湖沼区儿童青少年血吸虫再感染危险因素的队列研究

A cohort study on risk factors of reinfection with schistosoma japonicum among children and adolescent in lake endemic areas

目的研究我国血吸虫病流行区儿童青少年对日本血吸虫再感染的危险因素。方法1995年10月至1997年10月在湖北省石首市三个村采用队列研究方法进行了本研究。对＜20岁人群基线粪检阳性者行吡喹酮治疗后7个月复查，其中159名阴转者作为再感染观察队列。结果经过一个传播期，再感染率为34．59％（55／159）。用Logistic回归模型拟合，结果特异性抗体IgE／IgG4比值、基线感染度、疫水接触指数（WCI）、住址距堤烷距离、血中嗜酸性粒细胞计数（EOS）和近期化疗等6项因素进入模型。结论与儿童青少年血吸虫再感染率呈正向联系的因素是基线感染度、WCI及近期化疗；呈负向联系的是IgE／IgG4比值及EOS。

Objective To study the risk factors of reinfection with schistosoma japonicum among adolescents in endemic areas. Methods A cohort study was conducted in three villages of Shishou city, Hubei province from october, 1995 to october, 1997. Reexamination was conducted in the seventh month after treatment with praziquatel to positive eggs objects, 159 objects who were negative to eggs regarded as observation cohort for reinfection. Results The reinfection rate of 159 objects to pass a communication period was 34. 59% (55/159). Ten factors were significantly associated with reinfection by analysis to 23 relative factors. A logistic regression model was fitted to the 10 factors,six factors were selected into the model. These factors were IgE/IgG. ratio, baseline infection intensity, index of water contact(WCI), distance from house to river-side, EOS, and late treatment with praziquatel. Conclusions RIR is positively related to baseline infection intensity, WCI and late treatment with praziquatel; negatively to IgE/IgG4 ratio and EOS.