云南大理人群带绦虫感染和血清囊尾蚴抗体调查及其影响因素分析  

Analysis on Taenia infection and serum cysticercus antibody in population and their risk factors in Dali,Yunnan Province

作　　者：王文雅 刘剑峰 张米禛 钱沛君 刘柳 赵陆源 李科荣 张冬琦 刘瑜华 刘宏坤 陈绍荣 周长海 钱门宝 李石柱 WANG Wenya;LIU Jianfeng;ZHANG Mizhen;QIAN Peijun;LIU Liu;ZHAO Luyuan;LI Kerong;ZHANG Dongqi;LIU Yuhua;LIU Hongkun;CHEN Shaorong;ZHOU Changhai;QIAN Menbao;LI Shizhu(National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention,Chinese Center for Tropical Diseases Research,National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Key Laboratory on Parasite and Vector Biology,Ministry of Health,WHO Collaborating Centre for Tropical Diseases,National Center for International Research on Tropical Diseases,Ministry of Science and Technology,Shanghai 200025,China;Dali Autonomous Prefecture Institute of Schistosomiasis Control and Prevention,Dali 671000,Yunnan,China;School of Global Health,Chinese Center for Tropical Diseases Research,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心),传染病溯源预警与智能决策全国重点实验室,国家卫生健康委员会寄生虫病原与媒介生物学重点实验室,世界卫生组织热带病合作中心,科技部国家级热带病国际联合研究中心,上海200025 [2]大理州血吸虫病防治研究所,云南大理671000 [3]上海交通大学医学院-国家热带病研究中心全球健康学院,上海200025

出　　处：《中国寄生虫学与寄生虫病杂志》2024年第5期615-622,共8页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：国家重点研发计划(2021YFC2300800,2021YFC2300804);国家自然科学基金(32161143036,32311540013);一带一路澜湄热带病防控联合实验室项目(21410750200);上海市加强公共卫生体系建设三年行动计划(2023—2025年)。

摘　　要：目的 分析云南大理地区人群带绦虫感染和囊尾蚴抗体的流行特征及影响因素,为带绦虫和囊尾蚴病的防控提供科学依据。方法 2023年10—11月,在大理州带绦虫病和囊尾蚴病历史流行区选择大把关村、伙山村、金刚村和清水沟村开展调查,采用整群随机抽样的方法,抽取调查村3周岁以上常住居民为调查对象。通过问卷调查收集是否有排节片史、皮下结节、癫痫和剧烈头痛等症状以及饮食习惯、卫生行为和居住环境等信息;采集究对象粪样进行改良加藤厚涂片法(Kato-Katz法,一粪两检)检测,对粪检阳性或近一年有排节片史者采用槟榔南瓜子法进行药物诊断性驱虫。以粪检阳性或驱出虫体者为阳性感染者,计算带绦虫感染率。用囊尾蚴(猪带绦虫) IgG抗体检测试剂盒检测血清囊尾蚴特异性抗体。采用卡方检验、Fisher确切概率法和logistic回归分析对人群带绦虫感染和血清囊尾蚴抗体阳性的影响因素进行统计学分析。结果 4个村共1 842人参与问卷调查,近一年排节片者39人(占2.1%)。粪检1 533人,粪检阳性者25人(占1.6%)。共38人接受诊断性驱虫,33人驱出完整虫体(1名粪检阳性者未驱出虫体),人群带绦虫感染率为1.8%(34/1 842)。金刚、伙山、大把关和清水沟村人群带绦虫感染率分别为2.1%(10/475)、1.3%(6/450)、2.7%(12/450)、1.3%(6/467),差异无统计学意义(χ^(2)=3.31,P> 0.05)。男性感染率为2.6%(22/848),女性为1.2%(12/994)(χ^(2)=4.90,P <0.05),30~59岁年龄组(2.8%,24/862)、苗族(1/2)和农牧民(3.0%,28/944)等人群的感染率在各组中均为最高(χ^(2)=10.10,P <0.01,Fisher=26.04,P <0.01;χ^(2)=13.47,P <0.01)。人群血清囊尾蚴抗体阳性率为9.2%(82/887)。清水沟、大把关、伙山和金刚村的血清抗体阳性率分别为12.7%(20/157)、4.7%(11/236)、10.4%(26/251)、10.3%(25/243),差异有统计学意义(χ^(2)=8.88,P <0.05)。男性阳性率为9.2%(36/393),女性为9.3%(46/494)ObjectiveTo analyze the epidemic characteristics and influencing factors of Taenia infection and cysticercus antibody in the residents of Dali,Yunnan,to provide a scientific basis for prevention and control of taeniasis and cysticercosis.MethodsFrom October to November 2023,a survey was conducted in Dabaguan Village,Huoshan Village,Jingang Village and Qingshuigou Village in the historical endemic area of taeniasis and cysticercosis in Dali Prefecture.Permanent residents aged over 3 years were enrolled in the survey using the method of cluster random sampling.A questionnaire survey was conducted to collect information including whether there was a history of proglottid excreted,subcutaneous nodules,symptoms of epilepsy and severe headache,as well as the dietary habits,hygiene behaviors and living environment.Fecal samples were collected,and examined by the modified Kato-Katz method(two slide-reading for each sample).For residents with positive fecal test results or with a history of excreting proglottids in the past year,pharmacological diagnostic deworming was conducted using the areca-pumpkin seed method.Those positives in fecal examination and found expelled worms were considered as the infected persons and used to calculate the infection rate.Serum cysticercus specific antibodies were detected using cysticercus(Taenia solium) IgG antibody detection kit.The chi-square test,Fisher's exact probability method and logistic regression analysis were used to analyze the influencing factors of Taenia infection and serum cysticercus antibody positivity in the population.ResultsA total of 1 842 people from the 4 villages participated in the questionnaire survey,and 39people(2.1%) had excreted proglottids in the past year.Fecal examination was performed on 1 533 people,and 25people(1.6%) were found positive.A total of 39 people received diagnostic deworming,and 33 people expelled complete worms(1 person positive in fecal examination did not expel the parasite),and the infection rate was 1.8%(34/1 842).The infection rates

关 键 词：带绦虫病 囊尾蚴病 感染率 流行病学调查 影响因素 

分 类 号：R383.3[医药卫生—医学寄生虫学]