2016-2019年四川省甘孜州棘球蚴病综合防治效果评估

Evaluation of the comprehensive control effects on echinococcosis in Ganzi Prefecture, Sichuan Province from 2016 to 2019

目的评估2016-2019年四川省甘孜州棘球蚴病综合防治效果。方法 2016-2019年,在四川省甘孜州18个县开展棘球蚴病患者筛查、犬只驱虫和感染监测、牛血清抗体监测等综合防控工作。人群棘球蚴病患者筛查采用B超检查,覆盖90%以上常住人口(居住满6个月,年龄2周岁以上)。2016-2019年每年每县随机抽取4~6个乡(镇),每个乡(镇)随机采集不少于50份家犬粪样,ELISA检测犬粪棘球绦虫抗原。2016、2017、2019年每年每县随机抽取4~6个乡(镇),每个乡(镇)随机采集50份牦牛血样,ELISA检测牛血清抗棘球蚴抗体;2018年每县随机抽取不少于30副屠宰的牦牛肝、肺等脏器,采集有棘球蚴囊状物、包块或结节的病灶组织样品,PCR扩增棘球绦虫线粒体细胞色素c氧化酶亚基1(cox1)基因,PCR扩增阳性者判为棘球蚴病病牛。学生棘球蚴病防治知识知晓率调查为每年每乡(镇)随机抽取50名6~12岁学生开展问卷调查。分析2016-2019年甘孜州人群患者检出率、家犬感染率、牛血清抗体阳性率或患病率、6~12岁学生棘球蚴病防治知识知晓率的变化情况。结果2016-2019年,人群棘球蚴病患者检出率分别为1.58‰(693/439 091)、0.44‰(204/460 165)、0.56‰(244/436 473)和0.18‰(51/285 747),呈下降趋势(χ^(2)=617.21, P<0.05);6~12岁儿童检出率分别为0.35‰(24/68 166)、0.10‰(7/68 104)、0.14‰(10/70 096)和0.06‰(4/69 151),呈下降趋势(χ^(2)=19.38, P<0.05)。家犬粪棘球绦虫抗原阳性率分别为16.50%(1 241/7 519)、7.75%(501/6 464)、3.58%(63/1 758)和3.32%(193/5 813),呈下降趋势(χ^(2)=797.96, P<0.05)。2016、2017、2019年牛血清抗体阳性率分别为10.27%(572/5 569)、10.05%(511/5 087)和5.22%(141/2 700),呈下降趋势(χ^(2)=79.58, P<0.05);2018年共检测牛内脏492副,检出病变内脏20副,患病率为4.07%。6~12岁学生棘球蚴病防治知识知晓合格率分别为89.20%(15 925/17 854)、93.90%(17 740/18 892)、94.92%(18 685/19 686)和96.05%(23 564/24 532),呈上升趋势(χ^(2)=902.34, P<0.05)。结论2016-2019年四川省甘孜州棘球蚴病综合防治工作效果显著,人群患者检出率、家犬粪棘球绦虫抗原阳性率、牛血清抗体阳性率/患病率均呈下降趋势,6~12岁学生棘球蚴病防治知识知晓率呈上升趋势。

Objective To evaluate the comprehensive control effects on echinococcosis in Ganzi Prefecture,Sichuan Province, from 2016 to 2019. Methods From 2016 to 2019, comprehensive prevention and control measures, including screening for echinococcosis, deworming and monitoring of infection in dogs, and surveillance of cattle serum antibody, were carried out in 18 counties of Ganzi Prefecture. Ultrasound examination was performed in more than 90% of the residents(aged over 2 years in residence for at least 6 months) to screen for echinococcosis.To investigate the infection rate in dog feces, 4-6 townships were randomly selected from each county in each year of 2016 - 2019, and no less than 50 samples of dog feces were randomly collected from each township using ELISA for Echinococcus coproantigen. Meanwhile, 4-6 townships were randomly selected from each county in each year of2016, 2017 and 2019, and 50 yak blood samples were collected from each township for ELISA analysis of serum anti-metacestode antibody. In 2018, no less than 30 sets of slaughtered yak organs including liver, lungs were randomly collected in each county, and tissue samples with lesions of hydatid cysts, masses or nodules were collected to be used for PCR amplification of mitochondrial cytochrome c oxidase subunit 1(cox1) of Echinococcus spp. The yaks with positive PCR results were considered to have hydatid disease. Questionnaire was conducted to survey the awareness rate of echinococcosis knowledge in students, 50 students aged 6-12 years were randomly selected from each township every year. The survey data in 2016 - 2019 were analyzed including the positive rate in residents, the positive rate of Echinococcus coproantigen in domestic dogs, the positive rate of serum antibody or prevalence in cattle, and the changes of awareness rate of echinococcosis knowledge among students aged 6-12 years. Results From 2016 to 2019, the detection rates of new echinococcosis cases in the residents were 1.58 ‰(693/439 091), 0.44‰(204/460 165), 0.56‰(244/436 473) and 0.18‰(51/285 747), respectively, showing a trend of decrease(χ^(2)= 617.21, P<0.05). The detection rates in children aged 6-12 years were 0.35‰(693/439 091), 0.44‰(204/460 165), 0.56‰(244/436 473) and 0.18‰(51/285 747), respectively, showing a trend of decrease(χ^(2)= 19.38, P<0.05). The positive rate of Echinococcus coproantigen in domestic dogs were 16.50%(1241/7 519), 7.75%(501/6 464),3.58%(63/1 758) and 3.32%(193/5 813), respectively, showing a trend of decrease(χ^(2)= 797.96, P<0.05). The positive rates of serum antibody or prevalence in cattle were 10.27%(572/5 569), 10.05%(511/5 087), 4.07%(20/492), and 5.22%(141/2 700) in 2016, 2017, 2019, respectively, showing a trend of decrease(χ^(2)= 79.58, P<0.05).In 2018, 492 sets of slaughtered yak organs were inspected,, of which 20 were positive, and the prevalence in cattle was4.07%. The eligibility rates of the disease knowledge among students aged 6-12 were 89.20%(15 925/17 854), 93.90%(17 740/18 892), 94.92%(18 685/19 686), and 96.05%(23 564/24 532), showing an trend of increase(χ^(2)= 902.34, P<0.05). Conclusion There have been great achievements by comprehensive control of echinococcosis in Ganzi Prefecture. The positive rate in redidents, the positive rate of dog Echinococcus coproantigen and the positive rate of serum antibody in cattle all decreased year by year, while the awareness rate of echinococcosis knowledge among students aged 6-12 years revealed a trend of increase.