2016-2020年广西壮族自治区华支睾吸虫病监测结果分析

Analysis on clonorchiasis surveillance in Guangxi Zhuang Autonomous Region from 2016 to 2020

目的了解广西华支睾吸虫病的流行现状和态势,为制定防治对策提供科学依据。方法按照广西华支睾吸虫病流行程度选取6个县(市、区)作为固定监测点,各监测点按地理方位划分为东、西、南、北、中5个片区,每片区抽取1个乡镇(街道)的1个行政村(社区),每年度在每个行政村(社区)整群抽取3周岁以上居民200人,共1000人,覆盖儿童、青年、中年和老年各年龄组人群。采集3岁以上常住居民粪样,采用改良加藤厚涂片法检测华支睾吸虫卵并计数。如在检测中发现其他寄生虫感染,同时予以记录。从2016至2020年连续监测5年。结果2016—2020年,监测点各年华支睾吸虫感染率分别为11.98%(756/6308)、6.32%(394/6230)、10.97%(670/6110)、10.03%(680/6781)、7.96%(497/6242),感染率呈下降趋势(χ^(2)=13.627,P<0.01)。各年华支睾吸虫感染率男性均高于女性;以40~49岁、50~59岁年龄组感染率最高;感染率随文化程度的提高而升高;感染度以轻度为主。2016—2020年6个县(市、区)土源性线虫各年感染率分别为2.46%(155/6308)、2.30%(143/6230)、1.34%(82/6110)、1.11%(75/6781)、0.72%(45/6242),感染率逐年下降(χ^(2)=88.378,P<0.01);各年间钩虫均为主要的感染虫种。结论广西人群华支睾吸虫感染率仍然较高,华支睾吸虫病仍为今后预防和治疗的重点寄生虫病。

Objective To understand the endemic status of Clonorchis sinensis infection in Guangxi area for evidences to develop scientific prevention and control measures for this parasite infection.Methods Six counties(cities or districts)were selected as regular surveillance sites according to the epidemic severity of Clonorchis sinensis infection in Guangxi.Each monitoring site was divided into 5 areas by geographical location(east,west,south,north and middle areas),where one administrative village(community)was then selected from a township to serve as the surveillance site.By cluster sampling,200 permanent residents(a total of 1000)aged over 3 years were annually included from individual village(community)to undergo fecal examination using modified Kato-Katz thick smear method for the count of Clonorchis sinensis eggs,and other parasitic eggs were maintained if detected in the test.The surveillance lasted for five years(from 2016 to 2020),and covered all population group ranging from children,adults,middle-aged and the elderly.Results The infection rate of Clonorchis sinensis per year was 11.98%(756/6308),6.32%(394/6230),10.97%(670/6110),10.03%(680/6781)and 7.96%(497/6242),respectively,which showed a declined trend from 2016 to 2020(χ^(2)=13.627,P<0.01).The infection rate in each year is commonly higher in males than in females,and the highest in population aged between 40 and 49,50 and 59 years old.The infection was increased with added educational level,yet was generally mild.The infection rate of soil-transmitted nematodes was 2.46%(155/6308),2.30%(143/6230),1.34%(82/6110),1.11%(75/6781)and 0.72%(45/6242),respectively in the five years,and tended to decrease year by year(χ^(2)=88.378,P<0.01).Hookworm infection was dominate in each year among other parasites.Conclusion Infection of Clonorchis sinensis remains in a higher endemic level in Guangxi,which suggests that clonorchiasis should be the key in following prevention and control of the parasitic disease.