三峡工程建设对湖北省兴山县肺吸虫病流行影响的调查

A survey on the impact of construction of the Three Gorges Project on the epidemic of paragonimiasis in Xingshan county, Hubei province

目的了解三峡工程建设对兴山县肺吸虫病感染与患病的影响。方法于2012-2016年对兴山县开展4次肺吸虫病感染情况调查,内容包括人群血清学检测和溪蟹囊蚴感染率检测,并收集三峡工程建设前、建设初始及蓄水阶段的肺吸虫病流行资料进行对比分析。结果三峡大坝建成后开展的4次调查,共检测人群1 128人,人群血清学阳性率为2.57%(29/1 128),以2012年南阳镇阳性率最高为8.12%(25/308),差异有统计学意义(χ~2=64.313,P=0.000);采集溪蟹340只,总阳性率为27.94%(95/340),其中以古夫镇感染率最高为48.80%(61/125),差异有统计学意义(χ~2=22.942,P=0.000);工程建设前溪蟹感染率为28.48%(501/1 759),竣工后的溪蟹感染率为27.94%(95/340),均高于建设开始时的感染率(57/298,19.13%),差异有统计学意义(χ~2=11.348,P=0.003);人群血清学阳性率由于检测方法的不同未做比较。结论兴山县溪蟹感染率依然较高,由于三峡大坝建设对环境的改变,出现了新的溪蟹囊蚴高感染率地区,应持续开展监测防控和健康教育宣传,以免出现肺吸虫病暴发流行。

Objective To understand the impact of construction of the Three Gorges Project on the paragonimiasis in Xingshan county.Methods Four epidemiological surveys including sero-epidemiologic investigation and the metacercaria of Paragonimus from crabs captured were carried out in 2012-2016.The data of the paragonimiasis before the construction and the beginning of the construction and the water storage period were collected.Results The active surveillance was conducted on 1 128 residents and the total positive rate of serology test was 2.57%（29/1 128）,while the Nanyang town had the highest rate of 8.12%（25/308）with statistical significance（χ2=64.313,P=0.000）.All of the three hundred and forty fresh-water crabs were captured and the positive rate was 27.94%（95/340）,while the Gufu town had the highest rate of 48.80%（61/125）with statistical significance（χ2=22.942,P=0.000）.The infection rates of the crabs before and after the construction were higher than the beginning of the construction period.This account had statistical significance（χ2=11.348,P=0.003）.The positive rate of the serology tests cannot be compared because of the different detection technology.Conclusion The infection rate of the crabs was still high,and new area of high infection rate appeared in Xingshan because of the Three Gorges Project.Measures on continuous surveillance and health education should be taken to avoid the occurrence of outbreak.