2019—2022年江苏省幼儿园儿童蛲虫感染现状及影响因素分析

Prevalence and influencing factors of Enterobius vermicularis infection among kindergarten children in Jiangsu Province from 2019 to 2022

目的了解江苏省幼儿园儿童蛲虫感染现状、变化趋势及影响因素,为进一步调整与推进儿童蛲虫病防控策略提供科学依据。方法2019—2022年的每年9—10月,在江苏省的南、中、北部分别抽取至少1个县(市、区)作为调查点,每个调查点抽取2个幼儿园(包含1个农村性质、1个城镇性质幼儿园,规模均为200人以上)开展整群抽样,每个幼儿园至少调查200名包含大、中、小班儿童。对儿童进行肛拭法采样,若显微镜下查见蛲虫卵,即判定为蛲虫感染阳性。对儿童家长开展问卷调查,内容包括儿童基本信息、蛲虫感染相关卫生习惯、家庭情况和家长对蛲虫病的知晓情况等。结果2019—2022年在江苏省21个县(市、区)累计调查15669名幼儿园儿童,总感染率为0.7%(111/15669),逐年感染率分别为1.2%(44/3678)、0.5%(13/2568)、0.7%(27/3802)和0.4%(22/5621),呈下降趋势(χ^(2)=14.46,P<0.05);农村幼儿园逐年感染率分别为2.1%(41/1981)、0.2%(2/833)、1.0%(8/824)和0.6%(19/3271),呈下降趋势(χ^(2)=17.34,P<0.05),城区幼儿园分别为0.2%(4/1697)、0.6%(10/1635)、0.7%(20/2987)和0.2%(6/2650),趋势检验无统计学差异(χ^(2)=0.04,P>0.05)。2019—2022年苏南、苏中、苏北的总感染率分别为1.0%(56/5698)、0.5%(32/6135)和0.5%(22/4136)。2019—2022年,大班儿童的感染率分别为1.8%(23/1266)、0.8%(8/998)、1.4%(16/1167)和0.6%(10/1796),呈下降趋势(χ^(2)=8.01,P<0.05),普遍高于中班儿童的1.0%(13/1325)、0.5%(4/871)、0.5%(9/1687)、0.5%(10/2063)和小班儿童的0.8%(9/1087)、0%(0/699)、0.3%(3/948)、0.3%(5/1762)。问卷调查结果显示,2019—2022年幼儿园儿童吸吮手指的比例分别为20.8%、17.4%、20.5%和19.4%,吸吮玩具/文具的比例分别为12.5%、9.3%、10.1%和12.6%;幼儿园儿童家长对蛲虫病的主观知晓率(是否知道蛲虫病)分别为61.9%、76.0%、78.5%和70.3%,呈上升趋势(χ^(2)=202.86,P<0.05)。年龄越大(OR=1.447,95%CI=1.186~1.764,P<0.05)、洗晒频率越低(OR=1.121,95%CI=1.002~1.225,P<0.05)、幼儿园性质为农村的(OR=0.509,95%CI=0.333~0.776,P<0.05)儿童感染蛲虫的风险越高。结论2019—2022年江苏省幼儿园蛲虫感染率维持在较低水平且呈下降趋势,但仍存在不良的卫生习惯、家长相关知识知晓率不高等现象。年龄、洗晒频率、幼儿园性质为幼儿园儿童蛲虫感染的影响因素。

Objective To investigate the current status,trend of changes and influencing factors of Enterobius vermicularis infection in kindergarten children in Jiangsu Province,in order to provide the scientific basis for adjustment and improvement of enterobiasis control strategy.Methods From 2019 to 2022,at least one county(city,district)was selected from the southern,central and northern parts of the Province as survey sites,from each of which two kindergartens(one rural type and one urban type)with a size over 200 children each were selected for cluster sampling the participants.In each kindergarten,no less than 200 chidren separately from senior,middle,and junior classes participated in the suvey.Anal swab method was used to detect E.vermicularis eggs by microscopy.Children’s parents underwent questionnaire survey on basic information of children,hygienic habits related to E.vermicularis infection,family background,and knowledge awareness of enterobiasis.Results A total of 15669 children were examined in 21 counties(districts,cities),and the overall prevalence rate of pinworm infection was 0.7%in Jiangsu Province from 2019 to 2022.The annual prevalence was 1.2%(44/3678),0.5%(13/2568),0.7%(27/3802)and 0.4%(22/5621),with a significant decrease detected among the years(χ^(2)=14.46,P<0.05).The annual prevalence of rural kindergarten was 2.1%(41/1981),0.2%(2/833),1.0%(8/824)and 0.6%(19/3271),with a significant decrease detected among the years(χ^(2)=17.34,P<0.05).The annual prevalence of urban kindergarten was 0.2%(4/1697),0.6%(10/1635),0.7%(20/2987)and 0.2%(6/2650),with no significant difference detected among years(χ^(2)=0.04,P>0.05).The overall prevalence of South Jiangsu,Central Jiangsu,and North Jiangsu from 2019 to 2022 was 1.0%(56/5698),0.5%(32/6135),and 0.5%(22/4136).The prevalence among children of the senior class was 1.8%(23/1266),0.8%(8/998),1.4%(16/1167),and 0.6%(10/1796)from 2019 to 2022,respectively,with a significant decrease detected among years(χ^(2)=8.01,P<0.05),which were higher than that among children of the middle and junior class.The prevalence among children of middle class was 1.0%(13/1325),0.5%(4/871),0.5%(9/1687),and 0.5%(10/2063)from 2019 to 2022,respectively.The prevalence among children of junior class was 0.8%(9/1087),0(0/699),0.3%(3/948),and 0.3%(5/1762)from 2019 to 2022,respectively.The sucking-finger habit accounted for 20.8%,17.4%,20.5%,and 19.4%from 2019 to 2022,respectively.The habit of sucking toys/pens accounted for 12.5%,9.3%,10.1%,and 12.6%from 2019 to 2022,respectively.A total of 61.9%,76.0%,78.5%,and 70.3%(from 2019 to 2022,respectively)parents reported that they knew enterobiasis,with a significant increase detected among the years(χ^(2)=202.86,P<0.05).Being older(OR=1.447,95%CI=1.186-1.764,P<0.05),a low frequency of laundry(OR=1.121,95%CI=1.002-1.225,P<0.05),and rural precshool(OR=0.509,95%CI=0.333-0.776,P<0.05)were risk factors for pinworm infection.Conclusion The prevalence of E.vermicularis infection remained comparatively low in kindergarten children in Jiangsu Province from 2019 to 2022,with a prevalence decreasing trend.However,there exist inadequate hygienic habits in children,and parents showed low knowledge awarness rate on enterobiasis.It is suggested that the factors influencing pinworm infection in kindergarten may include children age,the frequency of washing and sunshining exposure of beddings,and the type of kindergartens.