河南省人体肠道原虫感染现状分析
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摘要
目的了解河南省人体肠道原虫的感染现状。方法 2014-2015年按照《全国人体重要寄生虫病现状调查方案》要求,根据河南省生态区划分及经济水平确定调查县,根据地形和经济水平等因素分层,每层随机数字表法抽取1个自然村为调查点,每个调查点调查当地农村常住人口250人。收集被调查者的新鲜粪样,采用生理盐水和碘液直接涂片法分别检查肠道原虫感染情况。不同人群感染率采用χ2检验进行比较。结果本次共调查河南省35个县(市)104个村26 866人。肠道原虫总感染率为0.57%(152/26 866)。检出肠道原虫7种,分别是布氏嗜碘阿米巴、哈门氏内阿米巴、微小内蜒阿米巴、溶组织内阿米巴、结肠内阿米巴、蓝氏贾第鞭毛虫、人芽囊原虫,其中以微小内蜒阿米巴感染率最高(0.19%,50/26 866),不同原虫感染率差异有统计学意义(P<0.05)。在不同生态区中,以华北平原生态区的原虫感染率为高,为0.67%(45/6 696),但不同生态区的感染率差异无统计学意义(P>0.05)。经人口标化后,在检出肠道原虫的27个县(市)中,项城市的原虫感染率最高,为2.69%。女性肠道原虫感染率为0.41%(57/13 901),低于男性的0.73%(95/12 965)(P<0.05);不同年龄组中,以<20岁和20~岁年龄组人群肠道原虫感染率为高,均为0.66%(31/4 667,18/2 742),且以人芽囊原虫感染为主。不同职业人群中,工人肠道原虫感染率为0.76%(4/528),高于农民的0.54%(96/17 896)。不同文化程度人群中,高中及以上人群肠道原虫感染率为0.71%(18/2 550),高于小学的0.52%(42/8 014)。不同民族人群中,汉族感染率最高,为0.57%(151/26 434)(P<0.05)。调查点农民年人均纯收入1 200~23 590元,中位数为5 950元。不同年龄、职业、文化程度、收入水平人群的肠道原虫感染率差异无统计学意义(P>0.05)。结论河南省人体肠道原虫调查共检出7种原虫,总体感染率较低。
Objective To understand the current status of human intestinal protozoal infection in Henan Province. Methods An epidemiological survey was carried out in Henan Province according to the Protocol of National Survey Scheme on Major Human Parasitic Diseases, in counties selected based on the ecological and economic conditions. A stratified sampling method was used to select one village in each county, and 250 residents in each village were examined. Fresh human fecal samples were collected, in which trophozoites and/or cysts of intestinal protozoa were examined by physiological saline direct smear method and iodine stain method, respectively. The infec-tion rate was compared between different populations using the chi-square test. Results A total of 26 866 persons from 104 villages in 35 counties(cities) were examined, and the overall infection rate of intestinal protozoa was0.57%(152/26 866). Seven species of intestinal protozoa were detected: Iodamoeba buetschlii, Entamoeba hartmani,Endolimax nana, Entamoeba histolytica, Entamoeba coli, Giardia lamblia and Blastocystis hominis, of which the Endolimax nana conferred the highest infection rate(0.19%, 50/26 866). There was a significant difference in infection rate among the species(P < 0.05). Among the 4 ecological regions, the North China Plain Ecological Region had higher infection rate(0.67%, 45/6 696), with no significant difference( P > 0.05). After normalization, Xiangcheng had the highest infection rate among the 27 counties(cities) detected with human intestinal protozoa(2.69%). The infection rate was higher in males(0.73%, 95/12 965) than in females(0.41%, 57/13 901)( P < 0.05). Among different age groups, the infection rate was higher in the groups of < 20(0.66%, 31/4 667) and 20-(0.66%, 18/2 742),predominated by Blastocystis hominis. Furthermore, among different occupations, infection rate in workers and farmers was 0.76%(4/528) and 0.54%(96/17 896), respectively. Populations with a level of high school or above and a primary school showed an infection rate of 0.71%(18/2 550) and 0.52%(42/8 014), respectively. The Han ethnicity had a higher infection rate(0.57%, 151/26 434)( P < 0.05). The average annual income per farmer in the survey was1 200-23 590 yuan, with a median of 5 950 yuan. There was no significant difference in the intestinal protozoa in-fection rate in age, occupation, education level, or income( P > 0.05). Conclusion Seven species of intestinal protozoa are identified with a low rate of infection in Henan Province.
Objective To understand the current status of human intestinal protozoal infection in Henan Province. Methods An epidemiological survey was carried out in Henan Province according to the Protocol of National Survey Scheme on Major Human Parasitic Diseases, in counties selected based on the ecological and economic conditions. A stratified sampling method was used to select one village in each county, and 250 residents in each village were examined. Fresh human fecal samples were collected, in which trophozoites and/or cysts of intestinal protozoa were examined by physiological saline direct smear method and iodine stain method, respectively. The infec-tion rate was compared between different populations using the chi-square test. Results A total of 26 866 persons from 104 villages in 35 counties(cities) were examined, and the overall infection rate of intestinal protozoa was0.57%(152/26 866). Seven species of intestinal protozoa were detected: Iodamoeba buetschlii, Entamoeba hartmani,Endolimax nana, Entamoeba histolytica, Entamoeba coli, Giardia lamblia and Blastocystis hominis, of which the Endolimax nana conferred the highest infection rate(0.19%, 50/26 866). There was a significant difference in infection rate among the species(P < 0.05). Among the 4 ecological regions, the North China Plain Ecological Region had higher infection rate(0.67%, 45/6 696), with no significant difference( P > 0.05). After normalization, Xiangcheng had the highest infection rate among the 27 counties(cities) detected with human intestinal protozoa(2.69%). The infection rate was higher in males(0.73%, 95/12 965) than in females(0.41%, 57/13 901)( P < 0.05). Among different age groups, the infection rate was higher in the groups of < 20(0.66%, 31/4 667) and 20-(0.66%, 18/2 742),predominated by Blastocystis hominis. Furthermore, among different occupations, infection rate in workers and farmers was 0.76%(4/528) and 0.54%(96/17 896), respectively. Populations with a level of high school or above and a primary school showed an infection rate of 0.71%(18/2 550) and 0.52%(42/8 014), respectively. The Han ethnicity had a higher infection rate(0.57%, 151/26 434)( P < 0.05). The average annual income per farmer in the survey was1 200-23 590 yuan, with a median of 5 950 yuan. There was no significant difference in the intestinal protozoa in-fection rate in age, occupation, education level, or income( P > 0.05). Conclusion Seven species of intestinal protozoa are identified with a low rate of infection in Henan Province.
引文
[1]马云祥,尚乐园,许汴利.河南省寄生虫病防治与研究:1949-2014[M].郑州:河南人民出版社,2014.
[2]邓艳,陈伟奇,张雅兰,等.2011-2015年河南省淮阳县土源性线虫病监测结果分析[J].中国寄生虫学与寄生虫病杂志,2016,34(6):533-536.
[3]邓艳,张雅兰,陈伟奇,等.2015年河南省豫东地区人体肠道寄生虫感染现状调查[J].中国寄生虫学与寄生虫病杂志,2017,35(5):450-455.
[4]苏云普,贺丽君,颜秋叶,等.河南省人体肠道原虫感染状况调查[J].中国热带医学,2010,10(4):398-399,425.
[5]环境保护部,中国科学院.全国生态功能区划[M].北京:中国环境科学出版社,2008.
[6]国务院人口普查办公室//国家统计局人口和就业统计司.中国2010年人口普查分县资料[M].北京:中国统计出版社,2012.
[7]胡缨,李艳文,卢作超.慢性腹泻患者1 185例感染人芽囊原虫的临床分析[J].中国热带医学,2012,12(6):713-715,718.
[8]宋太平,张威,巩跃生,等.肠阿米巴病113例误诊原因分析[J].临床误诊误治,2011,24(3):69-70.
[9]王爱华.溶组织内阿米巴致儿童痢疾误诊26例分析[J].中国误诊学杂志,2008,8(1):113-114.
[10]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.
[11]Taamasri P,Mungthin M,Rangsin R,et al.Transmission of intestinal blastocystosis related to the quality of drinking water[J].Southeast Asian J Trop Med Pub Hlth,2000,31(1):112-117.
[12]Nassir E,Awad J,Abel AB,et al.Blastocystis hominis as a cause of hypoalbuminemia and anasarca[J].Eur J Clin Microbiol Infect Dis,2004,23(5):399-402.
[13]何卓,唐阳,李正祥,等.2015年湖南省人体重点寄生虫病流行现状调查[J].实用预防医学,2017,24(3):291-296.
[14]金伟,郭见多,刘道华,等.安徽省人体重点寄生虫病现状调查报告[J].热带病与寄生虫学,2017,15(1):14-18,6.
[15]买买提江·吾买尔,陈晓英,伊斯拉音·乌斯曼,等.2015年新疆维吾尔自治区人体肠道原虫流行病学调查[J].中国寄生虫学与寄生虫病杂志,2016,34(4):361-365.
[16]胡缨,黎学铭,张鸿满,等.南宁市城区人群人芽囊原虫感染情况调查[J].中国病原生物学杂志,2013,8(6):547-548,555.
[17]李燕榕,李莉莎,程由注,等.福建省人体重要寄生虫感染家庭聚集性分析[J].热带医学杂志,2007,7(8):807-809.
[18]陈韶红,张永年,李浩,等.2011-2013年上海临床医院送检样品寄生虫检测结果分析[J].中国寄生虫学与寄生虫病杂志,2014,32(6):446-451.
[2]邓艳,陈伟奇,张雅兰,等.2011-2015年河南省淮阳县土源性线虫病监测结果分析[J].中国寄生虫学与寄生虫病杂志,2016,34(6):533-536.
[3]邓艳,张雅兰,陈伟奇,等.2015年河南省豫东地区人体肠道寄生虫感染现状调查[J].中国寄生虫学与寄生虫病杂志,2017,35(5):450-455.
[4]苏云普,贺丽君,颜秋叶,等.河南省人体肠道原虫感染状况调查[J].中国热带医学,2010,10(4):398-399,425.
[5]环境保护部,中国科学院.全国生态功能区划[M].北京:中国环境科学出版社,2008.
[6]国务院人口普查办公室//国家统计局人口和就业统计司.中国2010年人口普查分县资料[M].北京:中国统计出版社,2012.
[7]胡缨,李艳文,卢作超.慢性腹泻患者1 185例感染人芽囊原虫的临床分析[J].中国热带医学,2012,12(6):713-715,718.
[8]宋太平,张威,巩跃生,等.肠阿米巴病113例误诊原因分析[J].临床误诊误治,2011,24(3):69-70.
[9]王爱华.溶组织内阿米巴致儿童痢疾误诊26例分析[J].中国误诊学杂志,2008,8(1):113-114.
[10]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.
[11]Taamasri P,Mungthin M,Rangsin R,et al.Transmission of intestinal blastocystosis related to the quality of drinking water[J].Southeast Asian J Trop Med Pub Hlth,2000,31(1):112-117.
[12]Nassir E,Awad J,Abel AB,et al.Blastocystis hominis as a cause of hypoalbuminemia and anasarca[J].Eur J Clin Microbiol Infect Dis,2004,23(5):399-402.
[13]何卓,唐阳,李正祥,等.2015年湖南省人体重点寄生虫病流行现状调查[J].实用预防医学,2017,24(3):291-296.
[14]金伟,郭见多,刘道华,等.安徽省人体重点寄生虫病现状调查报告[J].热带病与寄生虫学,2017,15(1):14-18,6.
[15]买买提江·吾买尔,陈晓英,伊斯拉音·乌斯曼,等.2015年新疆维吾尔自治区人体肠道原虫流行病学调查[J].中国寄生虫学与寄生虫病杂志,2016,34(4):361-365.
[16]胡缨,黎学铭,张鸿满,等.南宁市城区人群人芽囊原虫感染情况调查[J].中国病原生物学杂志,2013,8(6):547-548,555.
[17]李燕榕,李莉莎,程由注,等.福建省人体重要寄生虫感染家庭聚集性分析[J].热带医学杂志,2007,7(8):807-809.
[18]陈韶红,张永年,李浩,等.2011-2013年上海临床医院送检样品寄生虫检测结果分析[J].中国寄生虫学与寄生虫病杂志,2014,32(6):446-451.