热带病与寄生虫学

热带病与寄生虫学 ›› 2021, Vol. 19 ›› Issue (3): 127-130,150.

• 论著 • 上一篇    下一篇

2016—2020 年四川省华支睾吸虫病监测结果分析

罗静雯1,田洪春1,谢红1,铁磊1,张丽萍1,龚希1,吕城燊2   

  1. 1. 四川省疾病预防控制中心,四川成都610041;　2. 四川省乐山市五通桥区疾控中心
  • 出版日期:2021-06-20 发布日期:2021-07-13
  • 通信作者: 田洪春,E-mail:tianhongchun118@sina.com
  • 作者简介:罗静雯,女,硕士,主管医师,研究方向:土源性和食源性寄生虫病。E-mail:luojingwencdc@126.com

Analysis on the surveillance results of clonorchiasis in Sichuan Province from 2016 to 2020

LUO Jing-wen1,TIAN Hong-chun1,XIE Hong1,TIE Lei1,ZHANG Li-ping1,GONG Xi1,LÜ Cheng-shen2   

  1. 1. Sichuan Center for Disease Control and Prevention；2. Wutongqiao Center for Disease Control and Prevention
  • Online:2021-06-20 Published:2021-07-13
  • Contact: TIAN Hong-chun,E-mail:tianhongchun118@sina.com

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摘要：

目的　了解四川省华支睾吸虫病流行现状,为指导四川省华支睾吸虫病防治提供科学依据。方法　2016—2020 年,按照全国及四川省肝吸虫病及土源性线虫病监测方案,每年在未开展规范化监测的县(市、区)选定流动监测点,乐山市五通桥区为固定监测点,采用改良加藤厚涂片法(一粪两检)检查人群华支睾吸虫虫卵。2017—2020 年在固定监测点用压片法检测淡水鱼虾囊蚴,用改良加藤厚涂片法检测猫、犬等保虫宿主粪便,对粪检人群开展人群卫生知识与行为问卷调查。结果　2016—2020 年,流动监测点共调查143 311 人,查出华支睾吸虫感染者28 人,感染率为0. 02%。2016—2020 年人群华支睾吸虫感染率均为较低水平,分别为0. 01%(5/34 967)、0. 02%(6/33 507)、0. 04%(7/19 326)、0. 02%(7/30 256)、0. 01%(3/25 255),不同年份感染率差异无统计学意义(χ 2 =4. 249,P =0. 373)。川西平原和丘陵地区华支睾吸虫感染率最高,分别为0. 03%(6/20 217)和0. 03%(19/64 989);川西北高原未查出华支睾吸虫感染,不同地形间感染率差异有统计学意义(χ 2 = 9. 949,P = 0. 028)。共有18 个县(市、区)查出了华支睾吸虫感染,占流动监测点总数的14. 06%。男性华支睾吸虫感染率为0. 02%(13/68 316),女性为0. 02%(15/74 995),差异无统计学意义(χ 2 =0.017,P=0.895); 40~59 岁组和≥60 岁组感染率分别为0. 02%(12/48 446)和0. 02%(12/48 873),0~9 岁组未检出,不同年龄组人群感染率差异无统计学意义(χ 2 = 4. 721,P =0. 291);初中组和高中、中专或中技组人群华支睾吸虫感染率分别为0. 03%(12/35 401)和0. 03%(2/7 772),大专及以上组未检出,不同文化程度人群华支睾吸虫感染率差异无统计学意义(χ 2 = 5. 155,P = 0. 326);农民组和其他职业组华支睾吸虫感染率分别为0. 02%(24/107 679)和0. 02%(2/9 525),幼托儿童、散居儿童、医务人员组未检出,不同职业人群华支睾吸虫感染率差异无统计学意义(χ 2 = 1. 794,P = 0. 805)。2016—2020 年,固定监测点的人群华支睾吸虫感染率分别为0. 49%(5/1 018)、0. 10%(1/1 013)、0(0/1 000)、0. 10%(1/1 026)、0(0/1 009),不同年份感染率差异有统计学意义(χ 2 =7. 131,P = 0. 008)。采集淡水鱼虾270 条(只),检测256 条(只),其中53 条(只)查出华支睾吸虫囊蚴,阳性率20. 70%。中间宿主中,麦穗鱼的阳性率最高,为48. 15%。采集保虫宿主粪便95 份,其中犬粪59 份,猫粪36 份,未查出华支睾吸虫虫卵。问卷调查共604 人,423 人听说过肝吸虫病,占70.03%, 92.38%的调查对象不生吃、半生吃淡水鱼虾,仅26. 66%的调查对象可以做到生熟菜板分开。结论　四川省人群华支睾吸虫感染率处于较低水平,但中间宿主麦穗鱼的阳性率较高,仍存在华支睾吸虫病传播的潜在风险,应继续加强综合防治措施,降低华支睾吸虫感染率,减轻华支睾吸虫病的危害。

关键词: 华支睾吸虫病, 监测, 四川省

Abstract:

Objective　To understand the prevalence of clonorchiasis in Sichuan Province for scientific guidance to prevention and control of Clonorchis sinensis infection in Sichuan area. Methods　By the national and Sichuan provincial monitoring plans for clonorchiasis and soil-transmitted nematodes,we selected certain mobile monitoring sites annually from the counties (cities/ districts) without standardized surveillance,and Wutongqiao District of Leshan City as regular monitoring sites. Modified Kato-Katz thick smear technique (two slides/ one sample) was used to detect the eggs of Clonorchis sinensis in population. In 2017—2020,the metacercariae in fresh water fish and shrimp were detected by compression method,and the feces of the reservoir host,including cat,dog or pig was detected by modified Kato-Katz thick smear method. A question-naire survey on health knowledge and behavior was carried out among the population undergone fecal examination. Results   From 2016 to 2020,a total of 143 311 people in the mobile surveillance sites underwent investigation,which revealed infection with Clonorchis sinensis in 28,with an infection rate of 0. 02%. The infection rate in population remained relative lower,ranging in 0. 01% (5/34 967),0. 02% (6/33 507),0. 04%(7/19 326),0. 02% (7/30 256) and 0. 01% (3/25 255)between 2016 and 2020,respectively. There was no significant difference in infection rate in different years(χ 2 =4. 249,P =0. 373). The highest infection rate of Clonorchis sinensis was seen in the plain(0. 03%,6/20 217) and hilly area(0. 03%,19/ 64 989) of Western Sichuan,yet clonorchiasis was not detected in the Northwest Sichuan Plateau. The difference was insignificant converging diverse terrain(χ 2 = 9. 949,P = 0. 028). Clonorchis sinensis was detected in 18 counties,accounting for 14. 06% of the total number of mobile surveillance sites. The infection rate of clonorchiasis was 0. 02% (13/68 316) in males and 0. 02% (15/74 995) in females,without significant difference between genders(χ 2 =0. 017,P =0. 895). The infection was 0. 02% (12/48 446) and 0. 02% (12/48 873),respectively for 40-59 years old group and ≥ 60 years old group,yet was not detected in 0-9 years old group. There was no significant difference among different age groups(χ 2 =4. 721,P =0. 291). The infection rate of Clonorchis sinensis was 0. 03% (12/35 401) and 0. 03% (2/7 772),respectively for junior school group and senior high school,technical secondary school/ polytechnic school group,however,the infection was not found in population with college degree or above. The difference was insignificant among population with different educational background (χ 2 = 5. 155,P = 0. 326) . Farmers and population with other occupations had infection rate of Clonorchis sinensis by 0. 02% (24/107 679) and 0. 02% (2/9 525),respectively,yet there was no infection detected in children in the kindergartens,children at home and medical professionals,and no difference among different occupation groups(χ 2 =1. 794,P =0. 805). The infection rate from 2016 to 2020 in regular surveillance sites was 0. 49% (5/1 018),0. 10% (1/1 013),0% (0/1 000),0. 10% (1/1 026) and 0% (0/1 009),respectively,without difference among years (χ 2 =7. 131,P =0. 008). Detection of the 256 freshwater fishes and shrimps out of 270 revealed infection with metacercariae of Clonorchis sinensis in 53,with a positive rate of 20. 70%. The highest positive rate(48. 15%) was seen in Pseudorasbora parva among the intermediate hosts. No Clonorchis sinensis eggs were detected in the 95 aliquots of feces collected,including 59 aliquots of dog feces and 36 cat feces. Of the 604 people surveyed by questionnaire,423 people(70. 03%) had the knowledge of clonorchiasis,and 92. 38% of the respondents had no history of intake of raw or semi-cooked freshwater fish and shrimp,while only 26. 66% of the respondents had the habit of using separate chopping board for raw and cooked dishes. Conclusion 　The infection rate of Clonorchis sinensis in population in Sichuan Province remains at a low level. Nevertheless,the positive rate is relatively higher in the intermediate host of Pseudorasbora parva,which suggests that risk of clonorchiasis transmission still exists,and further strengthened comprehensive prevention and control measures are necessary in order to reduce the infection rate of Clonorchis sinensis and its disease burden.


Key words: Clonorchiasis, Surveillance, Sichuan Province

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