2015年西藏自治区人体肠道重点寄生虫病现状调查分析

目的 了解和分析西藏自治区人体肠道重点寄生虫病的流行现状和态势，为制定防治方案提供科学依据。 方法 采用分层整群随机抽样方法，选取23个县70个调查点。采集受检对象的粪样，通过改良加藤厚涂片法检测肠道蠕虫卵，对3~6岁儿童采用透明肛试法加做蛲虫卵检查。通过碘液染色法和生理盐水涂片法检测肠道原虫包囊、滋养体。采取x2检验、多因素非条件logistic回归分析研究重点寄生虫感染的影响因素。结果 2015年西藏自治区人体肠道寄生虫病总感染率为16.09%（2886/17939），其中蠕虫感染率为10.84%（1945/17939），原虫感染率为6.23%（1117/17939）。各生态区间藏东-川西生态区21.61%（1489/6889）重点寄生虫感染率最高，藏北高原高寒生态区7.00%（306/4371）感染率最低，两者差异有统计学意义（x2=423.522 P<0.01）。共调查17939人，其中男性8301人，女性9638人，肠道寄生虫感染率分别为16.52%(1372/8301)、15.71%（1514/9638）差别无统计学意义（x2=2.219 P>0.05）。50~59岁年龄组人群肠道寄生虫感染率最高22.40%（511/2281）。不同文化程度中小学文化程度人群感染率最高18.51%（1185/6403）。各职业中农民感染率最高21.52%（2168/10076）。不同年龄组、文化程度、职业人群肠道寄生虫感染率差异有统计学意义（x2=333.987、66.577、503.642，P<0.01）。非条件logistic分析结果显示，小学文化程度、农牧民人群及藏东-川西生态区重点肠道寄生虫感染率均高于参考组，OR值及其95%CI分别为:2.709（1.565～4.690）、2.553（1.685～3.870）、1.338（1.219～1.468）。结论 西藏自治区人体寄生虫感染仍较严重，需加大农牧区重点人群的防治力度，加大健康教育宣传力度。

The status quo of human intestinal major parasitic diseases in Tibet Autonomous Region, 2015

To understand and analyze the epidemic status and trend of human intestinal major parasitic diseases inTibet Autonomous Ｒegion，and to provide scientific basis for the formulation of control programs. Methods The stratifiedcluster random sampling method was used to select 70 survey sites in 23 counties. Collect fecal samples of the test subjects，detect intestinal worm eggs by the modified Kato thick smear method，and use the transparent anal test method for pinworm eggsfor children of 3 ～ 6 years old. Intestinal protozoan cysts and trophozoites were detected by iodine staining method and salinesmear method. χ2 test and multi － factor unconditional logistic regression analysis were used to study the influencing factors ofkey parasite infections. Ｒesults In 2015，the total infection rate of human Tibet Intestinal parasite was 16. 09% ( 2 886 /17939) ，of which 10. 84 were helminths ( 1 945 /17 939) and 6. 23% were protozoa ( 111 /7 939) . 21. 61% ( 1 489 /6 889) of thekey parasites infection rate was the highest in each ecological region，and 7. 00% ( 306 /4 371) of the key parasites infectionrate was the lowest in the high － cold ecological region of Changtang. The difference was statistically significant ( χ2 = 423. 522，P ＜ 0. 01) . A total of 17，939 people surveyed，including 8 301 men and 9 638 women. The intestinal parasite infection rateswere 16. 52% ( 1 372 /8 301) and 15. 71% ( 1 514 /9 638) ，respectively. There was no statistically significant difference ( χ2 =2. 219，P ＞ 0. 05) . The infection rate of intestinal parasites in the 50 ～ 59 age group was the highest at 22. 40% ( 511 /2 281). The highest infection rate among people with different levels of education was 18. 51% ( 1 185 /6 403) . The highest infectionrate among farmers in all occupations was 21. 52% ( 2 168 /10 076) . Differences in intestinal parasite infection rates amongdifferent age groups，education levels，and occupational groups were statistically significant ( χ2 = 333. 987，66. 577，503. 642，P ＜ 0. 01) . The results of unconditional logistic analysis showed that the primary school education level，the population offarmers and herdsmen and the infection rate of key intestinal parasites in the eastern Tibet － West Sichuan ecological area werehigher than the reference group，the OＲ value and its 95% CI were: 2. 709 ( 1. 565 ～ 4. 690，respectively) ，2. 553 ( 1. 685 ～3. 870) ，1. 338 ( 1. 219 ～ 1. 468) . Conclusion Human parasite infection is still serious in Tibet Autonomous Ｒegion，so it isnecessary to strengthen the prevention and control of key population in agricultural and pastoral areas and strengthen healtheducation and publicity