2018-2022年四川省甘孜藏区棘球蚴病监测结果分析

Analysis on the surveillance results of echinococcosis in Ganzr Tibetan region of Sichuan from 2o18 to 2022

目的调查2018-2022年四川甘孜藏区棘球蚴病流行状况,为优化棘球蚴病的防控对策提供科学参考。方法采用影像学和血清学检测方法筛查甘孜藏区2018-2022年人群棘球蚴感染情况;通过解剖目检、PCR和测序法检测疑似染疫的牲畜(牛羊)和啮齿动物脏器;采用酶联免疫吸附试验检测犬科动物粪便中的棘球绦虫抗原,分析不同时间和区县棘球蚴病流行状况。结果甘孜藏区2018-2022年人群棘球蚴病总患病率为0.028%,且呈逐年下降趋势(χ^(2)_(趋势)=328.133,P<0.01);牲畜总感染率为3.44%,呈下降趋势(χ^(2)_(趋势)=325.295,P<0.01);啮齿类动物总感染率为2.96%,呈下降趋势(χ^(2)_(趋势)=257.235,P<0.01);犬科动物粪便中棘球绦虫抗原阳性率为1.40%,呈下降趋势(χ^(2)_(趋势)=899.060,P<0.01)。2022年与2018年相比,各区县(东路、南路和北路区县)中人群棘球蚴病患病率、牲畜棘球蚴感染率、啮齿动物棘球蚴感染率和犬科动物粪便中棘球绦虫抗原阳性检出率均显著降低,且均以北路区县降低最明显。截至2022年,不同区县人群棘球蚴病患病率和犬科动物粪便中棘球绦虫抗原阳性率均显著不同(χ^(2)=12.595,263.144,均P<0.01),以东路区县最高(分别为0.022%和1.71%);不同区县牲畜和啮齿动物棘球蚴感染率显著不同(χ^(2)=28.406,24.829,均P<0.01),以北路区县最高(分别为2.91%和2.75%)。结论2018-2022年甘孜藏区棘球蚴病流行总体呈下降趋势,但不同区县人群、牲畜、啮齿动物和犬科动物中棘球蚴病的流行程度不同,提示需关注不同区县棘球蚴病传播动力学因素,秉承“OneHealth”理念控制传染源和切断传播途径,防止棘球蚴病流行。

Objective To explore the epidemic situation of echinococcosis in Ganzr Tibetan Regionof Sichuan Province from 2018 to 2022,and provide scientific references for optimizing the strategies on prevention and control of echinococcosis. Methods In Ganzr Tibetan region from 2018 to2022,human with echinococcosis were investigated by imaging and serological testing methods;tissue organs of livestock(cattle and sheep) and rodent that were possibly infected by Echinococcus larvae, were suspected using anatomical visual examination, PCR and sequencing methods;and Echinococcus antigen in canine faeces were detected by enzyme-linked immunosorption test, and further, the prevalence of echinococcosis in different times and districts were analyzed using the descriptive method. Results In Ganzr Tibetan region from 2018 to 2022,the total prevalence rate of human echinococcosis was 0.028%,showing a significant decreased trend(χ^(2)_(trend)=328.133,P0.01);the total infection rate of Echinococcus in livestockand rodents was 3.44% and 2.96%,showing a significant decreased trend(χ^(2)_(trend)=325.295,P0.01;χ^(2)_(trend)=257.235,P0.01),respectively;the positive rate of Echinococcus antigen in canine faeces was 1.40%,showing a significant decline trend(χ^(2)_(trend)=899.060,P0.01). Compared with 2018,in 2022,the prevalence of human echinococcosis,the infection rate of echinococcosis in livestockand rodents, and the positive rate of Echinococcus antigen in canine faeces, were significantly declinedin three different districts(the East Road, South Road and North Road district),respectively, and among them, the North Road disctict are the most prominent.However, in 2022,significant differences in the three counties(χ^(2)=12.595,P=0.002;χ^(2)=263.144,P0.01),were observed in the prevalence of human echinococcosis and the positive rate of Echinococcus antigen in canine faeces, and among them, the highest value at 0.022% and 1.71% occurred in the East Road distict, respectively. At the same time, the infection rate of Echinococcus in livestock and rodents in the three counties reveal significant differences(χ^(2)=28.406,P0.01;χ^(2)=24.829,P0.01),respectively, and among them, the highest value were 2.91 % and 2.75%,which occurred in the North Road districts, respectively. Conclusion In 2018-2022,the epidemic of echinococcosis in Ganzr Tibetan region generally reveals a decreased trend, but the prevalence of the zoonoses in human, livestock, rodents and canines, is of great differentin different counties, and it suggests that the transmission dynamic factors of echinococcosis in different districts needs further investigation, and with the conception of One Health, to control the source of infection and block the transmission route, and curb the epidemic of echinococcosis.