广东省外来流动人口血吸虫感染状况的研究

Research on schistosomiasis distribution in mobile population in Guangdong province

目的了解广东省外来流动人口血吸虫感染情况及病人的分布状况,为制定血吸虫病监测技术方案提供科学依据。方法于2005年6月至2007年7月在广东省分粤东、粤西、粤北、粤中4个区,每区按经济发展程度高、中、低各随机抽取2个共24个县(市、区)作为调查点;采用分层整群抽样调查外来流动人口分布情况;每个调查点按整群抽样原则抽取来自疫区的流动人口1000人,并对其采用胶体金渗滤法(DIGFA)检测血清中血吸虫抗体、病原学检查(kato-katz)进行确诊;统计分析外来流动人口城乡分布、来自疫区人口比例、血吸虫病患病率、血吸虫病确诊率等。结果共调查22个县(市、区),收集统计外来流动人口数6360505人,主要集中在粤中的珠江三角洲地区,占91.18%,当中主要是分布在农村地区和城乡结合部,占82%。外来流动人口中来自疫区的占19.49%(24777/127122),主要是15～49岁的人群,占98.92%。来自疫区人群血吸虫抗体阳性率为1.74%(228/13076),以15～39岁的人群较高(P<0.01);血吸虫抗体阳性者血吸虫病患病率为21.93%(50/228),调查人群总患病率即为0.38%(50/13076);血吸虫抗体阳性者病原确诊率为2.63%(6/228),即调查人群总确诊率为0.05%(6/13076)。结论推算在广东省的外来流动人口中可能有血吸虫病患者3万例以上,大部分患者是居住在粤中水网地带的农村地区或城乡结合部,可能将对该地区血防成果的巩固造成一定的威胁。

Objective To know schistosomiasis and patient distribution in mobile population in Guangdong province in order to develop surveillance program. Methods After divided whole province into 4 parts （eastern, western, northern, and central）, a stratified randomly cluster sampling method was performed to select 24 counties with 2 counties in each high, median and low economic status areas in each part to investigate mobile population from June in 2005 to July in 2007. Then selected 1 000 people from schistosomiasis epidemic suffered areas by cluster sampling in each county to detect serological antibody of schistosomiasis by DIGFA, then diagnosed by kato - katz. Proportions and prevalence rate, diagnosed rate as well as distribution of mobile population were calculated to describe epidemiological features. Results Sample size included 22 counties （cities, districts） and 6 360 505 mobile population, which mainly in Pearl River Delta region （91.18%） and rural or rural and urban adjacent areas （82%）. 19.49 % （ 24777/127 122） was from schistosomiasis epidemic suffered areas, mainly in 15 -49 age group （98.92%）. 1.74% （228/13 076 ） of those from schistosomiasis epidemic suffered areas had positive schistosomiasis antibody, with highest rate in 15 -39 age group （P 〈0.01 ）, Prevalence rate in antibody positive eases was 21.93% （50/228） and 0, 38% （50/13 076） in general population. Diagnostic rate was 2.63% （6/228） in antibody positive eases and 0.05% （6/13 076） in general population. Conclusion 30 000 possible schistosomiasis eases were extrapolated among mobile population in Guangdong province which resided in the rural or rural and urban adjacent brooky water areas of central Guangdong.