2011～2015年重庆市土源性线虫市级监测点监测结果分析

Analysis on the endemic status of soil-transmitted nematode infections in municipal monitoring spot of Chongqing city from 2011 to 2015

目的掌握重庆市人群感染土源性线虫的动态和流行规律。方法 2011～2015年,每年在全市监测县(区)各监测点采集居民粪便,采用改良加藤厚涂片法检查蛔虫、钩虫和鞭虫虫卵;3～12岁儿童加做透明胶纸肛拭法检测蛲虫卵;采集家庭土壤样本,检查蛔虫卵。结果 5年重庆市市级监测点累计共调查21 195人次,2011～2015年土源性线虫感染率依次为6.44%、7.30%、6.85%、6.93%、5.56%。人群总体土源性线虫感染率无下降趋势(χ~2_(linear trend)=3.54,P>0.05);2012年女性感染率高于男性,差异有统计学意义(χ~2=5.75,P<0.05);各年龄组感染率以老年组与学龄前儿童组较高;文化程度与人群感染率存在线性趋势,文化程度越高,感染率越低(χ~2_(linear trend)=98.59,P<0.01);职业分布以儿童与农民检出率较高(χ~2=28.53,P<0.01);蛔虫和钩虫是感染的主要虫体,感染度以轻度为主,中度较少,重度感染最少。各年间全市儿童蛲虫感染率最低为1.86%,最高9.70%,并且呈上升趋势(χ~2_(linear trend)=15.65,P<0.01)。5年监测点土壤人蛔虫虫卵检出率分别为18.13%、15.63%、15.00%、8.10%、5.00%,并呈下降趋势(χ~2_(linear trend)=16.79,P<0.01)。结论重庆市监测点人群土源性线虫病感染水平总体较低,5年间已无下降趋势,应形成现代疾病防治的社会医学防治模式,同时继续加强健康教育及集体驱虫等防治措施。

Objective To understand infection status and epidemic law of soil-transmitted nematode infections in Chongqing area. Methods The stool samples were collected from the residents living in the monitoring spot of Chongqing city between 2011 and 2015,and detected for Ascaris lumbricoides,Trichuris trichiura and hookworms with modified Kato-Katz thick smear. Adhesive cellophane anal swab was additionally used in children aged from 3 to12 years to collect the eggs of Enterobius vermicularis. Soil samples were collected from the residential houses for ascaris eggs that were microscopically detected. Results A total of 21 195 subjects living in the municipal monitoring spot were investigated from 2011 to 2015. The annual infection rate was 6. 44%,7. 30%,6. 85%,6. 93%and 5. 56%,respectively,and did not decline in five years（ χ2linear trend= 3. 54,P〈0. 05）. The infection rate was higher in females than in males in 2012（ χ2= 5. 75,P〈0. 05）,and found the highest in the aged and children.There was a linear tread between educational background and population rate,and the infection rate remained lower in population with better education（ χ2linear trend= 98. 59,P〈0. 01）. Children and farmers were highly affected by occupational distribution（ χ~= 28. 53,P〈0. 01）. The infection was primarily associated with ancylostomiasis and ascaris. Mild infection was dominant,and moderate and severe infections were less. The infection rate of Enterobius vermicularis was 1. 86% and up to 9. 70% for children in five years,which indicated a rising tendency（ χ2linear trend= 15. 65,P〈0. 01）. The infection rate of ascaris eggs was 18. 13%,15. 63%,15. 00%,8. 10% and5. 00% from 2011 to 2015,with declined tendency（ χ2linear trend= 16. 79,P〈0. 01）. Conclusion Although the soil-transmitted nematode infections remain in lower level from 2011 to 2015,yet the infection rate does not decline.Prevention of the infection should be based on the modern model of social medicine as well as continuously enhanced health education and mass chemotherapy.