2016—2018年甘南州包虫病监测分析

Analysis of surveillance result of echinococcosis in Gannan prefecture from 2016 to 2018

目的了解甘肃省甘南藏族自治州(简称甘南州)包虫病流行区疫情动态变化,为制定包虫病防控策略提供依据。方法按照全国包虫病监测方案要求,选取甘南州管辖的Ⅰ类县玛曲、碌曲、夏河和Ⅱ类县(市)合作、卓尼,按整群抽样法抽取行政村,采用B超法调查人群患病情况;双抗体夹心ELISA法检测家犬和野犬棘球绦虫粪抗原;内脏剖检法检测牲畜和啮齿动物棘球蚴感染情况。结果甘南州人群包虫病检出率为84.46/10万(29/34335),病例均为囊型;检出率2017年最高(151.59/10万)、2016年最低(38.52/10万),不同年度差异有统计学意义(χ^2=8.706,P<0.05);犬棘球绦虫粪抗原阳性率为3.43%,2017年阳性率最高(5.41%)、2018年最低(2.15%),不同年度差异有统计学意义(χ^2=16.250,P<0.05);中间宿主家畜感染率为1.26%,2016年最高(1.72%)、2018年最低(0.78%),差异有统计学意义(χ^2=6.020,P<0.05),感染率羊高于牛;检查小型啮齿动物1502只,感染率为0.67%。结论甘南州包虫病广泛流行,终末宿主犬棘球绦虫粪抗原阳性率较高,传播风险极大;今后除应采取牧区包虫病的重点防控措施外,还应做好半农半牧区包虫病的监测工作,防止包虫病扩散蔓延。

Objective To understand the dynamic change of the epidemic of echinococcosis in Gannan Tibetan autonomous prefecture(Gannan prefecture)of Gansu province,and provide the basis for formulating the prevention and control strategy of echinococcosis.Methods According to the requirements of the national program of echinococcosis surveillance,the administrative villages were randomly selected with cluster sampling method in counties of classⅠof Maqu,Luqu,Xiahe and counties(cities)of classⅡof Hezuo and Zhuoni.Echinococcosis was examined in the population by B-ultrasound.Fecal antigen to Echinococcus in domestic and stray dogs was detected with double antibody sandwich ELISA method.Infection with Echinococcus in livestock and rodents was determined with visceral dissection method.Results All cases were cystic Echinococcus infection in Gannan prefecture.The detection rate was 84.46/100000,the highest in 2017(151.59/100000)and the lowest in 2016(38.52/100000),with statistical difference(χ^2=8.706,P<0.05)among different years.The positive rate of fecal antigen to Echinococcus canis was 3.43%in dogs,and the highest in 2017(5.41%),the lowest in 2018(2.15%),with statistical difference(χ^2=16.250,P<0.05)among different years.The infection rate of livestock was 1.26%,higher in sheep than in cattle,and the highest in 2016(1.72%)and the lowest in 2018(0.78%),with statistical difference(χ^2=6.020,P<0.05)among different years.Totally 1502 small rodents were detected with the infection rate of 0.67%.Conclusions Echinococcosis widely spreads in Gannan prefecture.The positive rate of faecal antigen in the final host of dog is high,with high risk of transmission.Besides the key prevention measures taking in the pastural area,the surveillance of echinococcosis should be carried out in farming-pastoral regions in the future to prevent echinococcosis from spread.