武强县小学生沙眼流行病学调查

目的调查河北省武强县小学生沙眼的患病率,并分析其危险因素。方法采用随机整群抽样调查方法,抽取武强县7所学校小学生共计1622例,其中男817例,女805例;年龄6～16岁,平均（11.91±2.24）岁。所有被调查对象均进行临床检查,沙眼诊断标准参照世界卫生组织（WTO）制定的沙眼分期标准;从临床诊断为沙眼的患者中,随机抽样进行结膜刮片,镜检法检查沙眼包涵体,利用酶联免疫学与聚合酶链反应（PCR）检测沙眼衣原体;同时选择正常小学生作为正常对照。结果被调查的1622例小学生中,临床诊断为沙眼的379例,患病率为23.4%[95%置信区间（CI）：25.5%～21.3%],其中滤泡性沙眼（TF）307例（81%）,浸润性沙眼（TI）72例（19%）。患病率男为20.9%,女为25.8%,两者比较差异有统计学意义（χ2=5.455,P=0.020）。各年龄组沙眼患病率比较,差异有统计学意义（χ2=9.972,P=0.019）。从379例临床诊断沙眼中随机抽样了168例及正常对照组42例进行结膜刮片检查,沙眼包涵体均为阴性,酶联免疫学检测阳性64例（38.1%）,PCR检测阳性109例（64.9%）。危险因素分析表明沙眼的发生与城郊区居住、性别、年龄有关。结论武强县小学生中仍有沙眼流行,主要以TF为主,需针对危险因素开展沙眼防治。

Prevalence of trachoma in children at primary school in Wuqiang County, China

Objective Trachoma is a preventable infective eye disease worldwide. The incidence rate of active trachoma in children can reflect the epidemical degree of trachoma in the location. This study tried to assess the prevalence and risk factors of trachoma in students at primary school in Wuqiang County, China. Methods An epidemiological survey was carried out in Wuqiang County in 2006. The investigators were from Wuqiang County Hospital and Beijing Tongren Eye Center and received special training. Primary school children aged 6- to 16-years-old were selected by a cluster sampling with the class shift as the sampling unit. Trachoma was clinically examined under the slim lamp and assessed based on the simplified classification for trachoma proposed by the World Health Organization (WHO). The C. Trachomatis inclusion body was detected from conjunctival swab of patients with trachoma using enzyme immunoassay and polymerase chain reaction (PCR). The questionnaire was performed in the examinees and parents. The survey followed the Declaration of Helsinki and written informed consent was obtained from the examinees. Results A total 379 cases with trachoma were determined in 1622 primary school examinees with the prevalence 23. 4% (95% CI:25. 5% -21. 3%) .including follicular trachoma in 81% and intense trachoma in 19% . The overall prevalence of trachoma was higher in female students than male ones (25. 8% versus 20. 9%, P = 0. 020). No inclusion body of the conjunctiva was observed. Sixty-four cases (38. 1%) presented the positive response for C. Trachomatis antigen by enzyme immunoassay, and 109 cases (64. 9%) were positive response by PCR. The multiple factors logistic regression analysis showed the risk factors for active trachoma included living location, suburbs and female and age(0R =0.763, 1.299, 1. 147 respectively). Conclusion Trachoma showes a disseminating procedure among primary school children in Wuqiang County. The prevention strategy should be made for related risk factors.