应用间接荧光抗体试验调查黄淮流域不同媒介地区当前疟疾流行水平的研究  

Evaluation on Malaria Situation in Areas along Yellow River and Huaihe River by Indirect Fluorescent Antibody Test

作　　者：郑香[1] 房文[1] 黄芳[1] 沈毓祖[2] 苏云普[3] 黄光全[4] 周水森[1] 

机构地区：[1]中国疾病预防控制中心寄生虫病预防控制所,世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海200025 [2]安徽省疾病预防控制中心,合肥230061 [3]河南省疾病预防控制中心,郑州450016 [4]湖北省疾病预防控制中心,武汉430079

出　　处：《中国寄生虫学与寄生虫病杂志》2008年第6期417-421,共5页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：科研院所社会公益项目(No.2005DIB1J092)~~

摘　　要：目的通过对黄淮流域居民进行间接荧光抗体试验(IFAT)调查,评价黄淮流域不同媒介地区疟疾流行水平。方法2006和2007年选择沿黄淮流域单一中华按蚊为媒介的安徽省宿州、怀远和砀山县、河南省永城县,嗜人按蚊与中华按蚊复合媒介地区的河南省桐柏县和湖北省广水县,每县分别选择2个自然村,采用重复横向调查方法,连续两年于疟疾流行季节末期对调查点居民(≥1.5岁)采制滤纸干血滴,用IFAT检测人群疟疾抗体水平,计算人群疟疾抗体阳性率与阳性几何平均滴度倒数(GMRT);分别以20岁以下年龄组的抗体阳性率通过可逆催化模型估算这些地区的疟疾感染概率,并与当年疟疾发病率进行比较。结果2006和2007年安徽、河南和湖北等3省6县12个自然村的平均抗体阳性率分别为6.1%(153/2489)和12.0%(295/2458),其中单一中华按蚊媒介地区2007年的平均抗体阳性率12.0%(194/1624)]明显高于2006年的4.1%(69/1670)(χ2=69.9,P<0.01);而嗜人按蚊和中华按蚊复合媒介地区平均抗体阳性率分别为10.3%(84/819)和12.1%(101/834),两年的差异无统计学意义(χ2=0.17,P>0.05)。2007年12个自然村平均阳性GMRT为26.2,略高于2006年的22.7。可逆催化模型估算结果显示,单一中华按蚊媒介地区和复合媒介地区年感染概率均明显高于当地疫情报告的疟疾发病比率,前者平均分别为后者的117.3倍和17.2倍。在抗体阳性者中,有87.8%为疟疾无症状者,表明黄淮流域地区存在一定比例的无症状潜在传染源。结论黄淮流域地区疟疾实际发病远较报告疫情为高,单一中华按蚊为媒介地区疟疾发病呈回升趋势,嗜人按蚊与中华按蚊复合媒介地区疟疾传播相对稳定。Objective To evaluate malaria situation by indirect fluorescent antibody test （IFAT） in 12 villages of six counties along Yellow River and Huihe River in Anhui, Henan and Hubei Provinces. Methods Crosssectional seroepidemiologic survey was conducted through IFAT in Anopheles sinensis area and A. anthropophagus plus A. sinensis area respectively in 2006 and 2007. The blood-filter papers collected from residents were tested by IFAT to calculate malaria antibody positive rate （APR） and positive GMRT in different age groups. The predictive infection probability was evaluated by reversible catalytic model based on antibody positive rate in the group of less than 20 year-old and compared to the annual parasite incidence. Results In 2006 and 2007, the average antibody positive rate in the investigated villages was 6.1% and 12.0% respectively. In An. sinensis areas, the APR in 2007 （12.0%） was significantly higher than that in 2006 （4.1%） （χ^2=69.9, P〈0.01） while in An. anthropophagus plus An. sinensis areas there was no significant difference in 2006 （10.3%） and 2007 （12.1%） （χ^2=0.17, P〉0.05）. The average positive GMRT of the 12 villages was 26.2 in 2007, slightly higher than that in 2006. In both An. sinensis area and An. anthropophagus plus An. sinensis area, the predictive infection probabilities were higher than the annual parasite incidence with an average 117.3 and 17.20 times higher than the latter respectively. 87.8% of the antibody positive cases were asymptomatic, indicating that there were potential infection sources with symptomatic parasitaemia in the areas. Conclusion Malaria is still prevalent in areas along Yellow River and Huihe River and the actual number of malaria cases are underestimated by the case report system. Malaria reemergenee may occur in An. sinensis area but relatively stable in An. anthropophagus plus An. sinensis area.

关 键 词：疟疾 间接荧光抗体试验 抗体阳性率 可逆催化模型 感染概率 

分 类 号：R531.31[医药卫生—内科学]