三峡库区流动人员日本血吸虫特异性抗体特征研究

ANTIBODY CHARACTERISTICS OF SCHISTOSOMA JAPONICUM OF FLOATING POPULATION IN THE THREE GORGES RESERVOIR AREAS

[目的]掌握三峡库区流动人员抗日本血吸虫特异性抗体水平分布特征,探讨流动人员抗血吸虫特异性抗体的影响因素。[方法]选择三峡库区从血吸虫病疫区到重庆市的流动人员为研究对象,用统一的调查表进行个案调查,采集2～3ml静脉血,检测人群血吸虫特异性抗体(IgG)。[结果]本次调查241人,人群血吸虫抗体水平几何平均数(OD均值)为0.0092,抗体阳性率为4.15%(10/241);男性OD均值为0.0073,女性为0.0130,性别间差异有统计学意义(t=2.445,P=0.015)。男性阳性率为3.38%,女性5.38%,差异无统计学意义(χ2=0.573,P=0.449)。10～19岁组OD均值最高(0.0128),年龄组OD均值差异无统计学意义(χ2=2.833,P=0.586),年龄组间阳性率差异有统计学意义(χ2=14.886,P=0.005);男性人群中30岁以下人群OD均值显著高于30岁以上(F=9.369,P=0.003),在30岁以上人群中,女性OD均值显著高于男性(F=13.783,P=0.000);来渝前工人OD均值显著低于农民(P=0.002)、学生(P=0.004)、商人(P=0.046)和其他职业人群(P=0.014),来渝后各职业OD均值差异无统计学意义(χ2=3.814,P=0.282);学历间差异无统计学意义(F=0.683,P=0.604);疫情未控制地区人群抗体水平显著高于传播阻断地区(Z=2.204,P=0.028)。多因素逐步回归分析表明,来渝前职业(t=-3.6675,P=0.0003)、患病情况(t=1.9301,P=0.0555)、流动原因(t=-2.6106,P=0.0100)和原居住地(t=-2.2180,P=0.0281)与抗体水平明显关联。[结论]疫区来渝人群可能对三峡库区血吸虫病的发生和流行带来潜在危险;建议进一步健全三峡库区血吸虫病监测体系,针对重点人群,开展健康教育,预防和控制血吸虫病在三峡库区发生和流行。

[Objective] To master the baseline characteristic of anti-schistosome antibody and to study the hazard factors of infection with S. japonicum in floating population in the Three Gorges Reservoir areas （TGR）. [Methods] The floating population arrived and returned from schistosomiasis endemic areas were investigated in TGR. Each case was interviewed by recording data in uniform form. 2-3ml venous blood was drew for study targets and examined by ELISA. [Results] 244 people were investigated. The geometric mean of OD value （OD-value） of anti-schistosome antibody level was 0.0092 and the positive rate was 4.15 % （10/241）. The OD-value of male was 0.0073 and its positive rate was 3.38%. The female was 0.0130 and its positive rate was 5.38%. The OD-value （t = 2.445, P= 0.015） was significant difference between male and female, but the positive rate （χ^2= 0.573, P = 0.449） was no significant difference. The highest OD-value was in the age group of 10-19 years （0.0128）. The OD-value （χ^2 = 2.833, P = 0.556） was no significant difference among age groups, but the positive rate （~ = 14.886, P = 0.005） was significant difference. The OD-value of below 30 years was higher than that of over 30 years （F= 9.369, P = 0.003 ） ; in over 30 years people, the OD-value of female was higher than that of male （F = 13.783, P = 0.000）. The OD-vale of worker was lower than that of the farmer （P = 0.002）, student （P = 0.004）, businessmen （P = 0.046） and other people （P = 0.014） before arriving Chongqing City, but the occupations was no significant difference after arrived Chongqing City （χ^2 = 3.814, P = 0.282）. There was no significant difference in OD-value among different educations （F= 0.683, P = 0.604）. The OD-vale of non-morbidity control areas was higher than that of Transmission interruption areas （Z = 2.204, P = 0.028）. The results from the multivariate stepwise regression analysis indicated that there was significant difference with antibody level for occupations （t = -3.667 5, P = 0.000 3）, infection （t = 1.930 1, P = 0.055 5）, floating reasons （t = -2.610 6, P = 0.010 0） and original residences （t = -2.218 0, P = 0.028 1）. [Conclusion] The potential social-behavior factors affecting schistosomiasis transmission exists. The floating population is a main source of infection of sehiatosomiasis in TGR. So the monitoring system of schistosomiasis should be improved and health education should be carried out in key populations to prevent infection from S. japonicum in the TGR.