2014年拉萨市肠道寄生虫感染流行病学调查分析
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摘要
目的了解西藏拉萨市肠道寄生虫感染的流行现状。方法 2014年在拉萨市采用分层随机整群抽样的方法选取城关区、当雄县、达孜县、曲水县的常住人口为调查对象,采用Kato-Katz法(一粪三检)检测土源性线虫感染情况;3~12岁儿童加做透明胶纸肛拭法检测蛲虫(Enterobius vermicularis)。用碘液染色法检测肠道原虫。对各虫种感染率的性别分布、年龄分布、职业分布进行统计描述,比较分析各虫种的感染率。结果本次调查共抽样1 015人,平均年龄(39.3±18.2)岁,最小的1岁,最大的89岁;其中男性391人(38.6%);女性623人(61.4%)。寄生虫总感染人数为249人,总感染率为24.5%(249/1 015);其中带绦虫(Taenia sp.)感染220例,感染率为21.7%(220/1 015);鞭虫(Trichuris trichiura)、蛲虫感染各2例,感染率均为0.2%(2/1 015);结肠内阿米巴(Entamoeba coli)感染42例,感染率为4.1%(42/1 015);蓝氏贾第鞭毛虫(Giardia lamblia)感染4例,感染率为0.4%(4/1 015);布氏嗜碘阿米巴(Iodamoeba butschlii)感染2例,感染率为0.2%(2/1 015);未检出其他寄生虫。男性带绦虫、鞭虫、蛲虫、结肠内阿米巴、蓝氏贾第鞭毛虫、布氏嗜碘阿米巴的感染率分别为21.2%(83/391)、0、0.3%(2/391)、5.4%(21/391)、0.8%(3/391)、0,女性感染率分别为22.0%(137/624)、0.3%(2/624)、0.2%(1/624)、3.4%(21/624)、0.2%(1/624)、0.3%(2/624),各虫种感染率性别间差异无统计学意义(P>0.05)。年龄分布分析结果显示,0~、18~、30~、40~、50~和60~岁组的带绦虫感染率分别为10.9%(18/165)、14.0%(18/129)、23.0%(43/187)、25.3%(61/241)、26.5%(41/155)和28.3%(39/138),0~与40~、50~和60~岁组间感染率差异有统计学意义(P<0.01)。结肠内阿米巴、鞭虫和布氏嗜碘阿米巴的感染率最高出现在50~岁组,分别为6.5%(10/155)、0.7%(1/155)和1.3%(2/155);蓝氏贾第鞭毛虫的感染率最高出现在18~岁组,为1.6%(2/129);各年龄组间感染率差异均无统计学意义(P>0.05)。职业分布分析结果显示,带绦虫、结肠内阿米巴、蛲虫、布氏嗜碘阿米巴的感染率均以农民为高,分别为44.5%(147/330)、6.4%(21/330)、0.6%(2/330)和0.3%(1/330);鞭虫感染率以家庭妇女为高,为2.5%(1/40);蓝氏贾第鞭毛虫感染率以学生为高,为0.7%(1/134)。结论拉萨市调查人群中存在多种肠道寄生虫感染,其中带绦虫的感染率最高,其他寄生虫的感染率处于较低水平。
Objective To investigate the prevalence of parasitic infections in Lhasa,Tibet. Methods The residents in Chengguan District,Dangxiong County,Dazi County and Qushui County were selected to participate in the study in 2014,using the stratified random sam pling method. Infections with the soil-borne nematodes in feces were examined in triplicates using the Kato-Katz method. Further,the Enterobius vermicularis were examined using the cellophane anal swab method in children aged 3-12 years,and the intestinal protozoa were detected by iodine staining. The parasitic infection was analyzed by sex,age,and occupation. Comparisons were made using Chi-square test. Results A total of 1 015 residents(39.3 ±18.2 years: age range,1-89 years) participated in the study,including 391 males(38.6%) and 623 females(61.4%). Two hundred and forty-nine participants were positive for parasitic infections,with an overall infection rate of 24.5%(249/1 015). The infection rate was 21.7%(220/1 015) for Taenia sp.,0.2%(2/1 015) for Trichuris trichiura and E. vermicularis respectively,4.1%(42/1 015) for Entamoeba coli,0.4%(4/1 015) for Giardia lamblia,0.2%(2/1 015) for Iodamoeba butschlii. No infection was found for other parasites. There was no significant sexual difference in the infection rate of Taenia(male 21.2%,83/391; female22.0%,137/624),T. trichiura(male 0; female 0.3%,2/624),E. vermicularis(male 0.3%,2/391; female 0.2%,1/624),E. coli(male 5.4%,21/391; female 3.4%,21/624),G. lamblia(male 0.8%,3/391; female 0.2%,1/624),or I. butschlii(male 0; female 0.3%,2/624)(P >0.05). The Taenia sp. infection rate in the age groups of 0-17,18-29,30-39,40-49,50-59 and ≥ 60 years was 10.9%(18/165),14.0%(18/129),23.0%(43/187),25.3%(61/241),26.5%(41/155),and 28.3%(39/138),respectively,with significant differences between groups of 0-17 and 40-49 years and between groups of 50-59 and ≥ 60 years(P<0.01). The infection rate of E. coli,T. trichiura and I. butschlii was highest in the age group of 50-59 years(6.5%,10/155; 0.7%,1/155; 1.3%,2/155 respectively). Among various occupations,farmers showed the highest infection rate for Taenia( 44. 5 %,147 / 330),E. coli( 6. 4 %,21 / 33),E. vermicularis( 0. 6 %,2 / 330) and I. butschlii( 0. 3 %,1 / 330); housewives had the highest infection rate for T. trichiura( 2. 5 %,1 / 40); and the students had the highest infection rate for G. lamblia( 0. 7 %,1 / 134). Conclusion There are infections with various intestinal parasites in the participants of Lhasa City,among which taenia infection reaches20. 7 % while others have a low level of infection.
Objective To investigate the prevalence of parasitic infections in Lhasa,Tibet. Methods The residents in Chengguan District,Dangxiong County,Dazi County and Qushui County were selected to participate in the study in 2014,using the stratified random sam pling method. Infections with the soil-borne nematodes in feces were examined in triplicates using the Kato-Katz method. Further,the Enterobius vermicularis were examined using the cellophane anal swab method in children aged 3-12 years,and the intestinal protozoa were detected by iodine staining. The parasitic infection was analyzed by sex,age,and occupation. Comparisons were made using Chi-square test. Results A total of 1 015 residents(39.3 ±18.2 years: age range,1-89 years) participated in the study,including 391 males(38.6%) and 623 females(61.4%). Two hundred and forty-nine participants were positive for parasitic infections,with an overall infection rate of 24.5%(249/1 015). The infection rate was 21.7%(220/1 015) for Taenia sp.,0.2%(2/1 015) for Trichuris trichiura and E. vermicularis respectively,4.1%(42/1 015) for Entamoeba coli,0.4%(4/1 015) for Giardia lamblia,0.2%(2/1 015) for Iodamoeba butschlii. No infection was found for other parasites. There was no significant sexual difference in the infection rate of Taenia(male 21.2%,83/391; female22.0%,137/624),T. trichiura(male 0; female 0.3%,2/624),E. vermicularis(male 0.3%,2/391; female 0.2%,1/624),E. coli(male 5.4%,21/391; female 3.4%,21/624),G. lamblia(male 0.8%,3/391; female 0.2%,1/624),or I. butschlii(male 0; female 0.3%,2/624)(P >0.05). The Taenia sp. infection rate in the age groups of 0-17,18-29,30-39,40-49,50-59 and ≥ 60 years was 10.9%(18/165),14.0%(18/129),23.0%(43/187),25.3%(61/241),26.5%(41/155),and 28.3%(39/138),respectively,with significant differences between groups of 0-17 and 40-49 years and between groups of 50-59 and ≥ 60 years(P<0.01). The infection rate of E. coli,T. trichiura and I. butschlii was highest in the age group of 50-59 years(6.5%,10/155; 0.7%,1/155; 1.3%,2/155 respectively). Among various occupations,farmers showed the highest infection rate for Taenia( 44. 5 %,147 / 330),E. coli( 6. 4 %,21 / 33),E. vermicularis( 0. 6 %,2 / 330) and I. butschlii( 0. 3 %,1 / 330); housewives had the highest infection rate for T. trichiura( 2. 5 %,1 / 40); and the students had the highest infection rate for G. lamblia( 0. 7 %,1 / 134). Conclusion There are infections with various intestinal parasites in the participants of Lhasa City,among which taenia infection reaches20. 7 % while others have a low level of infection.
引文
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[2]郭文敏,于德江,朗嘎卓玛,等.西藏拉萨、林芝地区四县人体寄生虫分布调查[J].寄生虫学与寄生虫病杂志,1991,9(S1):107-109.
[3]白玛卓嘎,贾雪莹,刘浩宇.拉萨市及周边地区小学生蛔虫感染与防治知识知晓率对比调查[J].西藏大学学报(自然科学版),2012,27(2):52-55.
[4]周晓农,陈家旭,汪天平,等.土源性寄生虫病[M].北京:人民卫生出版社,2011:3-35.
[5]李雍龙,管晓虹,牛安欧,等.人体寄生虫学[M].7版.北京:人民卫生出版社,2008:41-33.
[6]郭文敏,于德江,曾宪荣,等.西藏人体寄生虫分布调查[J].中国寄生虫病防治杂志,1994,7(2):131-132.
[7]于德江,郭文敏,曾宪荣,等.西藏自治区人体寄生虫分布调查[J].中国寄生虫学与寄生虫病杂志,1994,12(S1):74-76.
[8]全国人体重要寄生虫病现状调查办公室.全国人体重要寄生虫病现状调查报告[J].中国寄生虫学与寄生虫病杂志,2005,23(5):332-340.
[9]刘晓堂.西藏人体寄生虫病的流行与防治探讨[J].西藏科技,2010,4:34-43.
[10]央珍,贵桑曲珍,王群,等.拉萨市城关区绦虫和囊尾蚴病流行现状[J].寄生虫病与感染性疾病,2005,3(1):47.
[11]朱武军,郎书源,温二生,等.拉萨市蔡公堂乡牛带绦虫病的流行病学调查[J].热带医学杂志,2005,5(2):200-202.
[12]李雍龙,诸欣平,苏川,等.人体寄生虫学[M].8版.北京:人民卫生出版社,2013:132-135.
[13]Salam RA,Maredia H,Das JK,et al.Community-based interventions for the prevention and control of helmintic neglected tropical diseases[J].Infect Dis Poverty,2014,3:23.