新疆南疆地区6～12岁儿童棘球蚴病患病情况调查

Hydatidosis Prevalence in 6- to 12-year-old Children in Southern Xinjiang

目的 了解新疆南疆地区6～12岁儿童棘球蚴病患病情况，为制定相关防治策略提供科学依据。 方法 2012年8月-2013年9月采取整群分层抽样方法对新疆南疆5地（州）42个县（市）按照牧区、半农牧区、农区和城镇每层各抽取1所小学，在家长知情同意的情况下，对抽样小学的所有儿童（6～12岁）进行腹部B型超声检查和采集静脉血（5 ml），用ELISA检测棘球蚴病血清IgG抗体水平。分析该年龄段儿童的棘球蚴病的患病和血清抗体阳性情况。 结果 共调查168所小学80 429名儿童。B超检查结果显示，棘球蚴病患病者9例，患病率为0.01%；分布在克州3例、阿克苏地区2例、巴州2例、喀什地区2例。ELISA检测结果显示，血清抗体阳性者4 189例，阳性率为5.21%，其中喀什地区儿童血清抗体阳性率最高，为8.41%（2 143/25 495），阿克苏地区次之（5.69%，913/16 051），不同地区（州）之间的差异有统计学意义（χ2=977.303，P〈0.01）；6岁组血清抗体阳性率最低，为2.13%（44/2 065）；11岁组最高，为5.68%（822/14 462），各年龄组之间的差异有统计学意义（χ2=48.221，P〈0.01）；调查儿童涉及28个民族，血清抗体阳性率以维吾尔族儿童最高，为5.19%（3 899/75 115），蒙古族的次之（4.27%，68/1 592），不同民族间的差异无统计学意义（χ^2=4.072，P〉0.05）。生活方式以定居、游牧、冬季定居夏季游牧为主，定居儿童患病7例，冬季定居夏季游牧儿童患病2例；血清抗体阳性率分别为5.45%（4 184/77 512）、2.97%（3/101）、0.07%（2/2 816），三者差异有统计学意义（χ^2=148.609，P〈0.01）。 结论 新疆南疆地区6～12岁儿童棘球蚴病患病率较低，血清抗体阳性率在喀什地区、维吾尔族、定居儿童中较高。

Objective To understand the hydatidosis prevalence in 6- to 12-year-old children in southern Xinjiang Uygur Autonomous Region and provide scientific basis for formulation of control measures. Methods One primary school was selected from each of the pastoral area, pastoral-agricultural area, agricultural area, and township area in 42 counties （cities） of southern Xinjiang, using the stratified sampling method. With the consent of their parents, B ultrasonic abdominal scan and venous blood collection were performed on all the children （6-12 years） in the selected schools. Serum level of echinococcus antibody IgG was determined by ELISA. Hydatidosis prevalence and the serum level of IgG in these children were analyzed. Results A total of 80 429 children were examined from 168 primary schools. B ultrasonic scan revealed hydatidosis in 9 children （0.01%）, comprising 3 cases in Kezhou, 2 in Aksu, 2 in Bazhou, and 2 in Kashi. ELISA results showed that 4 189 children were positive for serum IgG, with a positive rate of 5.21%. The positive rate was highest in Kashi （8.41%, 2 143/25 495）, followed by Aksu （5.69%, 913/16 051）, with significant difference between different areas （χ^2=977.303, P〈0.01）. The positive rate was lowest in 6-year children （2.13%, 44/2 065） and highest in 11-year children （5.68%, 822/14 462） （χ^2=48.221, P〈0.01）. In addition, the positive rate was highest in Uighur children（5.19%, 3 899/75 115）, followed by Mongolian children （4.27%, 68/1 592）, with no significant difference between ethnic groups （χ^2=4.072, P〉0.05）. Among the children of residents, children with a nomadic lifestyle, and children settled in winter and living in a nomadic lifestyle in summer, hydatidosis occurred in 7 residents and 2 children who settled in winter and living in a nomadic lifestyle in summer; and the positive rate of serum antibody was 5.45% （184/77 512）, 2.97% （3/101）, 0.07% （2/2 816）, respectively（χ^2=148.609, P〈0.01）. Conclusion There is a low hydatidosis prevalence in 6- to 12-year-old children in southern Xinjiang, but the positive rate of serum echinococcus IgG in kashgar region, Uighur ethnicity, and children of the resident group are relatively high.