1962-2012年四川省甘孜藏族自治州棘球蚴病流行病学分析

Epidemiological Analysis on Echinococcosis in Ganzi Tibetan Autonomous Prefecture of Sichuan Province,1962-2012

目的了解1962-2012年四川甘孜藏族自治州棘球蚴病的流行特征和防控历程难点,为调整或完善现有的防控策略和措施提供可借鉴的科学依据。方法对1962—2012年甘孜州18个县的牧区、半农半牧区、农区采用整群分层随机抽样,对3周岁以上人群的B超、间接ELISA检查资料,对牦牛、绵羊、山羊、犬等动物感染资料,和对犬粪采用双抗体夹心法检测犬粪抗原资料进行汇总分析。同时,对纳入信息管理系统的病例也进行了平行分析。结果共调查农牧民84万余人中,共检出棘球蚴病例12 626例,其中泡型棘球蚴病（alveolar echinococcosis,AE）占总数的36.9%,囊型棘球蚴病（cystic echinococcosis,CE）占53.2%、混合型占9.9%。该病对牧区人群的危害大于半农半牧区,对半农半牧区人群的危害大于农区。7~13岁儿童感染率为4.97%。牦牛、藏系绵羊、山羊感染率分别为31.87%、44.82%、14.7%。共剖检犬324只,发现135只阳性,感染率为41.67%,2008-2011年查犬粪抗原阳性率为30.47%;查藏狐193只,发现多房棘球绦虫感染率为51.8%,红狐21只,感染率为57.1%。人间感染与患病因地域分布、海拔高度、产业类型不同,存在明显的差异。结论甘孜州存在3种棘球绦虫的广泛流行,尤以牧区为重,犬是已知最重要的传染源。

Objective To understand the epidemiological features and control difficulties in Ganzi Tibetan autonomous prefecture of Sichuan province in 1962 - 2012, and to provide scientific basis for improvement of current control strategies. Methods With stratified random sampling method, the pasture area, farming - pastoral area and farming area of the 18 counties in 1962 - 2012 were investigated. Data of B ultrasound, indirect ELISA were collected in the children over 3 years old, as well as the infection data of yak, sheep, goat and dog were collected as well. The dog feces were tested antigen with double antibody sandwich method. Moreover, the cases in the information management system were conducted parallel analysis. Results Of the investigated 840 000 agro -pastoralist, 12 6262 were detected with echinococcus, in which alveolar echinococoisis accounted for 36. 9% of the total, cystic echinococosis accounted for 53.2% of the total and the mixed type accounted for 9.9% of the total cases. The damage caused by this disease was most severe in the pasture area, then the farming- pastoral area, and finally the agricultural area. The infection rate of children with age of 7 -13 was 4.97%. The infection rate of yak, Tibetan sheep and goat was respectively 31.87%, 44. 82% and 14.7%. There were 324 dogs conducted necropsy, with 135 positive with echinococosis （57. 1% ） . The infection and prevalence distribution were mal- distributed among regions, altitude and type of industry. Conclusion The 3 type of echinococosis are widely spreading in Ganzi prefecture, especially severe in the pasture area. The dog is the most infection source so far known.