南方部分农村地区人群蓝氏贾第鞭毛虫疾病负担研究
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摘要
目的了解我国南方部分地区人群蓝氏贾第鞭毛虫疾病负担。方法采用多阶段随机抽样方法分别从我国湖北和广西某市各抽取约2000人作为调查对象,同时收集乡镇和县市级医院2014年10-12月门诊腹泻患者。利用碘液染色法检测粪便中贾第虫包囊,通过问卷调查收集调查对象一般人口学资料、就诊情况和疾病的社会经济影响等信息。结果一般人群和腹泻患者贾第虫感染率分别为1.72%(69/4015)和5.17%(20/387);按照地区、年龄、性别分组后的不同人群贾第虫感染率差别均无统计学意义(P>0.05)。贾第虫在湖北和广西地区DALYs分别为0.04029/千人和0.02783/千人。门诊腹泻患者中贾第虫感染者每次人均经济负担为140.81元,主要为直接经济负担。结论反映流行病学负担的贾第虫感染率和DALYs总体较低,但贾第虫病疾病经济负担较高,疾病防控应该在重点人群,预防为主,降低疾病负担。
To evaluate the disease burden of giardiasis among residents in southern areas of China,multistage sampling method was used.The 2 000 people were selected from city in Hubei and Guangxi provinces respectively.The out-patients with diarrhea attending township,county and municipal hospitals from October to December in 2014 were also selected.Faecal samples were collected and Giardia cysts in feces were detected by iodine staining methods.General demographic information,social and economic impact of the disease and other information were collected through questionnaires.The burden of disease was calculated in the form of disability-adjusted life years(DALYs).The infection rate in the general population was 1.72%(69/4015)while the infection rate in diarrheic patients was 5.17%(20/387).There was no significant difference among different groups after being grouped by region,age and sex(P> 0.05).DALYs were 0.040 29/1 000 persons and 0.027 83/1 000 persons in Hubei and Guangxi respectively.The average economic burden per case was CNY140.81,which was mainly from the direct economic cost.Giardiainfection rates and DALYs are generally low,but giardiasis has a higher economic burden.And disease prevention and control should focus on the key population to reduce the burden of disease.
To evaluate the disease burden of giardiasis among residents in southern areas of China,multistage sampling method was used.The 2 000 people were selected from city in Hubei and Guangxi provinces respectively.The out-patients with diarrhea attending township,county and municipal hospitals from October to December in 2014 were also selected.Faecal samples were collected and Giardia cysts in feces were detected by iodine staining methods.General demographic information,social and economic impact of the disease and other information were collected through questionnaires.The burden of disease was calculated in the form of disability-adjusted life years(DALYs).The infection rate in the general population was 1.72%(69/4015)while the infection rate in diarrheic patients was 5.17%(20/387).There was no significant difference among different groups after being grouped by region,age and sex(P> 0.05).DALYs were 0.040 29/1 000 persons and 0.027 83/1 000 persons in Hubei and Guangxi respectively.The average economic burden per case was CNY140.81,which was mainly from the direct economic cost.Giardiainfection rates and DALYs are generally low,but giardiasis has a higher economic burden.And disease prevention and control should focus on the key population to reduce the burden of disease.
引文
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[21]余森海,许隆祺,蒋则孝,等.首次全国人体寄生虫分布调查的报告Ⅰ.虫种的地区分布[J].中国寄生虫学与寄生虫病杂志,1994,12(4):241-247.
[22]田利光,程国金,陈家旭,等.我国农村HIV/AIDS高流行地区肠道寄生虫感染现况调查[J].中国血吸虫病防治杂志,2012,24(2):168-172.DOI:10.16250/j.32.1374.2012.02.022
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[25]马成骥,张巧玲,傅大仁.宁夏儿童青少年人体寄生虫感染现状[J].中国寄生虫学与寄生虫病杂志,1994,12(s1):92-94.
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[27]姚月娴,陈惠芳,莫锦,等.广州市某哨点医院腹泻儿童蓝氏贾第鞭毛虫感染的分子流行病学调查[J].中华疾病控制杂志,2014,18(9):900-902.
[28]徐利纳,吴国泉,席建伟,等.郑州市某医院儿童肠道寄生虫感染情况调查[J].热带医学杂志,2011,11(1):17-18.
[29]Hakim GD,Kiziltas S,Ciftci H,et al.The prevalence of Giardia intestinalis in dyspeptic and diabetic patients[J].ISRN gastroenterology,2011:580793.DOI:10.5402/2011/580793
[30]廖红群,邱伟,李新维,等.反复腹痛患儿蓝氏贾第鞭毛虫的检测与治疗[J].临床儿科杂志,2009,27(6):545-546.DOI:10.3969/j.issn.1000-3606.2009.06.012
[31]Fallah M.Rapid reinfection by Giardia lambliaafter treatment in a hyperendemic community,during one year follow up[J].Journal Of Research In Health Sciences,2011,3(2):29-32.
[32]Mohammed Mahdy AK,Lim YA,Surin J,et al.Risk factors for endemic giardiasis:highlighting the possible association of contaminated water and food[J].Transactions of the Royal Society of Tropical Medicine and Hygiene,2008,102(5):465-470.DOI:10.1016/j.trstmh.2008.02.004.
[33]王珊,张荣,陶勇.改水改厕典型地区腹泻疾病负担研究[J].环境与健康杂志,2014,31(2):159-162.DOI:10.16241/j.cnki.1001-5914.2014.02.022
[34]林玫,董柏青,梁大斌,等.广西感染性腹泻发病及疾病负担分析[J].中国公共卫生,2009,25(3):346-348.DOI:10.3321/j.issn:1001-0580.2009.03.054
[35]何敏媚,何闽江,崔斌.疾病经济负担研究进展[J].中国老年学杂志,2010,30(18):2700-2702.DOI:10.3969/j.issn.1005-9202.2010.18.071
[36]袁珩,祝小平,郝彩霞,等.四川省门诊和住院腹泻病患者疾病负担调查[J].预防医学情报杂志,2009,25(11):916-919.
[37]夏胜利,张玉凯,谢志强,等.河南省2007年腹泻病医院病例的疾病负担分析[J].中华流行病学杂志,2015,36(8):909-910.DOI:10.3760/cma.j.issn.0254-6450.2015.08.031
[38]叶中文.珠海市人群腹泻病疾病负担现状的调查研究[D].中山大学,2009.
[2]Plutzer J,Lassen B,Jokelainen P,et al.Review of Cryptosporidium and Giardiain the eastern part of Europe,2016[J].Euro Surveill,2018,23(4):1-23.DOI:10.2807/1560-7917.ES.2018.23.4.16-00825.
[3]Painter JE,Gargano JW,Collier SA,et al.Giardiasis surveillance-United States,2011-2012[J].MMWR Suppl,2015,64(3):15-25.
[4]Krol A.Giardia lambliaas a rare cause of reactive arthritis[J].Ugeskrift for laeger,2013,175(49A):V05130347.
[5]Daniels M E,Jenkins M W,Smith W A.Estimating Cryptosporidium and Giardia disease burdens for children drinking untreated groundwater in a rural population in India[J].Plos Neglected Tropical Diseases,2018,12(1).DOI:10.1371/journal.pntd.0006231
[6]胡缨,陈丽阳,李艳文.451例恶性肿瘤患者中肠道原虫感染情况研究[J].现代预防医学,2015,42(20):3816-3817,3833.
[7]余新刚,胡伟,李国清.蓝氏贾第鞭毛虫潜在致病机制初探[J].国际医学寄生虫病杂志,2015,42(2):112-117.DOI:10.3760/cma.j.issn.1673-4122.2015.02.013
[8]邓明俊,肖西志,孙涛,等.蓝氏贾第鞭毛虫检测技术研究进展[J].动物医学进展,2012,33(12):168-173.DOI:10.16437/j.cnki.1007-5038.2012.12.021
[9]Exner M,Gornik V.Parasitic zoonoses transmitted by drinking water.Giardiasis and cryptosporidiosis[J].Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz,2004,47(7):698-704.
[10]Vanathy K,Parija S C,Mandal J,et al.Cryptosporidiosis:a mini review[J].Trop Parasitol.2017 7(2):72-80.DOI:10.4103/tp.TP_25_17
[11]朱敏,张静,高永军,等.腹泻病疾病负担研究现状[J].卫生研究,2008,37(1):126-128.DOI:10.3969/j.issn.1000-8020.2008.01.042
[12]程晓明.卫生经济学(供预防医学·卫生管理类专业用)[M].2版.人民卫生出版社,2007:441,444-449.
[13]WHO.National tools[DB/OL].[2017-1-18].http://wwwwhoint/healthinfo/global_burden_disease/tools_national/en/.
[14]侯儒寅,高凤清.疾病经济负担研究方法案例分析[J].中国医药导报,2012,09(3):146-147.DOI:10.3969/j.issn.1673-7210.2012.03.066
[15]房俊勇,龚幼龙.疾病控制措施的经济学评价[J].国外医学(卫生经济分册),1999,16(1):1-10.
[16]诸欣平,苏川.人体寄生虫学[M].8版.北京:人民卫生出版社,2013:48.
[17]Hussein EM,Zaki WM,Ahmed SA,et al.Predominance of Giardia lamblia assemblage A among iron deficiency anaemic pre-school Egyptian children[J].Parasitology Research,2016,115(4):1537-1545.DOI:10.1007/s00436-015-4888-y
[18]El Basha NR,Zaki MM,Hassanin OM,et al.Giardia assemblages A and B in diarrheic patients:a comparative study in egyptian children and adults[J].J Parasitol,2016,102(1):69-74.DOI:10.1645/14-676
[19]Breurec S,Vanel N,Bata P,et al.Etiology and epidemiology of diarrhea in hospitalized children from low income country:A matched case-control study in central african republic[J].PLoS Negl Trop Dis,2016,10(1):e0004283.DOI:10.1371/journal.pntd.0004283
[20]Safar HH,Eldash HH.Parasitic infections:is male and female difference for anemia and growth retardation evident?[J].J Egypt Soc Parasitol,2015,45(3):467-475.
[21]余森海,许隆祺,蒋则孝,等.首次全国人体寄生虫分布调查的报告Ⅰ.虫种的地区分布[J].中国寄生虫学与寄生虫病杂志,1994,12(4):241-247.
[22]田利光,程国金,陈家旭,等.我国农村HIV/AIDS高流行地区肠道寄生虫感染现况调查[J].中国血吸虫病防治杂志,2012,24(2):168-172.DOI:10.16250/j.32.1374.2012.02.022
[23]王春东,李耀增,李远壁,等.沧州地区贾第虫感染情况调查[J].医学动物防治,1994,10(3):193-194.
[24]李申吾,孙富华.兰氏贾第鞭毛虫病214例临床分析[J].河南预防医学杂志,1986,03):17-18.
[25]马成骥,张巧玲,傅大仁.宁夏儿童青少年人体寄生虫感染现状[J].中国寄生虫学与寄生虫病杂志,1994,12(s1):92-94.
[26]朱名胜,朱敬,王绍基,等.十堰市儿童蓝氏贾第鞭毛虫感染情况调查[J].中国学校卫生,2009,30(12):1136-1137.
[27]姚月娴,陈惠芳,莫锦,等.广州市某哨点医院腹泻儿童蓝氏贾第鞭毛虫感染的分子流行病学调查[J].中华疾病控制杂志,2014,18(9):900-902.
[28]徐利纳,吴国泉,席建伟,等.郑州市某医院儿童肠道寄生虫感染情况调查[J].热带医学杂志,2011,11(1):17-18.
[29]Hakim GD,Kiziltas S,Ciftci H,et al.The prevalence of Giardia intestinalis in dyspeptic and diabetic patients[J].ISRN gastroenterology,2011:580793.DOI:10.5402/2011/580793
[30]廖红群,邱伟,李新维,等.反复腹痛患儿蓝氏贾第鞭毛虫的检测与治疗[J].临床儿科杂志,2009,27(6):545-546.DOI:10.3969/j.issn.1000-3606.2009.06.012
[31]Fallah M.Rapid reinfection by Giardia lambliaafter treatment in a hyperendemic community,during one year follow up[J].Journal Of Research In Health Sciences,2011,3(2):29-32.
[32]Mohammed Mahdy AK,Lim YA,Surin J,et al.Risk factors for endemic giardiasis:highlighting the possible association of contaminated water and food[J].Transactions of the Royal Society of Tropical Medicine and Hygiene,2008,102(5):465-470.DOI:10.1016/j.trstmh.2008.02.004.
[33]王珊,张荣,陶勇.改水改厕典型地区腹泻疾病负担研究[J].环境与健康杂志,2014,31(2):159-162.DOI:10.16241/j.cnki.1001-5914.2014.02.022
[34]林玫,董柏青,梁大斌,等.广西感染性腹泻发病及疾病负担分析[J].中国公共卫生,2009,25(3):346-348.DOI:10.3321/j.issn:1001-0580.2009.03.054
[35]何敏媚,何闽江,崔斌.疾病经济负担研究进展[J].中国老年学杂志,2010,30(18):2700-2702.DOI:10.3969/j.issn.1005-9202.2010.18.071
[36]袁珩,祝小平,郝彩霞,等.四川省门诊和住院腹泻病患者疾病负担调查[J].预防医学情报杂志,2009,25(11):916-919.
[37]夏胜利,张玉凯,谢志强,等.河南省2007年腹泻病医院病例的疾病负担分析[J].中华流行病学杂志,2015,36(8):909-910.DOI:10.3760/cma.j.issn.0254-6450.2015.08.031
[38]叶中文.珠海市人群腹泻病疾病负担现状的调查研究[D].中山大学,2009.