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目的观察高山型血吸虫疫区疫水暴露与血吸虫感染率之间的剂量-反应关系,评价3项常用疫水暴露指标的优缺点和适用性。方法2001年11月在高山型血吸虫病疫区随机抽取1 033名常住居民,采用Kato-Katz 3片法和3送3检孵化法诊断血吸虫病感染。用回顾问卷方式法调查当年4~10月疫水暴露频次(频次),平均疫水暴露时间(指数A)和平均疫水暴露强度(指数B)。结果3项疫水暴露指标与血吸虫感染率之间均存在剂量-反应关系。在既往调查血吸虫感染率≥10%的自然村中,频次与感染率之间存在典型的剂量-反应关系(χ2趋势=17.76,P<0.01),在感染率<10%的自然村指数A与感染率的剂量-反应关系明确(χ2趋势=11.08,P<0.01)。其他条件下疫水暴露指标与血吸虫感染率的关系呈波动状态,剂量-反应关系不明确。结论在高山型血吸虫疫区,频次可用于感染率较高人群的疫水暴露评价,指数A可用于感染率较低人群的疫水暴露评价。
Objective To observe the dose-response relationship between epidemic water exposure of schistosomiasis and infection rate of schistosomiasis, and to evaluate the advantages, disadvantages and applicability of the three common water exposure indicators. Methods A total of 1 033 permanent residents were randomly selected from the mountainous schistosomiasis-endemic area in November 2001. The schistosomiasis was diagnosed using the Kato-Katz 3-slice method and the 3-to-3 hatching method. The frequencies of frequency of water exposure, frequency of exposure to water (index A) and exposure to average water (index B) were investigated by means of retrospective questionnaire method from April to October of the same year. Results There was a dose-response relationship between the three indicators of exposure to water and the infection rate of schistosomiasis. In the natural villages with the infection rate of more than 10%, there was a typical dose-response relationship between the frequency and the infection rate (χ2 trend = 17.76, P <0.01). In natural villages with the infection rate <10%, the infection rate The dose-response relationship was clear (χ2 trend = 11.08, P <0.01). Under other conditions, the relationship between the index of exposure to water and the infection rate of schistosome fluctuated, and the relationship between dose and response was not clear. Conclusion In the endemic area of schistosoma japonicum, the frequency can be used to evaluate the water exposure in populations with high infection rate. Index A can be used to evaluate the water exposure in the population with lower infection rate.