青海省玛沁县棘球蚴病流行情况调查

目的掌握青海省玛沁县人体棘球蚴病感染状况,为该地区棘球蚴病防治提供依据。方法根据中华人民共和国卫生行业标准《包虫病诊断标准(WS257-2006)》,使用B超扫描和间接血凝试验对玛沁县所辖乡镇1岁以上常住居民进行棘球蚴病患病情况和血清学调查。在优云乡、当洛乡和下大武乡采集犬粪,采用ELISA法进行棘球绦虫粪抗原检测。结果B超结果显示,玛沁县人群棘球蚴病检出率为7.4%(116/1 561),细粒棘球蚴病和多房棘球蚴病检出率分别为5.3%(82/1 561)和2.2%(34/1 561)。人群血清抗体阳性率为23.8%(307/1 288)。82例细粒棘球蚴病患者中,23例棘球蚴直径10 cm,占28.1%(23/82),最大径者为18 cm。棘球蚴占位数量≥2个的患者24例,占20.7%(24/116)。玛沁县男性和女性患病率分别为5.3%(40/753)和9.4%(76/808),两者差异有统计学意义(P0.05)。各职业人群中家务、僧侣和牧民的棘球蚴病患病率较高,分别为18.0%(11/61)、12.2%(5/41)和11.1%(84/758),不同年龄组中以60岁以上和30~40岁人群棘球蚴病患病率最高,分别为18.2%(24/132)和10.3%(31/302),10岁以下儿童患病率为2.9%(18/628)。玛沁县棘球蚴病患病率最高的3个乡依次为优云乡、昌麻河乡和当洛乡,患病率分别为11.7%(29/247)、9.5%(6/63)和8.4%(54/645)。共采集犬粪199份,其中棘球绦虫粪抗原阳性54份,阳性率为27.1%(54/199),优云乡的阳性率为40.4%(23/57),显著高于其他两乡(P0.05)。结论玛沁县以细粒棘球蚴病为主、多房棘球蚴病为辅的混合流行区,以女性、家务和60岁以上人群患病率较高,地区分布上主要集中在优云乡、昌麻河乡和当洛乡。     

青海省久治县人群棘球蚴病流行病学调查

目的掌握果洛藏族自治州久治县人群棘球蚴病流行现状,为科学制定青藏高原本病控制策略提供依据。方法应用ELISA检测及B超探查综合确定人群棘球蚴病的感染与患病情况。结果人群棘球蚴病ELISA检测阳性率为29.26%(287/981)、患病率为8.01%(124/1549)。其中细粒和多房棘球蚴病患病率分别为5.42%(84/1549)和2.52%(39/1549)、两型混合患病1例,多房棘球蚴病所占构成比为31.45%(39/124)。结论进一步证实果洛藏族自治州久治县为棘球蚴病混合存在流行县,县内棘球蚴病危害极为严重。     

日喀则市棘球蚴病流行现状分析

目的了解西藏自治区日喀则市棘球蚴病流行现状。方法采用分层整群抽样方法,于2016年8-10月抽取日喀则市17个县(区)(亚东县于2012年已调查)的调查村,对1岁以上常住居民进行B超检查,疑似病例辅以血清学检测,计算人群棘球蚴病检出率,推算患病率和患病人数。每个调查村随机抽取家畜(猪、羊)10头或牛5头,采用内脏剖检法调查家畜棘球蚴病患病情况。发现细粒棘球蚴病病例的县,在患者居住地周围和犬经常活动的区域捕捉各种成年鼠数不少于300只,检查啮齿类动物棘球蚴感染情况。每个调查村随机抽取20个养犬户,采集犬粪,ELISA检测棘球绦虫抗原。随机抽取每个调查村20名村民,每个县抽1所完全小学4～6年级学生,采用问卷形式调查人群棘球蚴病防治知识认知情况。结果B超共检查日喀则市18个县(区)96个调查村21 497人(包含2012年调查的亚东县的数据),检出棘球蚴病患者289例,检出率为1.34%。推算人群患病率为1.10%,推算患病人数为7 792例。检出病例中以细粒棘球蚴病为主,占90.31%(261/289)。全市18个县(区)均有细粒棘球蚴病流行,13个县(区)同时发现多房棘球蚴病病例。不同县(区)中,仲巴县检出率最高,为4.03%(33/819),仁布县最低,为0.24%(2/833);不同地区棘球蚴病检出率差异有统计学意义(χ~2=39.963,P0.05)。女性棘球蚴病检出率为1.50%(191/12 737),高于男性的1.12%(98/8760)(χ~2=5.676,P0.05)。不同年龄组中,≥70年龄组棘球蚴病检出率最高,为2.75%(22/799),1～9岁年龄组检出率最低,为0.34%(12/3 479);人群棘球蚴病检出率随着年龄的增长而升高(χ~2=61.390,P0.05)。不同文化程度中,文盲人群检出率最高,为1.56%(190/12 214),小学、大专及以上人群检出率较低,分别为1.04%(74/7 086)和1.08%(4/372);不同年龄组棘球蚴病检出率差异有统计学意义(χ~2=61.502,P0.05),且有随文化程度增高而呈降低的趋势(χ~2趋势=5.704,P0.05)。不同职业中,牧民的棘球蚴病检出率最高,为2.68%(76/2 831);不同职业棘球蚴病检出率差异有统计学意义(χ~2=75.110,P0.05)。不同生产类型中,牧区的棘球蚴病检出率最高,为1.83%(85/4 654),农区最低,为0.91%(75/8 285);不同生产类型人群的棘球蚴病检出率差异有统计学意义(χ~2=24.450,P0.05)。终宿主犬粪棘球绦虫抗原阳性率为4.73%(92/1 946),家犬(5.42%,66/1 218)和野犬(3.57%,26/728)的棘球绦虫粪抗原阳性率差异无统计学意义(χ~2=3.155,P0.05)。中间宿主啮齿类动物棘球蚴感染检出率为1.02%(3/293),家畜(牛、羊)棘球蚴感染检出率为11.61%(67/577)。人群棘球蚴病防治知识认知合格率为33.08%(1 500/4 534),且小学生的棘球蚴病防治知识认知合格率(39.57%,1 064/2 689)高于居民的(23.63%,436/1 845)(χ~2=125.541,P0.05)。结论西藏自治区日喀则市人群和动物棘球蚴病/棘球绦虫病流行情况重,女性、高年龄组、低文化水平、牧民人群应为重点防治对象。     

青海省黄南藏族自治州棘球蚴病流行情况调查

为了解青海省黄南藏族自治州棘球蚴病的流行情况,于2012年6-8月,在青海黄南藏族自治州河南县、泽库县、尖扎县、同仁县等4县各随机抽取2~3个乡(镇),对1岁以上常住居民进行B超检查,调查人群患病情况。采用内脏剖检法调查羊棘球蚴病情况,ELISA检测现场随机采集的无主犬棘球绦虫粪抗原。结果显示,B超检查共11 231人,检出棘球蚴病患者77例,患病率为0.69%。不同地区中以泽库县棘球蚴病患病率最高,为2.12%(68/3 213),其次为河南县(0.26%,9/3 430)。女性棘球蚴病患病率为0.72%(44/6 094),略高于男性的0.64%(33/5 137)。各职业人群中以牧民棘球蚴病患病率最高,为0.83%(61/7 338)。不同年龄组中以50~59岁、60~69岁和30~39人群棘球蚴病患病率较高,分别为1.25%(9/721)、1.96%(13/663)和0.91%(24/2 637)。不同文化程度中以文盲和小学文化程度人群棘球蚴病患病率较高,分别为0.66%(18/2 709)和0.79%(59/7 432)。不同居住方式以冬季定居夏季游牧人群棘球蚴病患病率最高,为1.10%(70/6 391),其次为游牧人群(0.62%,6/965)。不同地区、年龄段、居住方式及文化程度间的患病率差异有统计学意义(P0.05),但不同性别、职业间差异无统计学意义(P0.05)。共检查羊3 525头,棘球蚴检出率为2.13%(75/3 525)。不同地区的羊棘球蚴检出率间差异有统计学意义(P0.05)。采集无主犬粪共1 282份,棘球绦虫粪抗原阳性率为11.70%(150/1 282)。不同地区的犬粪抗原阳性率间差异有统计学意义(P0.05)。提示黄南州人群棘球蚴病患病率较高,羊棘球蚴检出率和无主犬棘球绦虫粪抗原阳性率较高。     

青海省治多县棘球蚴病流行病学调查报告

【提要】 2006年7月在青海省治多县对1岁以上人群进行调查，间接红细胞凝集试验（IHA）检测棘球蚴抗体阳性率为4.5%（42/933）、ELISA的阳性率为8.2%（76/931），B超检查（结合血清学检测和临床表现判断）患病率为3.4%（33/979），其中细粒棘球蚴病和多房棘球蚴病患病率分别为3.2%（31/979）和0.2%（2/979）。用剖检法检测高原鼠兔棘球蚴感染率为15.1%（14/93），其中1例病变脏器经分子生物学鉴定确认为石渠棘球蚴病。用ELISA检测粪便棘球绦虫抗原阳性率，犬粪为6.2%（12/193），狼粪为35.7%（5/14）。认为治多县为多种棘球蚴病混合流行区。     

西藏自治区棘球蚴病病例分析

目的了解西藏自治区棘球蚴病病例构成、地区分布及病灶分布情况。方法于2016年8-10月,采用分层整群抽样的方法,抽取西藏自治区7个地(市)70个县的364个行政村进行棘球蚴病流行情况调查,对居民进行B超检查,疑似病例辅以血清学检查,临床及疑似病例进行个案调查,影像学专家结合影像学和血清学检测结果及病例基本情况对病例进行确诊。采用SPSS 20.0统计学软件对数据进行统计分析。结果共B超检查77 049人,检出棘球蚴病病例1 230例,检出率为1.60%(1 230/77 049),其中细粒棘球蚴病占87.64%(1 078/1 230),多房棘球蚴病占11.06%(136/1 230),未分型病例占1.30%(16/1 230);全区7个地(市)均有细粒棘球蚴病和多房棘球蚴病病例检出,且不同地(市)、性别、年龄、民族、职业、文化程度、居住地生产类型等病例构成也均以细粒棘球蚴病为主。病例的文化程度以文盲为主,占71.95%(875/1 214),随着年龄的增长细粒棘球蚴病有明显的病例堆积现象;不同职业病例构成中,牧民细粒棘球蚴病病例百分比(91.02%)高于半农半牧民(87.78%)(χ~2=10.710,P0.05),不同生产类型病例构成中,牧区细粒棘球蚴病病例百分比(91.38%)高于农区(83.54%)(χ~2=9.008,P0.05)。棘球蚴病病例的病灶分布多在右肝,79%以上的病例仅有1个病灶。结论西藏自治区棘球蚴病病例以细粒棘球蚴病为主,牧区的牧民是防治的重点人群。     

2012年青海省玉树藏族自治州棘球蚴病流行调查

目的了解2012年青海省玉树藏族自治州棘球蚴病的流行情况。方法 2012年6-8月在青海省玉树藏族自治州称多县、囊谦县、曲麻莱县、玉树县、杂多县和治多县等6县各抽取2~3个镇,对1岁以上常住居民进行B超检查,调查人群患病情况。ELISA检测人血清棘球蚴抗体。内脏剖检法调查鼠类和牲畜的棘球蚴感染情况;现场随机采集无主犬犬粪,ELISA检测犬粪棘球蚴抗原。结果B超检查共7 025人,查出棘球蚴病患者319例,患病率为4.54%。ELISA检测共2 790人,血清棘球蚴抗体阳性率为16.38%(457/2 790)。其中,人群患病率以称多县最高,为7.41%(181/2 444),血清抗体阳性率以玉树县最高,为23.18%(127/548)。男性患病率和血清抗体阳性率分别为3.91%(118/3 018)和13.93%(172/1 235),女性分别为5.02%(201/4 007)和18.33%(285/1 555)。年龄分布以60~岁和40~岁人群的患病率较高,分别为8.39%(38/453)和6.61%(67/1 014),70岁以上人群的血清抗体阳性率最高,为33.93%(19/56)。不同职业中,牧民、半农半牧和宗教人士的患病率较高,分别为5.28%(252/4 777)、6.52%(24/368)和3.37%(11/326),血清抗体阳性率以儿童、宗教人士和牧民较高,分别为24%(6/25)、18.79%(31/165)和18.34%(328/1 788)。不同文化程度中,文盲人群的患病率和血清抗体阳性率均最高,分别为5.04%(241/4 779)和18.34%(359/1 958)。不同居住方式中,冬季定居夏季游牧人群的患病率和血清抗体阳性率均最高,分别为8.25%(227/2 753)和19.48%(158/811)。不同地区、性别、年龄、职业、文化程度、居住方式间的患病率和血清抗体阳性率差异均有统计学意义(P0.05或P0.01)。共检查鼠类872只,棘球蚴检出率为0.46%(4/872)。共检查牛、羊809只,棘球蚴检出率为10.14%(82/809)。采集无主犬犬粪共838份,棘球蚴粪抗原阳性率为10.74%(90/838)。结论玉树州人群棘球蚴病患病率和血清棘球蚴抗体阳性率较高,牛、羊棘球蚴检出率和无主犬棘球蚴粪抗原阳性率较高。     

那曲地区棘球蚴病流行现状分析

目的了解西藏自治区那曲地区棘球蚴病流行现状。方法采用分层随机整群抽样的方法,于2016年8-10月抽取那曲地区安多、班戈、比如、嘉黎、那曲、尼玛、聂荣、申扎、双湖、索县等10个县(区)(巴青县2012年已调查)的调查村,对1岁以上常住居民进行腹部B超检查,计算人群棘球蚴病检出率,推算人群患病率和患病人数。采用内脏剖检和PCR结合的方法调查牛、羊和啮齿动物等中间宿主棘球蚴感染情况。ELISA检测犬粪棘球绦虫抗原。每个调查村随机抽取20名居民,每个县抽1所完全小学的4～6年级小学生,采用问卷形式进行棘球蚴病防治知识认知情况调查。不同人群的棘球蚴病检出率比较采用χ~2检验。结果B超共检查11个县(区)58个村11 897人,检出棘球蚴病患者382例,检出率为3.21%。推算那曲地区患病率为3.37%,患病人数为15 565例。11个县(区)均检出细粒棘球蚴病病例,7个县(区)检出多房棘球蚴病病例。检出病例以细粒棘球蚴病为主,占88.74%(339/382)。女性棘球蚴病检出率为3.66%(236/6 451),高于男性的2.68%(146/5 446)(χ~2=8.77,P0.05)。不同县(区)人群中,以安多县棘球蚴病检出率最高,为6.00%(50/833),班戈县最低,为1.44%(12/833);不同县(区)人群棘球蚴病检出率差异有统计学意义(χ~2=43.22,P0.05)。不同年龄组人群棘球蚴病检出率以≥80岁年龄组最高,为10.00%(8/80),1～9岁年龄组最低,为0.3%(5/1 665);不同年龄组棘球蚴病检出率差异有统计学意义(χ~2=123.29,P0.05),检出率随着年龄的增长而升高(χ~2趋势=123.29,P0.05)。不同职业间棘球蚴病检出率以其他职业最高,为5.94%(13/219),学生最低,为0.19%(2/1 075);不同职业检出率差异有统计学意义(χ~2=76.51,P0.05)。不同文化程度人群中,非文盲人群棘球蚴病检出率为2.61%(88/3 377),低于文盲人群的3.45%(294/8 520)(χ~2=5.29,P0.05);不同文化程度检出率之间差异有统计学意义(χ~2=15.62,P0.05)。那曲地区仅牧区和半农半牧2种生产类型,牧区人群棘球蚴病检出率为3.37%(339/10 072),高于半农半牧区的2.36%(43/1 825)(χ~2=4.75,P0.05)。小型啮齿类动物仅调查比如县,共检查黑唇鼠兔304只,棘球蚴感染检出率为0.33%(1/304)。共检查家畜(牛、羊)366头,棘球蚴感染检出率为5.74%(21/366),其中以申扎县最高,为32.5%(13/40)。检测犬粪棘球绦虫抗原阳性率为10.08%(109/1 081)。人群棘球蚴病防治知识认知合格率为31.01%(824/2 657),小学生的棘球蚴病防治知识认知合格率(34.29%,539/1 572)高于居民的(26.27%,285/1 085)(χ~2=18.93,P0.05)。结论那曲地区同时有细粒棘球蚴病和多房棘球蚴病流行,且检出率和推算患病率较高,女性、高年龄组、低文化程度、牧区人群为棘球蚴病重点防治对象。     

2018-2019年全国棘球蚴病监测分析北大核心CSCD

目的分析2018-2019年全国棘球蚴病监测结果,为全国棘球蚴病防治措施的制定提供参考依据。方法通过全国包虫病等重点寄生虫病防治规划(2016-2020年)终期评估数据库收集各流行省区(兵团)2018-2019年监测数据,对人群监测、终末宿主监测、中间宿主监测等相关数据资料采用SAS9.4软件进行统计分析。结果2018年人群棘球蚴病患病率为0.07%(214/294101),犬粪棘球绦虫抗原阳性率为2.31%(416/18024),家畜棘球蚴感染率为1.65%(855/51752),啮齿类动物棘球蚴感染率为1.03%(259/25048);2019年人群患病率为0.07%(571/797107),犬粪棘球绦虫抗原阳性率为1.12%(712/63363),家畜棘球蚴感染率为1.30%(1664/127599),啮齿类动物棘球蚴感染率为0.77%(478/62147)。结论2018-2019年全国棘球蚴病流行情况基本保持稳定,2016年至2019年全国监测点人群患病率、犬粪棘球绦虫抗原阳性率、家畜棘球蚴感染率和啮齿类动物棘球蚴感染率均呈下降趋势。     

2018-2019年全国棘球蚴病监测分析

目的分析2018-2019年全国棘球蚴病监测结果,为全国棘球蚴病防治措施的制定提供参考依据。方法通过全国包虫病等重点寄生虫病防治规划(2016-2020年)终期评估数据库收集各流行省区(兵团)2018-2019年监测数据,对人群监测、终末宿主监测、中间宿主监测等相关数据资料采用SAS9.4软件进行统计分析。结果 2018年人群棘球蚴病患病率为0.07%(214/294101),犬粪棘球绦虫抗原阳性率为2.31%(416/18024),家畜棘球蚴感染率为1.65%(855/51752),啮齿类动物棘球蚴感染率为1.03%(259/25048);2019年人群患病率为0.07%(571/797107),犬粪棘球绦虫抗原阳性率为1.12%(712/63363),家畜棘球蚴感染率为1.30%(1664/127599),啮齿类动物棘球蚴感染率为0.77%(478/62147)。结论 2018-2019年全国棘球蚴病流行情况基本保持稳定,2016年至2019年全国监测点人群患病率、犬粪棘球绦虫抗原阳性率、家畜棘球蚴感染率和啮齿类动物棘球蚴感染率均呈下降趋势。     

甘孜藏族自治州四县包虫病流行病学调查

目的调查四川西部甘孜藏族自治州两型包虫病（hydatidosis，HD）人群分布特征。方法在白玉、色达、巴塘、理塘4县的6个调查点，调查组采用以B超为主，辅以Dot-ELISA血清学试验的方法对3018人进行了检查。结果人群患病率为2．82％，其中细粒棘蚴病（cystic echinococcosis，CE）患病率为1．56％，泡球蚴病（alveolar echinococosis，AE）患病率为1．23％，混合型患病率为0．03％。结论女性患病率高于男性，性别分布差异有统计学意义（x^2=5．18，P〈0．05）。年龄分布显示中老年是高发人群。纯牧业乡的病情尤为严重，半农半牧乡病情较轻。职业分布显示牧民是高危人群，HD患病率达4．44％。人群中文盲及受教育程度低者患者较多。     

西藏自治区改则县棘球蚴病流行情况调查

目的 了解西藏自治区改则县棘球蚴病流行状况,为防治提供依据.方法 2017年6-11月采取普查的方式,对改则县所辖7个乡镇的2岁以上常住居民进行腹部B超检查,对疑似病例进行血清中棘球蚴IgG抗体检测,计算人群棘球蚴病患病率.并在改则镇、麻米乡和物玛乡采集犬粪,采用ELISA检测棘球绦虫抗原.结果 B超共检查21376人...     

2017年拉萨地区人群棘球蚴病流行现状与特征

目的了解拉萨地区人群棘球蚴病患病现状和流行特征。方法于2017年在拉萨地区采取普查的方式进行人群筛查,采用便携式B超仪对调查对象进行腹部B超检查,依据《包虫病诊断标准》(WS 257-2006),结合流行病学史及临床表现予以诊断。对疑似病例辅以血清学检测,ELISA检测血清中棘球蚴IgG抗体。采用SPSS 20.0统计学软件进行数据的统计分析。结果 2017年拉萨地区人群棘球蚴病总检出率为0.24%(935/392 592)。男、女性棘球蚴病检出率分别为0.20%(402/198 921)、0.28%(533/193 671)。各年龄组均有棘球蚴病检出,≥70岁组的人群棘球蚴病检出率最高(0.90%,106/11 769),<10岁组人群的检出率最低(0.09%,48/54 181),50~59岁、60~69岁、≥70岁人群中,女性棘球蚴病检出率分别为0.51%(111/21 812)、0.93%(92/9 924)、1.06%(70/6 629),均高于男性的0.35%(73/20 853)、0.57%(51/8 988)、0.70%(36/5 140)(P<0.05)。不同文化程度中,文盲及半文盲人群的棘球蚴病检出率最高(0.45%,369/82 206),大学及以上人群的检出率最低(0.14%,26/18 124),文盲及半文盲、小学人群中,女性棘球蚴病检出率分别为0.54%(232/43 171)、0.36%(148/40 655),均高于男性的0.35%(137/39 035)、0.28%(118/41 786)(P <0.05)。不同职业中,半农半牧民棘球蚴病检出率最高(1.20%,59/4 923),学生的检出率最低(0.12%,79/64 398),牧民和其他职业组人群女性的棘球蚴病检出率分别为0.96%(93/9 675)、0.26%(201/77 235),高于男性的0.52%(53/10 139)、0.14%(113/79 483)(P <0.05)。不同居住方式中,冬季定居夏季游牧人群棘球蚴病检出率最高(1.70%,26/1 529),冬季定居夏季游牧和定居的女性棘球蚴病检出率分别为2.65%(21/792)、0.28%(431/153 203),高于男性的0.68%(5/737)、0.20%(309/156 215)(P <0.05)。不同生产类型中,牧业人群棘球蚴病检出率最高(0.57%,128/22 351),农业人群的检出率最低(0.20%,266/130 298),除半农半牧以外,城镇、牧业、农业人群中,女性棘球蚴病检出率分别为0.24%(246/104 250)、0.73%(82/11 162)、0.24%(149/62 149),均高于男性的0.19%(195/103 092)、0.41%(46/11 189)、0.17%(117/68 149)(P <0.05);各县(区)人群棘球蚴病检出率为0.18%~0.41%,其中当雄县的最高(0.41%,102/24 588),尼木县的最低(0.18%,48/26 768)。林周县(0.28%,135/48 848)、当雄县、墨竹工卡县(0.28%,117/41 689)人群棘球蚴病检出率均高于拉萨市城关区(市区)(0.21%,378/180 594)(P<0.05)。结论女性、年龄≥70岁、职业为半农半牧、居住方式为冬季定居夏季游牧、文盲及半文盲、生产方式为牧业的人群是棘球蚴病的重点感染人群。     

Echinococcosis, toxocarosis and toxoplasmosis screening in a rural community in eastern Kazakhstan

Objective To determine the extent of carnivore‐transmitted parasitic zoonoses in a community in eastern Kazakhstan, a region where cystic echinococcosis (CE) re‐emerged in recent years. Methods Cross sectional ultrasound study of 3126 human subjects to determine the extent of human cystic and alveolar echinococcosis (AE). Blood samples were taken from each subject and analysed for antibodies against Echinococcus, Toxocara and Toxoplasma spp. Each subject was questioned about possible risk factors that might be associated with zoonotic transmission. Analysis employed a mixed modelling approach based on the results of the ultrasound study, the serological results and the results of the questionnaire. Bayesian techniques were employed to estimate diagnostic performance. A helminthological study of the local dog population was also undertaken. Results A total of 23 subjects tested positive for CE on ultrasound and a further three individuals had strong serological evidence of infection. Another 24 reported treatment for CE. Ultrasound lesions or treatment for CE were associated with poverty. No ultrasound evidence of AE was found, but one individual had strong serological evidence of exposure to Echinococcus multilocularis. Toxoplasma seropositivity (16%; 504 individuals) increased with age. Household level Toxoplasma‐seropositivity was associated with unsafe drinking water. Toxocara seropositivity (11%; 349 individuals) was more frequent in children and in individuals who disposed of dog faeces on the vegetable garden. A purgation study of dogs indicated that 13% of dogs in the community were infected with Echinococcus granulosus, 5% with E. multilocularis and 2% with Toxocara canis respectively. Conclusions There is significant transmission of E. granulosus to humans in this community. Transmission may be associated with poverty. There is little evidence of E. multilocularis transmission to humans, despite the presence in the parasite in the domestic dog population. Toxoplasma is actively transmitted and there is evidence for transmission by the water supply. Children are at highest risk of exposure to Toxocara.     

2019年四川省色达县棘球蚴病流行病学调查

目的　了解2019年四川省色达县棘球蚴病流行情况,为优化棘球蚴病控制措施提供参考依据。方法　2016—2019年对四川省色达县2周岁以上常住人口开展棘球蚴病调查,2019年调查家犬、牦牛和啮齿类动物棘球蚴感染情况,分析人群和动物棘球蚴病流行病学特征。结果　2016—2019年色达县人群棘球蚴病总患病率为3.72%（1 613/43 362）,其中细粒棘球蚴病、多房棘球蚴病和混合型棘球蚴病患病率分别为1.72%（745/43 362）、1.98%（860/43 362）和0.02%（8/43 362）。牧区居民棘球蚴病患病率为4.13%（1 577/38 149）,显著高于半农半牧区（0.69%,36/5 213）（[χ2] = 151.82,P < 0.05）;男、女性人群棘球蚴病患病率分别为3.76%（819/21 787）和3.68%（794/21 575）,差异无统计学意义（[χ2] = 0.19,P > 0.05）。学生患病类型以细粒棘球蚴病为主,占93.78%（422/450）;牧民患病类型以多房棘球蚴病为主,占72.16%（801/1 110）,患病类型差异有统计学意义（[χ2] = 588.57,P < 0.05）。游牧人群棘球蚴病患病率为4.58%（1 008/22 021）,显著高于定居人群（2.83%,605/21 341）（[χ2] = 91.88,P < 0.05）。2019年家犬棘球绦虫抗原阳性率为0.19%（4/2 157）,牦牛棘球蚴病检出率为8.00%（16/200）,啮齿类动物棘球蚴病检出率为3.10%（31/1 000）。结论　四川省色达县棘球蚴病流行较严重;需持续加强传染源控制,强化对患病人群救治力度,及时加强对游牧人群及宗教人士的健康教育工作。     

乌鲁木齐南郊农牧区囊型包虫病流行病学研究

目的了解乌鲁木齐南郊农牧区囊型包虫病流行现状及其流行病学特征。方法采取定点整群抽样的方法，对居民进行体检和血清学检测，确定居民囊型包虫病的感染率和患病率;用粪抗原检测法调查家犬细粒棘球绦虫感染率，通过问卷调查方法了解居民养犬情况。结果乌鲁木齐南郊农牧区居民囊型包虫平均感染率为35.7%（687/1925），平均患病率为1.12%（23/2049）。高山牧场居民包虫感染率最高，半农半牧地区次之，单纯农业区最低。包虫病患病率以农牧结合区最高，单纯农业区次之，高山牧场最低。结论乌鲁木齐南郊牧区囊型包虫病的传播呈现高度活跃状态，居民包虫感染率和患病率与民族、性别、年龄及养犬等有关。     

Use of disability adjusted life years in the estimation of the disease burden of echinococcosis for a high endemic region of the Tibetan plateau

Shiqu County, located on the Tibetan plateau of western China, has an extremely high prevalence of both human alveolar echinococcosis (AE), and cystic echinococcosis (CE). The short form 12 version 2 quality of life survey, which was used to evaluate the extent to which morbidity associated with echinococcosis should be accounted, verified that there was a significant reduction in the mean health scores in all categories for individuals diagnosed with abdominal echinococcosis compared with an age and sex cross-matched population. Results of a larger ultrasound survey, which screened 3135 subjects, demonstrated that the prevalence rates of AE and CE were both approximately 6% with a combined prevalence rate of 11.4%. Prevalence rates adjusted for the age and sex structure of Shiqu County were 4.6% for AE and 4.9% for CE with an estimated overall adjusted prevalence rate of 9.5%. The burden of disease associated with echinococcosis was calculated using disability adjusted life years (DALYs) based on these estimated prevalence rates. Monte-Carlo techniques were used to model the uncertainty in the prevalence estimates and the disability weights. Using these methods, we estimated that the total numbers of DALYs lost due echinococcosis was 50,933 (95% confidence interval [CI] = 41,995-61,026). The DALYs lost consisted of approximately 32,978 (95% CI = 25,019-42,422) due to AE and 17,955 (95% CI = 14,268-22,128) due to CE and suggests an average of approximately 0.81 DALY lost per person. This study has clearly shown that the impact of DALYs lost due to echinococcosis, in terms of medical treatment costs, lost income, and physical and social suffering, is likely to be substantial in this highly endemic region of China.     

A retrospective analysis of human cystic echinococcosis in Hamedan province, an endemic region of Iran

In a retrospective investigation, the medical files of the patients who, between 1992 and 2006, underwent surgery for the treatment of cystic echinococcosis (CE) in one of the three university hospitals in Hamedan province, in western Iran, were explored. Of the 179 patients involved, 44.1% were male and 55.9% female, giving a male/ female ratio of 0.79. The mean annual surgical incidence of CE in the catchment areas of the study hospitals was estimated to be 1.33 cases/100,000. Although most of Hamedan's population is urban (53.02% at the last census, in 1997), most (57.5%) of the patients lived in rural areas (P<0.05). Among the CE cases, housewives (47.3%), farmers (16.6%) and labourers (16.0%) were over-represented compared with the frequencies of these occupations in the general population of the region (P<0.05 for each). Most of the CE cases were aged 20-39 years (35.8%) or 40-59 years (29.0%) and most had liver cysts, either alone (60.9%) or with cysts in other sites (9.5%), although 19.6% of the cases appeared only to have lung cysts. Overall, 90.5% of the cases showed single-organ involvement. Liver involvement was 3.3-fold more common than lung involvement, the ratio between cases with liver cysts and those with lung cysts generally increasing with age (from 1.6 for the cases aged <20 years to 5.6 among the cases aged 40-59 years). The most common clinical symptoms were abdominal pain and/or a sensation of abdominal mass in those with hepatic CE, and chest pain, cough, dyspnoea and/or haemoptysis in those with pulmonary CE. Although 72% of the cases each had a single cyst, 19.6% had two cysts each and 8.4% each had at least three cysts. Only three (1.7%) of the cases had had previous surgery for CE. Diagnosis of CE in Hamedan province is largely dependent on ultrasonography and computed tomography. Together, these results confirm that CE is endemic in the province and indicate that certain occupations (housewife, farmer and labourer) and/or rural life are risk factors.     

Unique family clustering of human echinococcosis cases in a chinese community

We have identified a significant focus and unusual clustering of human cases of cystic echinococcosis (CE) and alveolar echinococcosis (AE) in the village of Nanwan, Xiji County, Ningxia Hui Autonomous Region, in one of the most highly endemic areas for both diseases in China. The village, a Chinese Hui Islamic community, is composed of 167 members of four extended families. A total of 28 people died (12 of echinococcosis) since the village was first settled in the 1950s. Despite similar life patterns, the number of AE and CE cases occurring in each family was different. Overall, the prevalences of AE and CE were 9% (20 cases) and 5.9% (13 cases), with a combined prevalence of 14.9%. In contrast to CE, a comparison of the prevalence of AE indicated significant differences between the four family clusters. Although suggestive that host genotype might play a role in susceptibility to AE, this hypothesis requires further investigation.     

Cystic and alveolar echinococcosis: an epidemiological survey in a Tibetan population in southeast Qinghai, China

An epidemiological investigation on echinococcosis was made in Jiuzhi County of Qinghai Province, western China. Ultrasonography and an indirect hemagglutination test revealed a morbidity of 8.0% (124/1,549) and a seroprevalence of 25.8% (287/1,113), respectively, in the Tibetan population. The morbidity in herdsmen (16.6%) and Buddhist priests (15%) was significantly higher than that in other occupation groups (3.2%), and it was higher in females (9.8%) than in males (6.2%). The ultrasound images showed a coexistence of cystic echinococcosis (CE) and alveolar echinococcosis (AE), occupying 69 and 31% of the cases, respectively. An Echinococcus Western blot assay was performed as a serological backup test for differentiating CE and AE. The assay revealed that serum samples from most cases with a positive AE image showed a specific antibody against antigen bands at 16/18 kDa. Autopsy proved that 9 out of 12 stray dogs were infected with Echinococcus granulosus (n = 8) and E. multilocularis (n = 1). Inspection at the abattoirs demonstrated a hydatid rate of 78.5% in yaks and 82.6% in sheep. The data indicate that Jiuzhi County is an important endemic area for both CE and AE, in both human and animal populations.