新疆阿克陶县棘球蚴病流行病学调查

Epidemiological investigations on echinococcosis in Akto County,Xinjiang

目的在阿克陶县境内进行流行病学调查，了解棘球蚴病的流行程度和特点，为防治工作提供依据。方法在阿克陶县农业区和牧业区抽取3个乡（镇），每个乡（镇）抽取4个村，共24个村作为调查点．进行全人群棘球蚴病、6～12岁学生血清棘球蚴病抗体、家畜棘球蚴和犬棘球绦虫感染的调查。采用B超常规腹部扫描检查棘球蚴感染：用ELISA方法检测6～12岁学生血清棘球蚴病IgG抗体和犬粪样中棘球绦虫抗体；对屠宰家畜的肝、肺、肾、脾、心和腹膜等脏器进行触摸和肉眼观察检查棘球蚴。结果农业区和牧业区共检查6113人，其中仅在牧业区喀尔克其克乡查出棘球蚴病患者1人．占0．02％（1／6113），患病率为0．49／10万（1／20．23万）。农业区与牧业区6～12岁学生血清抗体阳性率为2．70％（49／1813）；农业区阳性率（3．20％，28／875）与牧业区阳性率（2．24％。21／938）差异无统计学意义（χ^2=1．54，P〉0．05）。其中，男性占38．78％（19／49）。阳性率为1．74％（19／1093）．女性占61．22％（30／49），阳性率为4．17％（30／720）；阳性率女性高于男性（χ^2=9．73，P〈0．05）；农业区男性阳性率（2．20％，11／500）与女性阳性率（4．53％，17／375）差异无统计学意义（χ^2=3．76，P〉0．05）；牧业区男性阳性率1．35％（8／593）低于女性阳性率3．77％（13／345）（χ^2=5．83，P〈0．05）；6-12岁年龄组间阳性率差异无统计学意义（χ^2=0．20～2．20，P〉0．05）。羊棘球蚴囊携带率为5．25％（49／933），牛棘球蚴囊携带率为1．29％（4／311）。家犬粪抗原阳性率为0．46％（9／1967），农业区和牧业区间阳性率无统计学意义差异（χ^2=0．01，P〉0．05）。结论阿克陶县棘球蚴病患者以青壮年为主。农业区和牧业区6—12岁学生血清抗体阳性率和犬粪抗原阳性率两地间无差异．农业区女性感染率较高。应加强家犬管理，提高人群防病意识。有效降低人群感染率。

Objective To conduct an epidemiological investigation on echinococcosis in Akto County, Xinjiang for understanding the prevalence and characteristics of the disease, so as to provide evidence for prevention and treatment. Methods A total of 24 villages （4 villages in each town and 3 towns in agricultural and pasturing areas of Akto county respectively） were selected as investigation spots. The investigation on echinococcosis covered whole population while serum antibody against echinococcosis was detected in 6-12 years old students as well as the investigation on echinococcosis in livestock and dogs was conducted. B ultrasound scan of the abdomen was used to check the infection of the hydatid cyst. The ELISA method was used to detect the serum IgG antibody against echinococcosis among 6-12 years old students and the antibody in dog fecal samples. The organs such as liver, lung, kidney, spleen, heart and other organs and peritoneum of the slaughter livestock were examined through palpation and visual observation for the infection rate of the hydatid cyst. Results In agricultural and pasturing regions, a total of 6 113 people was investigated. Only one patient with hydatid disease was found at Carkeqike Town in pasturing region with a proportion of 0.02% （1/6 113） and a prevalence rate of 0.49/100 000 （1/202.3 thousand）. The positive rate of echinococcosis serum antibodies among 6-12 years old students in agricultural areas and pastoral areas was 2.70%（49/ 1 813） and it was 2.24%（21/938） in pasturing areas and 3.20%（28/875） in agricultural areas without statistical significance （χ^2= 1.54,P〉0.05 ）. Moreover, the positive rate in female was 4.17% （30/720）, higher than that in male（1.74%, 19/1 093）（χ^2=9.73 ,P〈0.05）, and the difference between the positive rate in pastoral areas（2.24%,21/938） and that in agricultural area （3.20%,28/875） was not statistically significant （χ^2= 1.54 ,P〉0.05）. The positive rate of female in pasturing areas （3.77%, 13/345） was higher than that of man （1.35%, 8/593） （χ^2=5.83 ,P〈0.05 ）, and the difference of positive rate between male 2.20%（11/500） and female 4.53% （17/375） was not statistically significant（χ^2=3.76, P〉0.05） in agricultural areas; and the positive rate of male 1.35% （8/593） was less than that of female 3.77% （13/345）（χ^2=5.83 ,P〈0.05）in pasturing areas. The positive rates between 6-12 age groups was not statistically significant（χ^2=0.20-2.20,P〉0.05）. The carrying rate of hydatid cyst in sheep was 5.25%（49/933 ）, and it was 1.29%（4/311 ） in bovine. The positive rate of rate nococeosis antibody in stool samples of domestic dogs was 0.46% （9/1 967 ）, and the difference of positive rate between the agriculture areas and pasturing region was not statistically significatant （χ^2=0.01 ,P〉0.05）. Conclusion The major population of eehinococeosis patients is young adult in Akto County. The positive rate of echinoeoceosis antibody in sera of 6-12 years old students and in stool samples of domestic dogs did not exhibit any difference. The infection rate was higher in female of agricultural areas. Therefore, the management of domestic dogs should be strengthened, the awareness of preventing the disease must be improved in people so as to effectively reduce the prevalence.