界村防治后上述指标无显著变化. 结论兰坪防治试点为亚洲无钩绦虫病流行区,居民主要通过生食猪肝感染 .采取驱虫、健康教育等综合性防治措施,可有效控制人群亚洲无钩绦虫感染.

Objective To know epidemiological factors and characteristics of Taenia saginata asiatica infection, in order to search for synthetic control measures. Methods The epidemiological investigation was carried out in pilot of Qinghua and Sanjie villages of Hexi Township of Lanping County, Yunnan Province, and the measures of chemotherapy and health education were used to control T. saginata asiatica infection, thereinto, health education was only for Qinghua, Sanjie was as a control. Results The total of 2 214 residents were investigated. There were 886 persons who had history of discharging gravid proglottids in the faeces in the past three months. The infection rates of T. saginata asiatica in Qinghua and Sangjie were 42.12%(489/1161) and 37.70%(397/1053), respectively. The case with epilepsy and subcutanous node was not found. The infection rates of male and female were 38.55 % and 41.44%, respectively, there is no significant difference on sex infection; The youngest case was only 9 months and the oldest one was 90 yeas old, the infection mainly concentrated in 30-50 age group(55.99%-60.66%). The infection rate of Pumi nationality was higher than that of others, and the peasant is higher than other occupation. The habit of food and drink was investigated, as a results: the residents of eating raw pig liver accounted for 95.12% of the total person, in which the infection rate was 41.74%. The infection rate of the family was significant difference among rearing different kind of domestic animals(χ 2 =299.266, P <0.01). In three years, the accumulative total of 7 771 person were followwed up, and the 3 285 person were deworm. The cure rate of antiscolic capsule and praziquantel were 82.50% (509/617) and 75.00%(150/200), respectively. After adopting synthetic control measure, the residents of eating raw pig liver reduced from 95.95% to 36.32%, the lavatory popularizing rate increased from 1.48% to 39.41% and the infection rate of T. saginata aciatica reduced from 42.12% to 17.67% in Qinghua, but all of figures was no changed in Sanjie. Conclusion Lanping County is the endemic area of T. saginata aciatica , the residents are mainly infected by eating raw pig liver. The synthetic control measures (including deworm and health education) are effective for control of T. saginata asiatica infection.