基于人群抗体水平的湖北省血吸虫病传播风险分析  

Assessment of transmission risk of human schistosomiasis japonica based on human population antibody level in Hubei Province

作　　者：吴家利[1] 李博[1] 刘斯[1] 涂祖武[1] 唐丽[1] 涂珍[1] 周晓蓉[1] 孙凌聪[1] 肖瑛[1] 朱红[1] WU Jia-li;LI Bo;LIU Si;TU Zu-wu;TANG Li;TU Zhen;ZHOU Xiao-rong;SUN Ling-cong;XIAO Ying;ZHU Hong(Hubei Provincial Center for Disease Control and Prevention,Auhan 430079,China)

机构地区：[1]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》2021年第5期578-584,共7页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：湖北省科技计划项目(自然科学基金2018CFC896);国家自然科学基金青年科学基金(81803297);湖北省卫生与计划生育委员会科研项目(WJ2017X013)

摘　　要：目的了解当前湖北省人群血吸虫病抗体水平与变化趋势,评估人群血吸虫病传播风险。方法于2016-2018年每年的9-12月,收集湖北省人群血吸虫病查病中血清抗体阳性者血清,采用间接血凝试验检测血清抗体滴度,记录抗体效价结果和阳性者基础信息;收集湖北省血吸虫病防治工作年报表中全省各疫区县(市、区) 2016-2018年查病情况和达标进展资料,将血清抗体阳性报告数、血清抗体阳性率、阳性血清抗体效价构成比和流行区类型等4项指标设立为传播风险评估具体指标。以县为单位,评估各流行地区的人群病情传播风险等级,并用ArcGIS 10.5软件制作湖北省人群血吸虫病传播风险等级可视化地图。采用SPSS 26.0统计学软件分析2016-2018年血清抗体阳性者基础信息,评估重点防控人群分布特征。结果 2016-2018年湖北省血检人数分别为1 728 300、 1 531 611、 1 498 039人,血清抗体阳性数分别为41 154、 31 532、 22 124例,血清抗体阳性率分别为2.38%、 2.06%、 1.48%,全省血清抗体阳性数呈逐年减少,血清抗体阳性率逐年下降(χ2=3 410.81,P <0.01)。2016、 2017年以传播控制地区报告为主,分别占当年总血清抗体阳性数的95.47%(39 290/41 154)、63.68%(20 081/31 532)(χ2=773.88, P <0.01);2018年以传播阻断地区报告为主,占当年总血清抗体阳性数的99.84%(22 088/22 124)。其中2016-2018年血清抗体效价≥1∶40者分别为4 459例、 4 498例、 2 482例,占血清抗体阳性数的10.83%、 14.26%、 11.22%, 3年间差异有统计学意义(χ2=217.46, P <0.01)。人群血吸虫病传播风险等级分析结果显示,全省1级风险区5个,分别为公安县、沙市区、江陵县、松滋市和潜江市;2级风险区10个,分别为阳新县、洪湖市、嘉鱼县、荆州区、荆州开发区、汉南区、石首市、蔡甸区、汉川市和仙桃市;3级风险区10个;其余38个流行地区均为4级风险区。血吸虫病传播风险重点�Objective To understand the current status of the antibody level and changing trend in human schistosomiasis japonica in Hubei Province, thereby to assess the transmission risk. Methods Serum samples were collected from the seropositives of Schistosoma infection during mass screening in September to December yearly of2016- 2018, and the serum antibody titer was determined by indirect hemagglutination test. The antibody titer and basic information of the examinees were recorded. The disease screening and control progress in endemic areas(cities, districts) of Hubei Province were collected from the annual report data in 2016 - 2018. Four indicators were defined for assessment of transmission risk: the number of serum antibody-positives, sero-positive rate, proportion of high antibody titers in sero-positives, and the type of endemic area. The transmission risk was evaluated by county,and visualized by constructing a risk grade map using ArcGIS 10.5 software. Basic information on the people with positive serum antibody was analyzed with SPSS 26.0 software, to assess the distribution characteristics of key population. Results From 2016 to 2018, the number of participants in schistosomiasis antibody testing was 1 728 300,1 531 611 and 1 498 039, respectively. In the three years, the numbers of seropositives reports with positive serum antibody were 41 154, 31 532 and 22 124, and the sero-positive rates 2.38%, 2.06%, and 1.48%, respectively,showing a decrease in both number and rate each year( χ2= 3410.81, P < 0.01). In 2016 and 2017, the sero-positives were mostly reported from the transmission-controlled areas, accounting for 95.47%(39 290/41 154) and63.68%(20 081/31 532) of the total seropositives( χ2= 773.88, P < 0.01), respectively, while in 2018, the seropositives were mainly reported from the transmission-interrupted areas, accounting for 99.84%(22 088/22 124) of the total. From 2016 to 2018, the numbers of seropositives with antibody titer ≥ 1 ∶ 40 were 4 459, 4 498 and 2 482,respectively, accounting for

关 键 词：血吸虫病 人群病情 传播风险 分析评估 湖北省 

分 类 号：R532.21[医药卫生—内科学]