岳阳市大中小学生肠道寄生虫感染状况及危险因素分析

Prevalence of intestinal parasites and related factors among students in Yueyang city

目的了解岳阳市部分大中小学生肠道寄生虫病感染现状,为进一步制定防治策略提供依据。方法分层随机抽查岳阳市大中小学校5所,每年级随机抽查2个班,采用改良加藤厚涂片(Kato-Katz)法,粪便检查虫卵。钩虫培养采用试管滤纸培养法。采用问卷调查法调查学生卫生知识和健康行为情况。结果共调查1 545名大中小学生,肠道寄生虫感染率小学(3.27%)>中学(2.42%)>大学(1.91%),随学生学段增高而降低(χ~2=2.54,P>0.05)。肠道寄生虫虫种感染率蛔虫(2.65%)>钩虫(1.49%)>鞭虫(0.13%)及姜片虫(0.13%)>华支睾吸虫(0.06%)。城市学生感染率(2.21%)低于农村学生(3.28%),男生感染率(2.65%)略低于女生(2.66%)(χ~2值分别为1.67,0.00,P值均>0.05)。小学、中学与大学肠道寄生虫病防治知识知晓率分别为87.07%,95.00%,97.13%,健康行为形成率分别为84.94%,94.03%,94.90%,且均随学生学段增高而增高,学段间差异均有统计学意义(χ~2值分别为40.12,39.58,P值均<0.01)。肠道寄生虫病防治知识知晓率与健康行为形成率之间呈正相关(r=0.99,P<0.05)。经常吃未洗瓜果、经常喝生水、经常饭前便后不洗手、经常生熟食物共用砧板、经常光脚旱地干活是肠道寄生虫病感染的危险因素[OR值(OR值95%CI)分别为6.14(3.22~11.73),4.13(2.10~8.14),3.74(1.95~7.18),2.64(1.41~4.93),2.45(1.32~4.57),P值均<0.01]。结论蛔虫与钩虫是岳阳市在校学生肠道感染的主要寄生虫种,小学生是重点防治对象。要继续坚持驱虫治疗,加强水及粪便管理,加强健康教育及培养个人良好文明卫生习惯的多种综合防治措施。

Objective To understand the prevalence of the intestinal parasite among students in Yueyang city and to provide basis for prevention and control strategies. Methods Participants were selected through stratified random sampling method from 2 classes of each of the 5 schools. Cellophane fecal thick smear examination technique（Kato） for diagnosis of intestinal schistosomiasis and test-tube cultivation method on the survey of hookworm. Health knowledge and health behavior were investigated by questionnaire survey. Results In all the 1 545 students, the infection rate of intestinal parasite was primary school （3.27%） 〉middle school （2.42%） 〉 university （1.91%）. Roundworm （2.65%） was the most common intestinal parasitic, followed by hookworm （1.49%）, whipworm （0.13%）, fasciolopsis buski （0.13%） and clonorchis sinensis （0.06%）. Infection rate was lower in urban areas （2.21%） and boys （2.65%） than that of rural area （3.28%） and female students （2.66%）. Awareness on intestinal parasitic disease prevention and control in primary, secondary and college students was 87%, 95% and 97%, respectively, while reported rate on health behavior adoption was 85%, 94% and 95% respectively（χ^2 = 39.58, P〈0.01）. Intestinal parasites infection awareness positively related with health behavior adoption （ r= 0.99, P〈0.05）. Eating unwashed fruits, drinking unboiled water, no hand-wash- ing before eating and after toilet, preparing raw meat and cooked food on the same chopping board, and bare foot walking were the main risk factors for intestinal parasitic infection [ 0R（95%C/） was 6.14（ 3.22-11.73）, 4.13（2.10- 8.14）, 3.74（ 1.95-7.18）, 2.64 （1.41-4.93） and 2.45（1.32-4.57）, respectively]. Conclusion Roundworm and hookworm are the most common intestinal parasitic species especially among primary school students. Strengthen water and stool management, public education, improving sanitation conditions, and practicing healthy lifestyle are the major keys to success in preventing the spread of intestinal parasitic infections.