上海市流动人口血吸虫病血清流行病学调查

Study on the Seroepidemiology of Schistosomiasis among Mobile Population in Shanghai

目的掌握流动人口血吸虫病疫情,为制订血吸虫病防治策略提供参考。方法按照整群分层随机抽样方法抽取5个区的30个行政村作为调查点,收集其流动人口信息,每个调查点对100名来自105个血吸虫病未控制县、38个疫情回升县的6～65岁流动人员进行问卷调查和间接血凝试验(IHA)检测,对IHA阳性者进行病原学追踪。结果共调查2 992人,3.82%的流动人口来自未控制县和疫情回升县,IHA检测阳性者64人,阳性率为2.14%。Logistic回归分析显示现职业、来源地类型、治疗史和省份是流动人口IHA检测结果的影响因素。本市流动人口中血清学阳性者约有4 233人,较2004年估算数下降71.88%。病原学追踪54人,均未查到血吸虫虫卵。结论输入性传染源是上海市血吸虫病潜在流行的主要隐患,建议将在市郊从事农牧业的未传播阻断县流动人员作为选择性主动监测的重点人群。

Objective To understand schistosomiasis of mobile population in Shanghai,and provide information for the development of control strategies.Methods Thirty survey points（administration villages） were selected by cluster sampling from 5 districts in Shanghai,and the information about mobile population was collected.In every survey point,100 people,from 105 schistosomiasis endemic counties or 38 re-endemic counties,age from 6 years to 65 years,was involved in this study.Questionnaire survey and serum tested by indirect hemagglutination（IHA）were done for every individual,and fecal examination was done to the person with positive of IHA.Results About 3.82% mobile population came from schistosomiasis endemic counties or 38 re-endemic counties.A total of 2 992 mobile people were surveyed.Sixty-four persons were positive by IHA test（2.14%）.Current occupation,type of endemic areas,treatment history,and respective province,were recognized as influence factor of the result of IHA test by binary logistic regression.It was estimated that there were about 4 233 mobile people with IHA positive in Shanghai.Compared to 2004,the number of serological positive cases dropped by 71.88%.Fecal samples of 54 IHA positive cases were collected and examined,but no schistosome egg was found.Conclusions The imported schistosomiasis cases was the major risk factor in the re-endemic of schistosomiasis in Shanghai.The workers from schistosomiasis endemic counties,engaged in agriculture or animal husbandry in Shanghai suburbs,were proposed as the key population for the selective initiative surveillance.