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目的 了解昌都市人群棘球蚴病和终宿主棘球绦虫感染的现状. 方法 2016年8-10月,在昌都市下辖的江达、贡觉、类乌齐、丁青、察雅、八宿、左贡、芒康、洛隆、边坝和卡若等11个县(区),按牧业区、半农半牧区、农业区和城镇采用分层整群抽样方法抽取行政村.每个行政村抽取常住居民200人进行B超检查,对疑似病例进行ELISA检测血清棘球蚴特异性抗体作进一步筛检,计算人群患病率.每个行政村抽取20户养犬户,收集犬粪,ELISA检测犬粪中棘球绦虫粪抗原.每个行政村抽取当地繁育、宰杀的羊(猪)10只或牛5头,检查肝、肺等脏器,记录动物年龄和发现的包囊数量.在检出多房棘球蚴病患者的行政村的居民居住地周围1 km范围内捕捉各种成年鼠(不少于300只),剖检鼠肝、肺棘球蚴感染情况.每个行政村随机抽取20名居民,每个县抽1所完全小学,在4～6年级每个年级抽不少于50名学生,以问卷形式对居民和学生进行棘球蚴病防治知识与行为调查. 结果 共调查了昌都市11个县(区)的68个行政村,11个县(区)均发现细粒棘球蚴病病例, 除芒康县外的其余10个县(区)均发现多房棘球蚴病病例.人群B超患病检出率为1.44％ (206/14 289).昌都市人群棘球蚴病推算患病率为1.50％,推算患病人数为9 842人.检出病例中细粒棘球蚴病占81.07％(167/206).人群棘球蚴病检出率以≥70岁年龄组最高,为4.05％ (9/222),检出率随着年龄的增长而升高(x2=33.706,P＜0.05);牧民棘球蚴病检出率最高,为4.66％ (103/2 208),不同职业检出率差异有统计学意义(x2=208.146,P＜0.05);文盲人群的棘球蚴病检出率最高,为2.00％ (149/7 455),检出率随文化程度增高而呈降低的趋势(x2=6.831,P ＜0.05);牧业区、半农半牧区、农业区和城镇棘球蚴病检出率分别是1.71％ (48/2 800)、1.69％ (144/8 506)、0.43％ (11/2 578)和0.74％ (3/405),不同生产类型人群检出率差异有统计学意义(x2=25.335,P＜0.05).终宿主犬粪棘球绦虫抗原阳性率为5.74％ (78/1 358).中间宿主啮齿类动物棘球蚴感染检出率为2.17％ (2/92),家畜(猪、牛、羊)棘球蚴感染检出率为12.09％ (41/339).居民棘球蚴病防治知识认知合格率为17.83％ (271/1 520),学生为21.82％ (340/1 558),二者差异有统计学意义(x2=7.714,P＜0.05)).结论 昌都市棘球蚴病流行范围广,居民患病率和感染风险均较高.“,”Objective To investigate the prevalence of echinococcosis in Changdu City.Methods Administrative villages were selected using stratified cluster sampling method in counties of Jiangda,Gongjue,Leiwuqi,Dingqing,Chaya,Basu,Zuogong,Mangkang,Luolong,Bianba,and Karuo District,covering four types of regions (pastoral area,semi-agricultural and semi-pastoral area,agricultural area,and town).Two hundred residents were selected for B ultrasound examination,and blood samples were collected from those with suspected infection.Specific antibody against Echinococcus in serum was detected by ELISA.Twenty household raising dogs were selected from each village,and Echinococcus antigen in dog feces was detected by ELISA.In each village,10 sheep/pigs or 5 cattle were selected to examine internal organs including liver and lung.The ages of animals and number of cysts found were recorded.At least 300 adult rodents were caught within 1 km away from the spots of the residents who were detected to have alveolar echinococcosis,and hydatid cysts in liver and lung were examined by autopsy.Twenty villagers were randomly selected in each village,and no less than 50 students were selected from each of grades 4-6 in primary schools(one primary school from each county) for survey on the knowledge of echinococcosis prevention and behaviors by questionnairing.Ressults Sixty-eight villages were examined in 11 counties/regions of Changdu City,all were found with cases of cystic echinococcosis,and all had cases of alveolar echinococcosis except Mangkang County.The morbidity rate by B ultrasound was 1.44％ (206/14 289).The estimated prevalence of hydatid diseases in Changdu City was 1.50％,with an estimated number of cases being 9 842,and they were dominated by cystic echinococcosis (81.07％,167/206).The prevalence elevated with age,being highest in the population group of ≥ 70 years (4.05％,9/222);it was significantly different among occupations (x2 =208.146,P＜ 0.05),being highest in herdsmen (4.66％,103/2 208);and it showed a trend of decrease with higher educational level (x2 =6.831,P ＜ 0.05),being highest in those illiterates (2.00％,149/7 455).The prevalence of hydatid diseases in pastoral area,semi-agricultural and semi-pastoral area,agricultural area,and town were 1.71％ (48/2 800),1.69％ (144/8 506),0.43％(11/2 578) and 0.74％ (3/405),respectively (x2 =15.726,P＜ 0.01).The prevalence showed a significant difference among populations with different types of production activities (x2 =25.335,P ＜ 0.05).The infection rate was 2.17％ (2/92) in intermediate host rodents and 12.09％ (41/339) in livestock.The antigen positive rate in dog feces was 5.74％ (78/1 358).The qualifying rate on the knowledge of echinococcosis control was 17.83％ (271/1 520) in residents and 21.82％ (340/1 558) in pupils (x2 =7.714,P ＜ 0.05).Conclusion Echinococcosis is widely prevalent in Changdu City,with a high infection rate and a high risk of infection.