湖南省肝吸虫病高发区流行因素及综合防治模式研究  

Study on Risk Factors and Comprehensive Control and Prevention Mode of Clonorchis sinensis Infection in High-risk Areas in Hunan Province

作　　者：陈培厚[1] 段绩辉[1] 唐阳[1] 陈文华[2] 唐小雨 伍艳君 黄奇荣 夏荣发 王巧智 

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005 [2]湖南省祁阳县疾病预防控制中心 [3]湖南省永州市冷水滩区疾病预防控制中心 [4]湖南省结核病防治所

出　　处：《实用预防医学》2012年第3期344-348,共5页Practical Preventive Medicine

基　　金：湖南省科技计划项目(2010FJ4144)

摘　　要：目的了解湖南省南部地区祁阳县和冷水滩区肝吸虫流行现状、流行因素和居民对肝吸虫病的知、信、行情况,探讨肝吸虫病高发区全民驱虫和健康教育综合干预的效果,为制定肝吸虫病防治规划与策略提供依据。方法在祁阳县和冷水滩区交界处的肝吸虫病高发乡镇进行整群随机抽样。采用改良加藤厚涂片法(Kato-Katz)粪检肝吸虫卵;用压碎法、压片法和人工消化法检查中间宿主的自然感染情况;用解剖方法调查哺乳动物肝吸虫自然感染情况;以座谈和现况调查的方式,了解当地与感染有关的生产生活方式、风俗习惯等情况。对调查点居民开展问卷调查收集与感染有关的危险因素和居民对肝吸虫的知信行情况。对试点村全民驱虫和健康教育干预一年后进行效果评价。采用Epi data3.0建立数据库,利用SPSS 13.0中的χ2分析和Logistic检验分析数据。结果 2006-2010年祁阳县和冷水滩区共调查9个乡镇16个村4 472人,肝吸虫感染人数2 169人,平均感染率48.5%。男、女性别之间的感染率差异无统计学意义(χ2=2.91,P>0.05);各年龄组均有感染,且感染率随年龄增长而升高,各年龄组间差异有统计学意义(χ2=430.799,P<0.05);不同职业人群感染率间差异有统计学意义(χ2=407.720,P<0.05);不同文化程度人群肝吸虫感染差异有统计学意义(χ2=222.227,P<0.05)。共回收1 307份有效问卷,经与肝吸虫病感染有关的危险因素的多因素非条件Logistic分析,与肝吸虫感染有关的危险因素有:年龄、文化程度、饭前便后不洗手、砧板生熟混用、粪便喂鱼、自食生鱼、认为吃生鱼片卫生和没听说过华支睾吸虫病。采取全民驱虫和健康教育干预措施后,人群肝吸虫感染率下降27.2%,干预措施前后感染率差异有统计学意义(χ2=55.725,P<0.05)。纹沼螺、长角函螺感染率分别为17.4%和7.4%,为当地肝吸虫主要的第一中间宿主;鲫鱼、鲤鱼肝�Objective To investigate the epidemic status,risk factors,and the residents＇ knowledge,attitude and practice about Clonorchis sinensis infection in southern area of Hunan Province.To explore the effectiveness of praziquantel,health education,and comprehensive interventions in high-risk areas,and to provide the scientific evidence for making control and prevention programs and strategies of clonorchiasis. Methods Cluster random sampling was performed to survey the incidence of clonorchiasis at the boundary of Qiyang County and Lengshuitan District.The Kato-Katz method was used for etiological examination.Crushing-tabletting and manual digestion were used to test the infection status of intermediate host.The results of mammal infection were collected through dissection.The information of local production,lifestyle and custom related to infection was collected through discussion and field investigation.Questionnaire survey was conducted to collect the risk factors of Clonorchis sinensis infection and the surveyed residents＇ knowledge,attitude and practice of clonorchiasis.The database was established using Epi data 3.0 software,and then descriptive statistics,χ2 test and Logistic analysis were carried out with SPSS13.0 software. Results Totally 2,169 residents were test-positive for Clonorchis sinensis infection among 4,472 residents selected from 16 villages of 9 towns,and the average infection rate was 48.5%.The difference of the infection rates between male and female showed no statistical meaning（χ2=2.91,P0.05）.The study showed that the infection rate of each age group was increased with the increasing age,and the differences in the infection rates were statistically significant among different age groups（χ2=430.799,P0.05）.There were statistically significant differences in the infection rates among the populations with different occupations and with different educational backgrounds（χ2=407.720,P0.05;χ2=222.227,P0.05）.A total of 1,307 valid questionnaires were retrieved.Multivariate uncondit

关 键 词：肝吸虫病 高发区 流行因素 综合防治模式 

分 类 号：R532.23[医药卫生—内科学]