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目的了解新疆温泉县棘球蚴病的流行程度和分布特点,为防治工作提供依据。方法于2009-2014年,以温泉县的2镇4乡共74个村为调查点,随机选择全年龄组部分人群采用B超常规腹部扫描检查棘球蚴感染情况;ELISA检测6~12岁学生血清棘球蚴Ig G抗体;内脏剖检法调查屠宰家畜的棘球蚴感染情况;采集犬粪,ELISA检测棘球绦虫抗原。结果B超共检查49 627人,年龄最小5岁,最大89岁,平均36岁。查出棘球蚴病患者192人,均为细粒棘球蚴病,患病率为0.39%。几年间的患病率呈下降趋势,2009年最高,为1.22%(72/5 919),2011年最低,为0.17%(15/9 011)(P<0.05)。男性和女性患病率分别为0.34%(72/21 226)和0.42%(120/28 401),两者差异无统计学意义(P>0.05)。患者年龄分布主要集中在20~59岁人群,占总患病人数的91.67%(176/192);农业区、牧业区和城区人群的患病率分别为0.43%(130/30 492)、0.33%(49/14 649)和0.29%(13/4 486),差异无统计学意义(P>0.05)。牧民患病率最高,为0.34%(86/24 963),与其他各职业人群差异有统计学意义(P<0.05)。蒙古族和哈萨克族患病率较高,分别为0.51%(45/8 696)和0.42%(49/11 434)。文盲患病率最高,为1.92%(63/3 285),与其他学历人群差异有统计学意义(P<0.05)。ELISA共检测6~12岁学生7 369人,血清棘球蚴抗体阳性率为3.60%(265/7 369),阳性率从2009年的6.06%(37/611)降至2014年的2.59%(22/850);农业区学生的阳性率为3.99%(207/5 193),高于牧业区的2.89%(43/1 487)和城区内的2.18%(15/689)(P<0.05);汉族学生的阳性率最高,为4.06%(177/4 361)。共检查家畜4 677只,家畜棘球蚴感染率为13.04%(610/4 677),也呈逐年下降趋势,由2009年的25.05%(127/507)降至2014年的8.80%(44/500),其中2013年最低,为7.90%(79/1 000)(P<0.05)。家犬全粪棘球绦虫抗原阳性率为5.18%(365/7 049),由2009年的16.98%(81/477)逐步降至2014年的2.56%(41/1 600)(P<0.05)。结论温泉县棘球蚴病流行程度逐年降低,患者以青壮年为主。棘球蚴病患病率、6~12岁学生血清棘球蚴抗体阳性率、家畜棘球蚴感染率和犬棘球绦虫抗原阳性率仍较高。
Objective To understand the prevalence and distribution of hydatid disease in Wenquan County, Xinjiang, to provide basis for prevention and treatment. Methods From 2009 to 2014, 74 villages in 2 townships and 4 townships in Wenquan County were selected as the survey sites. Some people of all age groups were randomly selected to undergo echinococcosis infection by abdominal ultrasonography. ELISA was used to detect students aged 6-12 years Serum Echinococcus granulosus Ig G antibody; visceral necropsy investigation of slaughtered livestock echinococcosis infection; dogs were collected, ELISA detection of Echinococcus antigen. Results A total of 49 627 patients were examined by B ultrasound. The youngest was 5 years old and the oldest was 89 years old, with an average of 36 years old. Echinococcosis patients 192 were detected, are particles of hydatid disease, the prevalence was 0.39%. The prevalence rate showed a downward trend in several years, the highest in 2009 was 1.22% (72/5 919) and the lowest in 2011 was 0.17% (15/9 011) (P <0.05). The prevalence rates of males and females were 0.34% (72/21 226) and 0.42% (120/28 401) respectively, with no significant difference (P> 0.05). The age distribution of patients mainly concentrated in the population aged from 20 to 59, accounting for 91.67% (176/192) of the total number of patients. The prevalence rates in the agricultural, pastoral and urban areas were 0.43% (130/30 492) 0.33% (49/14 649) and 0.29% (13/4 486) respectively, with no significant difference (P> 0.05). The highest incidence of herdsman was 0.34% (86/24 963), which was significantly different from other occupational groups (P <0.05). The Mongolian and Kazak nationalities had a higher prevalence of 0.51% (45/8 696) and 0.42% (49/11 434) respectively. The highest illiteracy prevalence was 1.92% (63/3 285), which was significantly different from other academic groups (P <0.05). ELISA detected 7 369 students aged 6 to 12 years, the positive rate of serum antibody was 3.60% (265/7 369), the positive rate dropped from 6.06% (37/611) in 2009 to 2.59% in 2014 22/850). The positive rate of students in agricultural areas was 3.99% (207/5 193), higher than that of pastoral areas (2.89% (43/1 487)) and urban areas (2.18% (15/689) ); Han students had the highest positive rate of 4.06% (177/4 361). A total of 4 677 domestic animals were examined. The infection rate of hydatid cysts in domestic animals was 13.04% (610/4 677), which also showed a declining trend from 25.05% (127/507) in 2009 to 8.80% (44 / 500), with the lowest in 2013 at 7.90% (79/1 000) (P <0.05). The positive rate of echinococcus antigen in domestic dogs was 5.18% (365/7 049), which gradually decreased from 16.98% (81/477) in 2009 to 2.56% (41/1 600) in 2014 (P <0.05) . Conclusion The prevalence of hydatid disease in Wenquan County decreased year by year with the majority of patients being young adults. The prevalence of hydatid disease, the positive rate of serum antibody to hydatid cyst, the rate of echinococcus granulosus and the positive rate of antigen of echinococcus granulosus of 6 ~ 12-year-old students were still high.