藏区人群细粒棘球蚴病患病影响因素的病例对照研究

A case-control study on risk factors of cystic echinococcosis in humans in Tibetan areas

目的了解藏区人群细粒棘球蚴病患病的影响因素,为制定相关的防治策略提供依据。方法于2017年8-9月,在环境、海拔相似的西藏那曲县和四川石渠县共选择4个细粒棘球蚴病患病率较高的乡,采用1∶1病例对照的研究方法,通过入户问卷方式调查影响当地人群患细粒棘球蚴病的相关因素并进行统计分析。结果共调查了378人,病例组和对照组各189人。单因素分析发现,养狗年数(OR=1.032,P<0.05)、养狗数量(OR=1.260,P<0.05)、养狗方式(OR=1.434,P<0.05)、是否喂狗内脏(OR=1.531,P<0.05)、周围是否有流浪狗(OR=1.946,P<0.05)是患细粒棘球蚴病的危险因素。多因素分析中,是否喂狗内脏、周围是否有流浪狗、饮水来源等3个变量纳入了多因素回归模型。结论喂狗内脏、周围有流浪狗、饮用河水均是人群患棘球蚴病的危险因素。

Objectives To understand the risk factors of cystic echinococcosis in Tibetan population,so as to provide the reference for development of prevention and control strategies.Methods Four cystic echinococcosis highly-prevalent townships were selected from Naqu County of Tibet and Shiqu County of Sichuan Province,which had similar environmental and altitude conditions,from August to September,2017. Applying the 1∶1 case-control study,a household survey was conducted to investigate the risk factors of echinococcosis in humans.Results A total of 378 residents were investigated,of which the numbers of cases and non-cases were both 189. The univariate analysis showed that the years of keeping dogs（OR = 1.032,P 〈0.05）,the number of keeping dogs（OR = 1.260,P〈 0.05）,the way of raising dogs（OR = 1.434,P〈 0.05）,feeding with raw viscera（OR = 1.531,P 〈0.05）,and there being stray dogs around（OR = 1.946,P〈 0.05）were the risk factors of echinococcosis. As a result of the multivariate logistic regression analysis,only three risk factors,feeding with raw viscera,there being stray dogs around,and drinking water resource,were included in the regression model.Conclusion Feeding with raw viscera,there being stray dogs around,and drinking water resource are the risk factors of echinococcosis in humans.