2013—2022年浙江省华支睾吸虫感染监测结果分析  

Analysis on surveillance results of clonorchiasis in Zhejiang Province from 2013 to 2022

作　　者：柴应植 陈华良[1] 余可根[1] 张轩[1] 王笑笑[1] 张家祺 徐文婕 阮卫[1] CHAI Yingzhi;CHEN Hualiang;YU Kegen;ZHANG Xuan;WANG Xiaoxiao;ZHANG Jiaqi;XU Wenjie;RUAN Wei(Department of Infectious Diseases,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,Zhejiang,China;Changshan Center for Diseases Control and Prevention,Quzhou 324200,Zhejiang,China)

机构地区：[1]浙江省疾病预防控制中心传染病防治所,浙江杭州310051 [2]常山县疾病预防控制中心,浙江衢州324200

出　　处：《中国寄生虫学与寄生虫病杂志》2024年第4期469-474,共6页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：浙江省卫生健康科技计划(2022KY718)。

摘　　要：目的了解浙江省华支睾吸虫感染流行现状。方法2013—2017年,每年选择浙江省1个曾有华支睾吸虫病例报告的县(市、区)为监测点,每个监测点选择3个乡(镇)开展人群监测,各乡(镇)选择至少100位3周岁以上当地居民采集静脉血,使用酶联免疫吸附试验(ELISA)检测华支睾吸虫抗体,计算监测对象的抗体阳性率;对2013—2015年的监测对象开展影响华支睾吸虫感染率因素的问卷调查。2018—2022年,每年以宁波市宁海县为固定监测点、另选7~9个县(市、区)为流动监测点,每个监测点按地理位置划分为东、西、南、北、中等5个片区,每个片区抽取1个乡(镇)的1个行政村,整群抽取3周岁以上当地居民200人采集粪样(>30 g),使用改良加藤厚涂片法检测华支睾吸虫虫卵,计算检测对象感染率。2013—2017年,每年在监测点的自然水体环境中采集淡水鱼;2018—2022年,每年在固定监测点和随机一个流动监测点的自然水体环境中采集淡水鱼,鉴定鱼种后采用压片法检查囊蚴感染情况。2018—2022年,每年在固定监测点和监测中间宿主的流动监测点采集猫、犬或猪粪样,用改良加藤厚涂片法检测华支睾吸虫虫卵。用SPSS 19.0进行数据统计分析,感染率的比较采用卡方检验。结果2013—2017年浙江省共监测1516人,抗体阳性率为2.51%(38/1516);2018—2022年共监测52626人,粪样中均未检出华支睾吸虫虫卵,感染率为0(0/52626)。各监测点人群抗体阳性率以磐安县最高(6.00%,18/300),不同监测点间人群抗体阳性率差异有统计学意义(χ^(2)=21.212,P<0.01)。监测人群中3~17岁年龄组抗体阳性率最高(8.82%,6/68),不同年龄组间抗体阳性率差异有统计学意义(χ^(2)=13.105,P<0.05)。2013—2022年中间宿主囊蚴感染率为12.56%(476/3791),感染率最高的为2018年的宁海县(33.47%,84/251),不同监测点间中间宿主感染率差异有统计学意义(χ^(2)=242.727,P<0.01)。逆鱼囊蚴感�Objective To ascertain the endemic status of Clonorchis sinensis in Zhejiang Province.Methods From 2013 to 2017,one county(city,district)which had clonorchiasis cases reported before in Zhejiang Province was selected as the regular surveillance site and 3 townships in each site were selected for monitoring each year.No less than 100 permanent residents over age 3 in each township were selected as monitored objects.Venous blood samples were collected,and serum C.sinensis antibody was detected by enzyme‑linked immunosorbent assay(ELISA).The positive rate of antibodies in the monitored objects was calculated.And questionnaire surveys were conducted on the fac‑tors affecting the infection of C.sinensis from 2013 to 2015.From 2018 to 2022,Ningbo City was selected as the fixed surveillance site and 7-9 counties(cities,districts)were selected as the mobile surveillance sites.Each surveil‑lance site was divided into 5 areas as geographically at east,west,south,north and centre.In each area,one adminis‑trative village was randomly selected from one township for cluster sampling of no less than 200 permanent residents over age 3.Fecal samples(over 30 g)were collected for examining C.sinensis eggs using the modified Kato‑Katz thick smear method.The infection rate of the monitored object was calculated.Freshwater fish from natural water were collected in regular surveillance sites from 2013 to 2017 and in the fixed surveillance site and a mobile surveil‑lance site from 2018 to 2022.The infection of encysted metacercaria was detected by pressing method after identified the species.From 2018 to 2022,the fecal samples of cats,dogs and pigs were collected in surveillance sites which monitoring the intermediate hosts,and examined C.sinensis eggs using the modified Kato‑Katz thick smear method.SPSS 19.0 was used for data statistical analysis.Infection rates were compared between groups using the chi‑squared test.Results From 2013 to 2017,a total of 1516 people were examined in Zhejiang Province and antibody posi‑

关 键 词：华支睾吸虫 中间宿主 保虫宿主 感染率 监测 

分 类 号：R532.23[医药卫生—内科学]