江西省人体蛔虫感染现状分析

Endemic status of human Ascaris lumbricoides infection in Jiangxi Province

目的了解和分析江西省蛔虫感染情况现状和态势,为制定全省蛔虫病防治策略提供科学依据。方法按照2014年全国第三次人体重点寄生虫感染现状调查方案和细则要求,结合江西省的具体情况,以生态区为基础,按照经济条件和地理方位两个特征分层整群随机抽样。共抽取全省32个县92个调查点,每个调查点调查3岁以上常住居民250人,用改良加藤厚涂片法粪检虫卵(一粪二检)。不同人群感染率差异采用χ2检验进行比较。结果共粪检23 606人,蛔虫感染者206例,感染率为0.87%(206/23 606)。蛔虫感染者中,查获受精虫卵感染者97例(47.09%),未受精卵感染者109例(52.91%),受精和未受精虫卵同时感染者46例(22.33%)。20个县查获蛔虫卵阳性者,占调查县的62.5%(20/32),其中于都县感染率最高,为5.35%(42/785),奉新等12个县未检出蛔虫感染者,不同县间感染率差异有统计学意义(P <0.01)。生态区分布以南岭生态区最高(1.65%, 78/4 742),浙闽生态区最低(0.10%, 6/5 887),不同生态区间感染率差异有统计学意义(P <0.05)。女性感染率为0.99%(120/12 068),高于男性感染率0.75%(86/11 538)(P> 0.05)。各年龄组均有感染者,以30～39岁组感染率最高(1.14%, 28/2 465)。职业分布以商人感染率最高(1.50%, 4/267),待业人员最低(0)(P <0.01)。文化程度分布以小学以下感染率最高(1.13%, 43/3 818),高中最低(0.49%, 8/1 631)。不同年龄组、职业、文化程度间感染率差异均有统计学意义(P <0.01)。结论江西省蛔虫感染率已降至历史最低水平,受精卵比未受精卵出现率低,区域分布明显,局部地区感染率较高,仍然是江西省今后寄生虫病防治的重点之一。

Objective To understand and analyze the prevalence and endemic status of Ascaris lumbricoides infection in Jiangxi province, so as to provide scientific basis for the development of control strategy. Methods A survey was performed in Jiangxi Province according to the protocol detailed by the 3 rd National Investigation of Human Key Parasitic Infections in 2014. Total 92 survey sites in 32 counties were chosen using stratified cluster sam-pling method based on the different ecological, economical and geographical status. More than 250 permanent resi-dents with age over 3 years old were involved in each site. The stool samples were collected from each participant and the eggs of A. lumbricoides in the stool samples were microscopically examined by Kato-Katz technique in duplicate. The difference in infection rate was compared between different groups of participants using the chi-square test. Results A total of 23 606 villagers were surveyed and the overall prevalence of A. lumbricoides infection among the investigated population was 0.87%(206/23 606). The infection of A. lumbricoides was found in the 20 of 32 surveyed counties with highest prevalence in Yudu(5.35%, 42/785), which is statistically different compared with prevalence in other surveyed counties( P < 0.01). For the prevalence in different ecological regions, the prevalence in Nanling ecological region(1.65%, 78/4 742) was significantly higher than that in Zhejiang/Fujian ecological region(0.10%, 6/5 887)(P < 0.05). The prevalence of A. lumbricoides infection in male villagers was 0.75%(86/11 538)that is not significantly different compared with the prevalence in female(0.99%, 120/12 068)( P > 0.05). Among 206 infected people, 97 were identified with fertilized eggs(47.09%), 109 were identified with unfertilized eggs(52.91%), and 46 were identified with mixed fertilized and unfertilized eggs. The infection was found in all age groups with the highest infection rate in the 30-39 year group(1.14%, 28/2 465). For the occupation distribution,the infection rate was highest in businessman(1.50%, 4/267) and lowest in unemployed people(0). In terms of education, the infection rate was highest in the people with illiteracy(1.13%, 43/3 818), and lowest in people with high school(0.49%, 8/1 631). There is statistical difference among the people with different age groups, occupations,and education level, respectively(P < 0.01). Conclusion The prevalence of A. lumbricoides has dropped to the lowest level in Jiangxi Province. More unfertilized eggs were identified than fertilized eggs in the infected people.However, the regional distribution of A. lumbricoides infection was regionally discrepant with some areas with high infection, which is still one of the key issues for the control of ascariasis in Jiangxi Province.