2006-2019年河南省棘球蚴病疫源地调查分析

Investigation of the natural epidemic focus of echinococcosis in Henan province from 2006 to 2019

目的了解河南省人群棘球蚴病及犬只棘球绦虫感染情况,评估河南省棘球蚴病传播风险。方法 2006-2019年选择焦作市等8个曾有疑似本地棘球蚴病病例报告的地区,通过便利抽样法采集当地6岁及以上儿童和居民血清,ELISA法检测血清抗棘球蚴IgG抗体,对部分血检者进行B超筛查;各调查点采集502只犬粪样本,通过ELISA法检测棘球绦虫犬粪抗原。结果 2006-2019年间共调查2 871人,人群血清抗棘球蚴抗体平均阳性率为1.53%(44/2 871),其中2019年人群棘球蚴血清抗体阳性率最高,达22.58%(14/62)(χ^(2)=70.506,P<0.05);不同地区中邓州市阳性率最高,为22.58%(14/62)(χ^(2)=40.320,P<0.05);男女之间阳性率差异无统计学意义(χ^(2)=1.295,P>0.05);不同民族间,回族高于汉族(χ^(2)=16.736,P<0.05)。B超检查484人,阳性率为3.31%(16/484),其中新发现2例棘球蚴病病例,均为邓州儿童,无流行病学史;回族B超检出阳性率高于汉族(χ^(2)=6.176,P<0.05)。犬只调查中累计检测502只犬,犬粪抗原阳性率1.59%(8/502),除洛阳外,其余地区犬粪抗原阳性率差异有统计学意义(χ^(2)=11.251,P<0.05),邓州犬的粪抗原阳性率最高,为20.00%(1/5)。结论河南省邓州市可能存在棘球蚴病潜在流行区,应加强当地棘球蚴病的疫情监测和流行病学调查。

Objective To understand the endemic status of echinococcosis and evaluate the risk of echinococcosis transmission in Henan province. Methods Serum samples were collected by convenience sampling from the residents aged more than six in eight regions which had the suspected local echinococcosis cases reported from 2006 to 2019. Hydatid IgG antibody was tested with enzyme linked immunosorbent assay(ELISA)method. And partial of the blood tested people received the B-ultrasound scanning. Moreover,canine antigens were detected by Copro-ELISA in feces collected in the endemic regions. Results A total of 2 871 residents were tested;the seroprevalence of Echinococcus was 1.53%(44/2 871)and the highest positive rate was exhibited in 2019(22.58%,14/62)(χ^(2)=70.506,P<0.05). Dengzhou city had the highest prevalence(22.58%,14/62) compared with other seven cities (χ^(2)=40.320,P<0.05). No significant difference in seroprevalence of Echinococcus in different gender population (χ^(2)=1.295,P>0.05). The Hui nationality had the higher prevalence than Han people(χ^(2)=16.736,P<0.05). The positive rate was 3.31%(16/484)in 484 people who received Bultrasound scanning. Besides,two new cases of echinococcosis were diagnosed,who were both children in Dengzhou city and had no epidemiological history available. The positive rate of B-ultrasound scanning in Hui nationality was higher than that in Han people(χ^(2)=6.176,P<0.05). In canine survey,the hydatid infection rate was 1.59%(8/502)in total of 502 dogs. Obviously,Dengzhou city had the highest infection rate of Echinococcus(χ^(2)=11.251,P<0.05). Conclusion The natural epidemic focus of echinococcosis might exist in Dengzhou of Henan province;the surveillance and epidemiological investigation of echinococcosis should be strengthened.