论文部分内容阅读
目的 了解西藏自治区山南市棘球蚴病流行现状. 方法 于2016年8-10月采用分层整群抽样方法,抽取山南市浪卡子、隆子、错那、扎囊、贡嘎、乃东、琼结、加查、桑日、曲松、洛扎等11个县(区)的调查村,每村抽取200名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.采用内脏剖检法调查家畜棘球蚴感染情况.采集家犬粪样,ELISA检测犬粪棘球绦虫抗原情况.每个调查村随机抽取20名居民,每个县抽1所县小学的4~6年级学生(每个年级不少于50名),进行棘球蚴病防治知识调查. 结果 B超共调查10 287人,人群棘球蚴病检出率为1.00% (103/10 287),以细粒棘球蚴病为主(100例,占97.09%).11个县(区)均有棘球蚴病流行,检出率较高的为浪卡子县、隆子县和错那县,分别为2.03% (17/836)、1.81% (15/830)、1.43% (12/839),最低的为洛扎县,为0.11% (1/931);不同县(区)棘球蚴病检出率差异有统计学意义(x2=34.08,P< 0.05).男性棘球蚴病检出率为0.84% (31/3 683),女性检出率为1.09% (72/6 604),两者差异无统计学意义(x2=1.47,P> 0.05).不同年龄组中,以≥60和45~59岁组人群棘球蚴病检出率较高,分别为1.76% (30/1 708)和1.32% (44/3 333);人群棘球蚴病检出率随着年龄的增长而升高(x2趋势=25.64,P<0.01).不同职业人群中,以牧民、农民和半农半牧民的棘球蚴病检出率较高,分别为1.81% (17/937)、1.04%(64/6 155)和1.03% (18/1 740);不同职业人群棘球蚴病检出率间差异有统计学意义(x2=20.73,P<0.05).不同文化程度人群中,以文盲人群的棘球蚴病检出率最高,为1.26% (63/5 009);人群棘球蚴病检出率随文化程度增高呈降低的趋势(x2趋势=7.63,P< 0.05).不同生产类型地区人群中,以牧区人群的棘球蚴病检出率最高,为1.19% (20/1 682);不同生产类型人群棘球蚴病检出率差异无统计学意义(x2=0.85,P> 0.05).本次共检查家畜307头,棘球蚴感染检出率为11.40% (35/307),其中曲松县的感染检出率最高,为85.00% (34/40);不同地区家畜的棘球蚴感染检出率差异有统计学意义(x2=175.409,P<0.01).共采集犬粪932份,犬粪棘球绦虫抗原阳性率为6.87% (64/932).其中,浪卡子县的犬粪棘球绦虫抗原阳性率最高,为27.50% (22/80),错那县和隆子县次之,分别为13.75% (11/80)和7.50% (6/80);不同县(区)犬粪抗原阳性率间差异有统计学意义(x2=61.41,P< 0.01).人群棘球蚴病防治知识和行为合格率为51.63%(1 343/2 601),不同县(区)人群棘球蚴病认知合格率以桑日县和曲松县较高,分别为97.83% (225/230)和91.34% (211/231);错那县和浪卡子县合格率较低,分别为10.24% (17/166)和18.55% (41/221);不同县(区)合格率差异有统计学意义(x2=605.52,P<0.05). 结论 山南市浪卡子县、隆子县、错那县人群棘球蚴病检出率和犬粪棘球绦虫抗原阳性率较高、棘球蚴病防治知识认知合格率较低,应作为棘球蚴病重点防治地区.“,”Objective To investigate the prevalence of echinococcosis in Shannan City of Tibet Autonomous Region.Methods Villages were selected using stratified cluster sampling method from the counties of Langkazi,Longzi,Cuona,Zhanang,Gonggar,Qiongjie,Gacha,Sangri,Qusong,Luozha and Naidong District in Shannan City,from August to October,2016.In each village,200 residents aged > 1 year were selected for B ultrasound examination to calculate the prevalence of hydatid disease among the populations.Visceral necropsy was performed in livestock to investigate the status of hydatid infection.Feces from home-raised dogs were collected to examine Echinococcus antigen using ELISA method.Knowledge on echinococcosis control was surveyed in 20 randomly-selected residents in each village and no less than 50 students of each grade of grades 4-6 in a selected primary school in each county.Results Among the 10 287 persons receiving B ultrasound examination,103 were detected to have hydatid cysts (1.00%),dominated by Echinococcus granulosus (97.09%).The 11 counties (districts) were all found with cases of hydatid disease,of which Langkazi County,Longzi County,and Cuona County had a high prevalence of 2.03% (17/836),1.81% (15/830),and 1.43% (12/839),respectively,while Luozha County had the lowest prevalence of 0.11% (1/931).There was a significant difference in prevalence among the 11 counties/districts.There was no significant difference between males (0.84%,31/3 683) and females (1.09%,72/6 604) (xt2 =1.47,P > 0.05).The detection rate elevated with increased age (x2trend =25.64,P < 0.01),being highest in the population groups of ≥ 60 years (1.76%,30/1 708) and 45-59 years (1.32%,44/3 333),and was significantly different among occupations (x2 =20.73,P< 0.05),being highest in herdsmen (1.81%,17/937),farmers (1.04%,64/6 155),and semiherdsman-and-farmers (1.03%,18/1 740).The prevalence showed a trend of decrease with higher educational level (x2trend =7.63,P < 0.05),being highest in those illiterates (1.26%,63/5 009).The prevalence of hydatid disease was highest in pastoral area (1.19%,20/1 682);there was no significant difference in the prevalence of hydatid disease among populations with different types of production (x2 =0.85,P > 0.05).Among the 307 livestock examined,the prevalence of hydatid disease was 11.40% (35/307).There was a significant difference in livestock prevalence among the 11 counties (districts) (x2 =175.409,P< 0.01),with Qusong County having the highest prevalence.Among the 932 fecal samples collected,the positive rate of Echinococcus antigen was 6.87% (64/932),with Langkazi County having the highest positive rate (27.50%,22/80),followed by Cuona County (13.75%,11/80) and Longzi County (7.50%,6/80) [x2 =61.41,P < 0.01,among the 11 counties (districts)].The overall qualified rate on knowledge of echinococcosis control was 51.63% (1 343/2 601) in the residents.It was better in Sangri County (97.83%,225/230)and Qusong County (91.34%,211/231),and poor in Cuona County (10.24%,17/166) and Langkazi County (18.55%,41/221) [x2 =605.52,P< 0.05,among the 11 counties (districts)].Conclusion There is a high prevalence of hydatid disease in human populations,a high positive rate of Echinococcus antigen in dog feces,and poor knowledge on echinococcosis control in some counties of Shannan City,Tibet.