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目的了解青海省果洛藏族自治州(简称果洛州)人与动物棘球蚴病的流行情况。方法 2012年6-8月,在果洛州班玛、达日、甘德、久治、玛多、玛沁等6个县各抽取2~3个乡(镇),对1岁以上常住居民进行B超检查,计算人群棘球蚴病检出率;使用Ig G抗体检测试剂盒ELISA检测血清抗棘球蚴抗体,计算人群血清抗体阳性率。采用内脏剖检法调查啮齿动物鼠类及牲畜棘球蚴感染情况,现场随机采集家犬粪,ELISA检测粪抗原阳性情况。结果 B超检查共15 890人,查出患病者826例,检出率为5.20%(826/15 890)。ELISA检测共1 200人,血清抗体阳性率为16.75%(201/1 200)。达日县人群棘球蚴病检出率最高,为11.93%(430/3 605);甘德县血清抗体阳性率最高,为48.15%(65/135),其次为班玛县(12.77%,136/1 065)。女性棘球蚴病检出率和血清抗体阳性率分别为6.37%(499/7 839)和26.01%(142/546),均高于男性的4.06%(327/8 051)和9.02%(59/654)(P<0.01)。牧民、宗教人士、学生和家务人员的棘球蚴病检出率均较高,分别为5.24%(700/13 370)、6.46%(41/635)、8.39%(25/298)和5.68%(18/317)。60~、30~和≥70年龄组棘球蚴病检出率均较高,分别为6.91%(76/1 100)、6.25%(255/4 078)和8.08%(37/458);≥70、60~、40~年龄组血清抗体阳性率均较高,分别为48.28%(14/29)、28.57%(20/70)、23.12%(40/173)。文盲人群的棘球蚴病检出率和血清抗体阳性率均最高,为5.85%(431/7 365)和62.61%(72/115)。冬季定居夏季游牧人群的棘球蚴病检出率和血清抗体阳性率最高,为6.36%(642/10 087)和60.49%(147/243)。不同地区、性别、职业、年龄组、文化程度以及不同居住方式间差异有统计学意义(P<0.05)。果洛州鼠类棘球蚴感染率为2.41%(98/4 058),其中久治县最高,为4.82%(49/1 016);终宿主犬粪抗原阳性率为14.90%(303/2 034),其中玛沁县最高,为18.76%(160/753);中间宿主牛棘球蚴感染率为28.37%(570/2 009),其中达日县最高,为62.80%(314/500)。不同地区间中间宿主牛、啮齿动物鼠类的感染率和终末宿主犬粪抗原阳性率的差异有统计学意义(P<0.05)。结论果洛州棘球蚴病疫情流行严重,犬是主要传染源。
Objective To understand the epidemiology of human and animal hydatid disease in Guoluo Tibetan Autonomous Prefecture of Qinghai Province (referred to as Guoluo Prefecture). Methods From June to August 2012, 2 to 3 townships (towns) were sampled from 6 counties in Bangalore, Dari, Gander, Jiuzhi, Maduo, and Maqin in Guoluo, and residents of over 1 year old were enrolled B ultrasound examination to calculate the detection rate of population echinococcosis; using Ig G antibody detection kit ELISA detection of serum anti-hydatid antibody, calculate the population of serum antibody positive rate. The visceral dissection was used to investigate the echinococcosis infection in rodents and livestock. Dog faeces were randomly collected on the spot and the positive results of fecal antigens were detected by ELISA. Results A total of 15 890 B-ultrasound patients were detected, of which 826 were detected. The detection rate was 5.20% (826/15 890). ELISA test of a total of 1 200 people, the positive rate of serum antibody was 16.75% (201/1 200). The highest detection rate of echinococcosis was 11.93% (430/3 605) in Dari County, the highest was 48.15% (65/135) in Gande County, followed by Baima County (12.77% 136/1 065). The positive rate of female echinococcosis and the positive rate of serum antibody were 6.37% (499/7 839) and 26.01% (142/546), respectively, higher than those of men (4.06%, 327/8 051) and 9.02% (59 /654)(P<0.01). The detection rates of echinococcosis among herdsmen, religious persons, students and house-keeping staff were all higher, accounting for 5.24% (700/13 370), 6.46% (41/635), 8.39% (25/298) and 5.68% (18/317). The detection rates of echinococcosis were higher in 60 ~ 30 and 70 years old groups, which were 6.91% (76/1 100), 6.25% (255/4 078) and 8.08% (37/458) respectively. The positive rates of serum antibodies were higher in 70, 60 ~, 40 ~ age groups, 48.28% (14/29), 28.57% (20/70) and 23.12% (40/173) respectively. The detection rate of echinococcosis and the positive rate of serum antibody were highest in illiterate population, which were 5.85% (431/7365) and 62.61% (72/115). The positive rates of echinococcosis and serum antibody in the summer nomads settled in summer were the highest, which were 6.36% (642/10887) and 60.49% (147/243). The differences among different regions, genders, occupations, age groups, educational level and living styles were statistically significant (P <0.05). The infection rate of rat echinococcosis was 2.41% (98/4 058) in Gyokhoo State, which was the highest in Jiuzhi County, which was 4.82% (49/1 016). The positive rate of end-stage dog faecal antigen was 14.90% (303/2 034) ), Of which Maqin County was the highest (18.76% (160/753)). The infection rate of intermediate host Echinococcus granulosus was 28.37% (570/2 009), of which the highest was 62.80% (314/500) in Dari County. There were significant differences in the infection rates of intermediate host cattle and rodents among different regions and the positive rate of terminal host dog faecal antigen (P <0.05). Conclusion The epidemic situation of Echinococcosis in Los Angeles is very serious, with dogs being the main source of infection.