湖北省西部山区并殖吸虫病流行现状调查

目的了解湖北省西部山区并殖吸虫病流行现状。方法选取兴山县、恩施市、郧西县和保康县等4个县(市)作为并殖吸虫病监测点,开展主动监测。在监测点采集溪蟹检测囊蚴感染情况,采用酶联免疫吸附试验(ELISA)检测人群血清并殖吸虫特异性抗体Ig G和Ig M,同时开展相关知识行为的问卷调查。结果共采集人群血清1 143人份,总体阳性率为1.84%(21/1 143);其中男性阳性率1.78%(10/562),女性阳性率1.89%(11/581),差异无统计学意义(χ2=0.002,P0.05)。共采集溪蟹161只,平均重量11.72 g,阳性率为9.32%(15/161),感染度为7.07个/只。其中雌性溪蟹阳性率为11.54%(9/78),雄性为7.23%(6/83),差异无统计学意义(χ2=0.884,P0.05);雌性溪蟹感染度为6.67个/只,雄性溪蟹为7.67个/只。参与问卷调查的1 143人中,有生食或半生食溪蟹行为者占0.44%,有喝生水行为者占0.87%。结论湖北省西部山区并殖吸虫病传播链仍然存在,部分监测点第二中间宿主感染率回升,应持续开展监测防控和健康教育宣传,以免出现暴发流行。

Survey of epidemic status of paragonimiasis in western mountainous areas in Hubei Province

Objective To understand the current status of paragonimiasis epidemic in western mountain areas in Hubei Province. Methods Four counties （cities） of Western Hubei Province （Xingshan， Enshi， Yunxi， Baokang） were selected as the investigation sites for active surveillance. Crabs were captured and the metacercariae of Paragonimus were detected. Meanwhile， the blood samples were collected from the residents in the surveillance sites and the unique IgG and IgM antibodies against Paragonimus in the sera were detected by ELISA. In addition， a questionnaire survey about knowledge and behavior of prevention and control of paragonimiasis was taken among the residents. Results A total of 1 143 residents were investigated in the active surveillance， the total positive rate of the serology test was 1.84% （21/1 143）， while the rates of the male and the female were 1.78% （10/562） and 1.89% （11/581）， respectively， with no statistical significance between them （[χ2]= 0.002， P > 0.05）. The average weight of 161 fresh?water crabs captured was 11.72 g， with the positive rate of 9.32% （15/161） and the infective density of 7.07 metacercariae per positive crab. The positive rates of the male and female crabs were 11.54% （9/78） and 7.23% （6/83）， respectively （[χ2]= 0.884， P > 0.05）， and the infective densities were 6.67 and 7.67 metacercariae per positive crab， respectively. Totally 1 143 residents were investigated by questionnaires， and 0.44% of them had the behavior of eating raw or half?done fresh?water crab， and 0.87% of them had the behavior of drinking un?boiled stream water. Conclusions The transmission chain of paragonimiasis still exists in the nature environment of mountain area in Western Hubei Province. The positive rate of the second intermediate host rebounds in some investigation sites. Therefore， the measures of continuous surveillance and health education should be taken to avoid the appearance of the prevalence or outbreak.