湖北省2021—2023年并殖吸虫病监测结果  

Surveillance results of paragonimiasis infection in Hubei Province from 2021 to 2023

作　　者：涂珍[1] 夏菁[1] 孙凌聪[1] 张聪[1] 朱红[1] 李博[1] 万伦[1] 张娟[1] 曹慕民[1] TU Zhen;XIA Jing;SUN Lingcong;ZHANG Cong;ZHU Hong;LI Bo;WAN Lun;ZHANG Juan;CAO Mumin(Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China)

机构地区：[1]湖北省疾病预防控制中心,湖北武汉430079

出　　处：《中国热带医学》2024年第9期1052-1058,共7页China Tropical Medicine

基　　金：湖北省自然科学基金项目(No.2020CFB130);湖北省卫生健康委员会科研项目(No.WJ2021Q047)。

摘　　要：目的了解湖北省并殖吸虫病流行现状,为制定相关防治策略提供科学依据。方法2021—2023年在湖北省选取12个县(市、区)作为并殖吸虫病监测点,开展主动监测。在每个监测点采集6岁以上常住居民静脉血清样本不少于300份,采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)对血清中并殖吸虫IgG和IgM抗体进行检测,血清学抗体阳性者收集痰液,浓集后进行病原学检测。在监测点内的小河沟、小山溪中采集溪蟹,捣碎水洗沉淀后在生物解剖镜下检测囊蚴感染情况。对采集血样的所有居民进行问卷调查,调查内容包括姓名、年龄、职业、文化程度等基本情况和并殖吸虫病感染相关健康行为。结果2021—2023年在12个并殖吸虫病监测点共采集人群血清样本3670份,检出血清学抗体阳性者135例,血清学抗体总阳性率为3.68%,采用痰检法未检出并殖吸虫虫卵。12个监测点间血检阳性率差异有统计学意义(χ^(2)=143.873,P<0.01)。共调查溪蟹488只,囊蚴感染率为10.25%(50/488),平均感染度为4.74个/只,蟹组织携带囊蚴数为0.25个/g。其中,五峰县溪蟹感染率最高,为84.38%(27/32)。调查问卷结果显示,男性和女性血检阳性率分别为3.22%(60/1864)和4.15%(75/1806),差异无统计学意义(χ^(2)=2.258,P>0.05)。汉族人群,年龄段为6~<10岁的青少年及餐饮食品从业者血检阳性率较高,不同民族、年龄段和职业的调查对象间,血检阳性率差异均有统计学意义(χ^(2)=23.081、25.761、210.535,P<0.01)。本次调查中不同教育程度人群间的血检阳性率差异无统计学意义(χ^(2)=8.154,P>0.05)。饮用不同水源的人群中,饮用溪水者血检阳性率最高,为10.00%(15/150),不同饮用水类型的血检阳性率差异有统计学意义(χ^(2)=31.978,P<0.01)。是否生食或半生食溪蟹、蝲蛄及其制品,是否喝生水的人群间,血检阳性率差异均有统计学意义(χ^(2)=10.059、11.891,P<0.01)。Objective To understand the current epidemic status of paragonimiasis in Hubei Province,thus providing a scientific evidence for planning relevant control strategies.Methods From 2021 to 2023,12 counties(cities,districts)in Hubei Province were chosen as the surveillance sites to carry out active surveillance.No less than 300 venous serum samples were collected from permanent residents over 6 years old in every surveillance site,and the Paragonimus antibodies of IgG and IgM in the serum were tested by ELISA(enzyme-linked immunosorbent adsorption test).Pathogenic tests were conducted after concentrating the sputa from the antibody-positive subjects.Freshwater crabs were caught in the small rivers and streams at the surveillance sites,and a stereo microscope was used to check the metacercariae infections after crushing and washing to gather the precipitates.All residents who provided serum samples were surveyed via questionnaire,which included basic information such as name,age,occupation,education degree,and so on,as well as the infection-related behaviors that could lead to paragonimiasis.Results From 2021 to 2023,a total of 3670 serum samples were obtained from the population at 12 paragonimiasis surveillance sites,with 135 antibody-positive cases,resulting in an overall seropositive rate of 3.68%.No Paragonimus eggs were detected through sputum examination.The serum antibody positive rates differed significantly among the 12 monitoring sites(χ^(2)=143.873,P<0.01).A total of 488 freshwater crabs were caught,with a metacercaria infection rate of 10.25%(50/488)and an average infection density of 4.74 metacercariae per positive crab,and the metacercariae carried by positive crab tissues was 0.25 per gram.Among them,Wufeng County had the highest positive rate of freshwater crabs,which reached up to 84.38%(27/32).The results of the questionnaire survey showed that the positive rates of males and females were 3.22%(60/1864)and 4.15%(75/1806),respectively,with no statistically significant difference(χ^(2)=2.258,P>0.05

关 键 词：并殖吸虫病 自然疫源性 溪蟹 血清学检测 湖北省 

分 类 号：R532[医药卫生—内科学]