我国华支睾吸虫病流行区感染现状调查

Current Prevalence of Clonorchis sinensis Infection in Endemic Areas of China

目的了解我国华支睾吸虫病流行区的感染现状。方法2002-2004年对全国27个省(市、区)按不同流行程度和水系流域进行分层整群随机抽样,对样本人群采用改良加藤厚涂片法检查华支睾吸虫虫卵(一粪三检)。结果调查217829人,检出华支睾吸虫感染者5230例,感染率为2.40%,推算全国华支睾吸虫感染者约为1249万。平均每克粪便含虫卵2208个,低、中、高度感染构成比分别为78.93%、17.40%和3.67%。19个省(市、区)查出感染者,感染率居前3位的是广东(16.42%,2278/13876)、广西(9.75%,1365/13990)和黑龙江(4.72%,636/13458)。男性平均感染率(2.94%,3267/111262)高于女性(1.84%,1963/106567)。各年龄组均有感染,其中50～59岁年龄组感染率最高(9.16%)。华支睾吸虫感染存在职业差异,以商人感染率最高(13.42%,124/924)、其次为工人(7.9%,298/3773)和离退休人员(5.28%,70/1327)。在以食生鱼片为主要感染方式的地区,成人感染为主,其他地区则以儿童为主。不同地形间感染率亦有差异,水网地区感染率最高(5.23%,687/13125),其次为丘陵地区(2.34%,1111/47552)。采用二项分布拟合法分析,发现华支睾吸虫感染具家庭聚集性。结论华支睾吸虫病在我国流行范围广、感染率高,呈地方性分布,成年男性感染率高,具家庭聚集性。

Objective To investigate the current prevalence of Clonorchis sinensis infection in the known endemic areas of China. Methods According to different endemic level and river system, the lamination stochastic group sampling was carried out in 27 Provinces/Municipalities/Autonomous Regions （P/M/A） from 2002 to 2004. Eggs in stool were examined by modified Kato-Katz thick smears method. Results A total of 5 230 cases of Clonorchis infection was found from 217 829 sampled population of 27 P/M/A, and the mean prevalence was 2.40% by which the number of infected people was estimated to be 12.49 millions. The geometry mean worm egg density was 2 208 EPG（stool）. Li-ght, moderate and heavy infection occupied 78.93%, 17.40%, and 3.67% respectively. Infection was found in 19 out of 27 P/ M/A investigated, with the highest prevalence in the provinces of Guangdong （16.42%, 2278/13 876）, Guangxi （9.75%, 1 365/13 990） and Heilongjiang （4.72%, 636/13 458）. Males showed higher prevalence （2.94%, 3 267/111 262） than females （1.84%, 1 9631106 567）. There was infection in all age groups,with the highest prevalence in the group of 50 to 59 years（9.16%）. By occupations, more infections were found in businessmen （13.42%, 124/924）,followed by factory workers （（7.9%, 298/3 773）, and retirees and veterans （5.28%, 70/1 327）. Adults showed heavier infection in some provinces where the main infection way was raw fish-eating, but in children in other provinces. For geographical distribution, the terrain in network of rivers and lakes showed higher prevalence （5.23%, 687/13 125） than the hilly terrain （2.34%, 1 111/47 552）. Prevalence showed family-aggregation feature. Conclusion Clonorehiasis is widely endemic in China with a high prevalence in some provinces. Male adults have been more involved with a family aggregation.