桂林市游泳儿童隐孢子虫感染现状调查
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摘要
目的了解广西壮族自治区桂林市游泳儿童隐孢子虫感染现状。方法根据桂林市地理位置抽取6家游泳馆,于2017年8月初问卷调查选中游泳馆中小于14岁的游泳儿童,同时采集儿童24h内的新鲜粪便,使用RIDA~隐孢子虫快速检测法检测粪便隐孢子虫卵囊;每个游泳馆采集2次泳池水样,每次采集1份水样,并于4h内检测水质微生物指标(细菌总数、大肠菌群),其余水质指标(游离性余氯、浑浊度、尿素、pH)现场测定。结果共调查298人(2~13岁),男性儿童165人,女性儿童133人,游泳儿童隐孢子虫感染率为4.0%,其中男性儿童感染率为4.2%,女性儿童感染率为3.8%,5岁以下游泳儿童感染率最高(4.5%),10岁以上游泳儿童感染率最低(2.9%);6家游泳馆水质检测指标中尿素(33.3%)和余氯(16.7%)合格率较低,其余检测指标(浑浊度、pH、细菌总数、大肠菌群)合格率为100.0%。游泳儿童隐孢子虫感染人数在不同性别、年龄段中差异无统计学意义(P>0.05);在不同余氯浓度、不同浑浊度游泳馆中分布差异有统计学意义(P<0.05),。结论该地区游泳儿童存在隐孢子虫感染;增加泳池余氯量不能降低游泳儿童感染隐孢子虫的风险,降低泳池水浑浊度有利于降低游泳儿童隐孢子虫感染风险。
Objective To explore the prevalence of Cryptosporidiuminfection in child swimmers in Guilin,Guangxi.Methods 6 natatoriums were selected based on the geographical location of Guilin.A questionnaire survey was conducted among child swimmers under 14 years old at the 6 natatoriums.Specimens of fresh feces within 24 hours were collected,and RIDA~ Quick Cryptosporidium method was used to detect Cryptosporidiumoocysts in the specimens.Water samples were collected from each swimming pool for detection of microbiological indicators(total bacterial count,coliform group)and other inspection items(pH,turbidity,urea,free residual chlorine).Results A total of 298 children aged 2 to 13 years were examined,including 165 boys and 133 girls.The overall incidence rate of Cryptosporidium was 4.0%,and the incidence rates in boys and girls were 4.2%and 3.8%,respectively.The incidence rate was highest(4.5%)in the age group of under 5 years old,and lowest(2.9%)in the age group of age more than 10 years.Among the 6 swimming pools,the compliance rates of urea level(33.3%)and residual chlorine(16.7%)were low,while those of other indicators and inspection items(turbidity,pH,total bacterial count and coliform group)were 100%.Unfavorable outcome(P>0.05)occurred in male and female child swimmers and in different age groups.There was significant association between Cryptosporidiuminfection and swimming pools with different concentrations of residual chlorine and different turbidity levels(P<0.05).Conclusion Cryptosporidium infection occurs in child swimmers in the investigated region.Increasing the level of free residual chlorine can′t reduce the risk of Cryptosporidiuminfection,but decreasing the level of turbidity may help to reduce the risk of Cryptosporidiuminfection in child swimmers.
Objective To explore the prevalence of Cryptosporidiuminfection in child swimmers in Guilin,Guangxi.Methods 6 natatoriums were selected based on the geographical location of Guilin.A questionnaire survey was conducted among child swimmers under 14 years old at the 6 natatoriums.Specimens of fresh feces within 24 hours were collected,and RIDA~ Quick Cryptosporidium method was used to detect Cryptosporidiumoocysts in the specimens.Water samples were collected from each swimming pool for detection of microbiological indicators(total bacterial count,coliform group)and other inspection items(pH,turbidity,urea,free residual chlorine).Results A total of 298 children aged 2 to 13 years were examined,including 165 boys and 133 girls.The overall incidence rate of Cryptosporidium was 4.0%,and the incidence rates in boys and girls were 4.2%and 3.8%,respectively.The incidence rate was highest(4.5%)in the age group of under 5 years old,and lowest(2.9%)in the age group of age more than 10 years.Among the 6 swimming pools,the compliance rates of urea level(33.3%)and residual chlorine(16.7%)were low,while those of other indicators and inspection items(turbidity,pH,total bacterial count and coliform group)were 100%.Unfavorable outcome(P>0.05)occurred in male and female child swimmers and in different age groups.There was significant association between Cryptosporidiuminfection and swimming pools with different concentrations of residual chlorine and different turbidity levels(P<0.05).Conclusion Cryptosporidium infection occurs in child swimmers in the investigated region.Increasing the level of free residual chlorine can′t reduce the risk of Cryptosporidiuminfection,but decreasing the level of turbidity may help to reduce the risk of Cryptosporidiuminfection in child swimmers.
引文
[1]Ryan U,Fayer R,Xiao L.Cryptosporidium species in humans and animals:Current understanding and research needs[J].Parasitology,2014,141(13):1667.
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[7]Polgreen PM,Sparks JD,Polgreen LA,et al.A statewide outbreak of Cryptosporidiumand its association with the distribution of public swimming pools[J].Epidemiol&Infect,2012,140(8):1439-1445.
[8]Castor ML,Beach MJ.Reducing illness transmission from disinfected recreational water venues:Swimming,diarrhea and the emergence of a new public health concern[J].Pediatric Infect Dis J,2004,23(9):866-870.
[9]LU Jun,LI Chaopin.The survey of Cryptosporidiuminfection among young children in Kindergartens in Anhui Province[J].Chin J Parasitol&Parasitic Dis,2004,22(6):331-333.(in Chinese)陆军,李朝品.安徽省幼儿园儿童隐孢子虫感染情况调查[J].中国寄生虫学与寄生虫病杂志,2004,22(6):331-333.
[10]朱名胜,宋明华.十堰市幼儿园儿童隐孢子虫感染情况[J].中国学校卫生,2007,28(11):1040-1040.
[11]XU Hongping,RAN Zhilin,LI Shaofeng,et al.Removal and inactivation of cryptosporidium and giardia in drinking water treatment[J].Chem Engin,2014(8):50-54.(in Chinese)徐宏平,冉治霖,李绍峰,等.饮用水中隐孢子虫与贾第虫的危害及其去除灭活研究[J].化学工程师,2014(8):50-54.
[2]Gómez-Dantés H,Fullman N,Lamadrid-Figueroa H,et al.Dissonant health transition in the states of Mexico,1990-2013:A systematic analysis for the Global Burden of Disease Study2013[J].Lancet,2016,388(10058):2386.
[3]Simango C,Mutikani S.Cryptosporidiosis in Harare,Zimbabwe[J].Central African J Med,2004,50(5/6):52.
[4]CAI Ru,LI Chaopin,WANG Jian,et al.An epidemiological survey of cryptosporidiosis with diarrhea in Huainan area[J].J Trop Dis&Parasitol,2003,1(1):26-28.蔡茹,李朝品,王健,等.淮南地区腹泻患者隐孢子虫感染的调查[J].热带病与寄生虫学,2003,1(1):26-28.
[5]Smith A,Reacher M,Smerdon W,et al.Outbreaks of waterborne infectious intestinal disease in England and Wales,1992-2003[J].Epidemiol&Infect,2006,134(6):1141.
[6]Takagi M,Toriumi H,Endo T,et al.An outbreak of cryptosporidiosis associated with swimming pools[J].Kansenshogaku Zasshi,2008,82(1):14-19.
[7]Polgreen PM,Sparks JD,Polgreen LA,et al.A statewide outbreak of Cryptosporidiumand its association with the distribution of public swimming pools[J].Epidemiol&Infect,2012,140(8):1439-1445.
[8]Castor ML,Beach MJ.Reducing illness transmission from disinfected recreational water venues:Swimming,diarrhea and the emergence of a new public health concern[J].Pediatric Infect Dis J,2004,23(9):866-870.
[9]LU Jun,LI Chaopin.The survey of Cryptosporidiuminfection among young children in Kindergartens in Anhui Province[J].Chin J Parasitol&Parasitic Dis,2004,22(6):331-333.(in Chinese)陆军,李朝品.安徽省幼儿园儿童隐孢子虫感染情况调查[J].中国寄生虫学与寄生虫病杂志,2004,22(6):331-333.
[10]朱名胜,宋明华.十堰市幼儿园儿童隐孢子虫感染情况[J].中国学校卫生,2007,28(11):1040-1040.
[11]XU Hongping,RAN Zhilin,LI Shaofeng,et al.Removal and inactivation of cryptosporidium and giardia in drinking water treatment[J].Chem Engin,2014(8):50-54.(in Chinese)徐宏平,冉治霖,李绍峰,等.饮用水中隐孢子虫与贾第虫的危害及其去除灭活研究[J].化学工程师,2014(8):50-54.