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目的运用催化模型分析抗血吸虫抗体阳性率资料,评估血吸虫病传播风险和特征。方法 2008年对江西(曹会村、新华村、井头村)、安徽(渔业村、铁拐村、垅上村)、湖北(河北村)等3个省的7个血吸虫病不同流行程度的行政村开展横断面调查,采集当地6~65岁的常住居民静脉血,血清用间接红细胞凝集试验检测居民抗血吸虫抗体Ig G,计算不同流行村、性别、年龄组的抗体阳性率,并进行组间差异分析。用两级催化模型、可逆两级复合催化模型分别对各个流行村不同年龄组的抗体阳性率资料进行分析;使用最大似然比方法估计模型参数,两级催化模型估计血清学转化率、血清学失去率;可逆两级复合催化模型估计血清学转化率、血清学失去率和血清学逆转率。用卡方检验和相关性分析评价模型的拟合效果,确定各流行村抗体阳性率资料的最佳催化模型,绘制拟合曲线。用最佳模型估计的参数分析各村血吸虫病传播风险。结果7个流行村共调查有效人群6 428人,受检人群的抗血吸虫抗体阳性率平均为39.80%(2 485/6 428)。按年龄组分,曹会村、新华村、井头村、渔业村、铁拐村、垅上村、河北村的抗体阳性率最高峰分别出现在46~50、31~35、31~35、41~45、51~55、56~60和16~20岁组,分别为82.86%(58/70)、60.78%(31/51)、68.42%(26/38)、55.04%(71/129)、62.38%(63/101)、31.43%(33/105)和21.88%(7/32)。各行政村抗体阳性率总体上随年龄增加呈先升后降趋势。曹会村、新华村、井头村和渔业村抗体阳性率资料的最佳拟合模型为两级催化模型,血清学转化率分别为0.049 5、0.044 0、0.055 7和0.034 4,均远高于其血清学失去率(0.005 9、0.019 6、0.015 5和0.017 8)。垅上村、铁拐村以及河北村血清学资料的最佳拟合模型为可逆两级复合催化模型,血清学转化率分别为0.062 9、0.168 1和0.039 4,血清学逆转率和失去率分别为0.168 8、0.121 1、0.152 2和0.001 7、0.000 2、0.090 9。结论基于年龄组别的抗体阳性率资料构建的催化模型可以反映血吸虫病在人群中的传播速率和风险,并为今后的防治策略提供参考。
Objective To evaluate the prevalence and characteristics of schistosomiasis by using the catalytic model to analyze the prevalence of anti-schistosome antibodies. Methods In 2008, the administrative levels of seven schistosomiasis patients with different prevalences in three provinces (Jiangxi Province, Caohui Village, Xinhua Village and Jingtou Village), Anhui Province (Fishery Village, Tiegu Village and Shangshang Village) and Hubei Province Village cross-sectional survey to collect local residents 6 to 65-year-old resident blood, serum using indirect hemagglutination test residents anti-schistosomiasis Ig G, calculate the prevalence of antibodies in different prevalence of the village, gender, age group, and between groups Difference analysis. The two-stage catalytic model and the reversible two-stage composite catalytic model were used to analyze the antibody positive rate data of different age groups in each endemic village. The maximum likelihood ratio method was used to estimate the model parameters. Two-stage catalytic model was used to estimate the serological conversion rate, serological Lost rate; The reversible two-stage composite catalytic model estimates the seroconversion rate, the serological loss rate and the serological reversal rate. The chi-square test and correlation analysis were used to evaluate the fitting effect of the model, and the best catalytic model of the antibody positive rate in each endemic village was determined and the fitting curve was drawn. The risk of schistosomiasis transmission in each village was analyzed using the parameters estimated by the best model. Results A total of 6 428 effective population were surveyed in 7 endemic villages. The average prevalence of anti-schistosoma antibody in the tested population was 39.80% (2 485/6 428). According to the age group, the highest peak of the positive rate of antibody in Caohui Village, Xinhua Village, Jingtou Village, Fishery Village, Tieguai Village, Huangshan Village and Hebei Village occurred at 46 ~ 50,31 ~ 35,31 ~ 35,41 ~ 45,51 ~ 55,56 ~ 60 and 16 ~ 20 years old were 82.86% (58/70), 60.78% (31/51), 68.42% (26/38) and 55.04% (71/129) , 62.38% (63/101), 31.43% (33/105) and 21.88% (7/32) respectively. The positive rates of antibody in all administrative villages generally increased first and then decreased with increasing age. The best fitting model for the antibody positive rate data of Caohui Village, Xinhua Village, Jingtou Village and Fishery Village was a two-stage catalytic model with serological conversion rates of 0.049 5,0.044 0,0.055 7 and 0.034 4, respectively, both of which were far higher In its serological loss rates (0.005 9,0.019 6,0.015 5 and 0.017 8). The best fit model of serological data in 垅 Shangcun, Tieguai Village and Hebei Village was reversible two-stage composite catalytic model with serological conversion rates of 0.062 9, 0.1668 1 and 0.039 4, respectively. The serological reversal rate and loss rate were 0.168 8,0.121 1,0.152 2 and 0.001 7,0.000 2,0.090 9. Conclusion The catalytic model constructed based on antibody positive rate data of age group can reflect the transmission rate and risk of schistosomiasis in the population and provide a reference for future prevention and treatment strategies.