Abstract:

Objective To analyze the epidemiological characteristics in the extant patients with hepatic fibrosis resulting from schistosomiasis in Jiangxi Province for scientific basis to precisely manage and treatment this group of patients. Methods The basic information, including the gender, age, education level, occupation, endemic type and epidemic category of schistosomiasis, were collected from the liver fibrosis patients in Jiangxi Province in 2021. The liver fibrosis was graded according to B-ultrasound examination, and then the data were descriptively analyzed concerning the characteristics of temporal, regional and population as well as the severity of hepatic fibrosis. Results In 2021, there were 17 575 patients with liver fibrosis from schistosomiasis in Jiangxi Province. The average age was (64.9±12.6) years, and the male to female ratio was 1.45∶1. The education level was mainly junior high school and below (96.83%, 17 017/17 575), and the occupation was mostly farmers (90.09%, 15 833/17 575). The cases were primarily distributed in areas under transmission control, including Jiujiang City (7 546 cases), Shangrao City (7 072 cases) and Nanchang City (2 192 cases). The proportion of patients with grade Ⅰ, grade Ⅱ and grade Ⅲ liver fibrosis was 36.03% (6 333/17 575), 52.38% (9 206/17 575) and 11.58% (2 036/17 575), respectively. The liver fibrosis grades of patients in the marshland and hilly endemic areas were mainly grade Ⅱ, accounting for 46.40% (4 004/8 630) and 58.16% (5 202/8 945), respectively. Hepatic fibrosis of grade Ⅱ was most seen in the transmission control and elimination areas, which accounted for 49.48% (4 109/8 305) and 71.19% (4 149/5 828), respectively, whereas grade Ⅰ predominated in the transmission interuption areas(69.67%, 2 398/3 442). There were significant differences in the constituent ratio of liver fibrosis grading in patients with different epidemic types and epidemic categories (χ²=248.21, H=509.81, both P<0.05). The grade of liver fibrosis was mainly grade Ⅰ in patients aged 40 years and below, and grade Ⅱ in those over 40 years. However, grade Ⅲ fibrosis was the lowest in patients of any age group, and the composition ratio of liver fibrosis grading in different age groups was significantly different (H=204.89, P<0.05). Conclusion Patients with liver fibrosis resulting from schistosomiasis in Jiangxi Province are mainly distributed in transmission-controlled areas, and the degree of liver fibrosis is mostly grade Ⅰ and grade Ⅲ. These results suggest that provision with early screening and precise intervention in the population can effectively prevent the development of chronic schistosomiasis from advanced schistosomiasis.

Key words: Schistosoma japonicum, Hepatic fibrosis, Epidemiological status, Jiangxi Province