西藏疟疾流行区血清流行病学调查  

Seroepidemiological investigation on malaria in Momo County and Chayu County, Linzhi District, Tibet

作　　者：房文[1] 潘嘉云[1] 黄芳[1] 周水森[1] 郑香[1] 蒋伟康[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,卫生部寄生虫病原与媒介生物学重点实验室,世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海200025

出　　处：《国际医学寄生虫病杂志》2012年第3期163-166,共4页International JOurnal of Medical Parasitic Diseases

摘　　要：目的通过开展西藏疟疾流行区墨脱和察隅两县人群血清流行病学调查，评价当地疟疾流行程度。方法2010—2011年在墨脱县的背崩、达木、甘登、朱村、墨脱村、地东和察隅的格拥、米古、西巴、嘎堆、塔玛、日玛、松古、扎巴、沙玛共15个居民点采集1520名不同年龄组人群（1—80岁）的滤纸血，用间接荧光抗体试验法检测疟疾抗体水平，计算抗体阳性率及阳性几何平均滴度倒数（geometric mean reciprocal titer，GMRT）；20岁以下年龄组人群抗体阳性率用可逆催化模型估算当地年感染概率，并与当年疟疾发病率进行比较；以抗体滴度≥1：80以上者估算带虫率。结果墨脱调查点平均疟疾抗体阳性率为3．51％（31／883），以此估算的年感染概率为0．51％，与当年疟疾发病率0．32％较为接近；察隅调查点平均抗体阳性率为5．51％（22／399），以此估算的年感染概率为1．24％，而当年疟疾发病率为0。两地不同年龄组人群抗体阳性率均随着年龄增长而升高。结论血清学调查抗体阳性率和以此估算的年感染概率基本能反映西藏疟疾流行区墨脱县和察隅县的疟疾流行程度，人群较高的抗体水平显示两地均存在地方性流行。Objective To evaluate malaria endemic situation by seroepidemiological investigation in Motuo County and Chayu County in Tibet. Methods 1 520 blood filter papers were collected from 1-80 years old in 15 study sites at the Beibeng, Damu, Gandeng, Zhucun, Motuo town, Didong, Geyong, Migu, Xiba, Gadui, Tama, Rima, Songgu, Zhaba, Shama of Motuo County and Chayu County in 2010 and 2011. All the blood samples were tested by indirect haemagglutination test （IFAT） to calculate malaria antibody positive rate （APR） and positive geometric mean reciprocal titer （GMRT）. 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, and the predictive parasitic rate was calculated by the number of sample malaria antibody titer over 1： 80. Results The average APR in Motuo sites was 3.51% （31/883） , and the predictive infection probability was 0.51% , well matched to the annual malaria incidence （0.32%） ; The APR in Chayu sites was 5.51% （22/399）, and the predictive infection probability was 1.24%, while the annual malaria incidence was 0 in the same year. The APRs in different age groups were increased by age in these two counties. Conclusion The APR and the predictive infection probability based on seroepidemiological investigations can well evaluate malaria endemic situation in Tibet. Higher APR indicated the existence of malaria transmission there in recent years. Although no malaria cases were reported in the study period, higher APR and the predictive infection probability implied the existence of potential infectious resources of malaria there.

关 键 词：抗体阳性率 估算感染概率 疟疾 西藏 

分 类 号：R512.62[医药卫生—内科学]