2016-2020年福建省土源性线虫病监测结果分析

目的了解福建省土源性线虫病流行动态,为制定防治对策提供科学依据。方法按《全国肝吸虫病和土源性线虫病监测方案(试行)》要求,根据福建省寄生虫病历史流行情况,2016—2020年选取全省9个地市46个县(市、区)作为土源性线虫病监测点。采用改良加藤厚涂片法(Kato-Katz)检查蠕虫感染情况,试管滤纸培养法鉴定钩虫虫种,透明胶纸肛拭法检查3~9岁儿童蛲虫感染情况。结果采用改良加藤厚涂片法共调查9个地市46个县(市、区)48103人,检查出钩虫、蛔虫和鞭虫感染604人,总感染率为1.26%,其中钩虫、蛔虫、鞭虫的感染率分别为1.11%(535/48103)、0.01%(7/48103)、0.13%(62/48103);采用透明胶纸肛拭法检查3~9岁儿童7813人,感染者497人,感染率为6.36%。9个地市土源性线虫感染率分别为:福州0.49%(31/6269)、厦门0.19%(10/5249)、漳州1.11%(46/4127)、泉州0.51%(31/6083)、莆田0.63%(27/4256)、南平1.33%(55/4125)、三明4.16%(352/8470)、宁德0.31%(13/4210)、龙岩0.73%(39/5314),各地市间总感染率差异有统计学意义(χ^(2)=735.44,P<0.05)。男性土源性线虫感染率为1.00%,女性感染率为1.49%,女性高于男性,两者差异有统计学意义(χ^(2)=22.92,P<0.01)。各年龄组人群均有感染,80岁及以上年龄组、70~79岁组的感染率较高,分别达4.31%、3.71%。不同文化程度的人群中文盲或半文盲、小学感染率较高,分别为2.92%、1.82%,其感染率差异有统计学意义(χ^(2)=277.13,P<0.01)。儿童及学生感染主要以蛲虫为主,农民感染则以钩虫为主。结论福建省人群土源性线虫总感染率呈下降趋势,并处于低感染状态。小学低年级学生和学龄前儿童的蛲虫感染率仍呈较高水平,应加强防治工作。

Analysis on the surveillance results of soil-transmitted nematodes in Fujian Province from 2016 to 2020

Objective　To understand the prevalence status of soil-transmitted nematodes in Fujian Province for scientific evidence to develop prevention and control measures for this infection. Methods　According to the requirements specified in the National Surveillance Program for Liver Fluke Diseases and Soil-transmitted Nematodes(Trial) and prevalence status of parasitic diseases in history in Fujian Province,46 counties(cities/ districts) were included as surveillance sites for soiltransmitted nematodes from 2016 to 2020. Modified Kato-Katz thick smear method was used to measure the helminth eggs,and culture method (tubes with filter paper) was used to identify species of hookworms. Anal swab test with cellophane tape was performed to screen pinworm eggs in children aged between 3 and 9 years old. Results　Totally,48 103 persons from the 46 counties(cities/ districts) underwent the survey. Modified Kato-Katz thick smear test revealed infection with hookworm, roundworm and whipworm in 604. The total infection rate was 1. 26%,in which infection with hookworm,roundworm and whipworm and was 1. 11%,0. 01% and 0. 13%,respectively. Anal swab test with cellophane tape showed that 497 of the 7 813 children aged from 3 to 9 years old were infected with pinworm,with an infection rate of 6. 36%. Of the 9 cities surveyed, the infection rate of soil-transmitted nematodes was 0. 49% (31/6 269) in Fuzhou,0. 19% (10/5 249) in Xiamen, 1. 11% (46/4 127) in Zhangzhou,0. 51% (31/6 083) in Quanzhou,0. 63% (27/4 256) in Putian,1. 33% (55/4 125) in Nanping,4. 16% (352/8 470)in Sanming,0. 31% (13/4 210)in Ningde,and 0. 73% (39/5 314) in Longyan. The difference was significant among cities (χ 2 = 735. 44, P < 0. 05) . Females had higher infection than males ( 1. 49%vs. 1. 00%;χ 2 =22. 92,P<0. 01). Of the population aged over 80 years and aged between 70 and 79 years,the infection rate was 4. 31% and 3. 71%,respectively,and the highest in population aged 80 years or above. As far as the educational level was concerned,the infection rate was 1. 82% for elementary school students,2. 92% for illiterates and semiliterates (χ 2 =277. 13,P<0. 01). Infection with pinworm was dominant in children and students,yet infection with hookworm was more common in farmers. Conclusion　Total infection rate of soil-transmitted nematodes tends to decrease in population in Fujian Province,and remains in relatively lower status. However,the infection of pinworm is still higher in low grade of primary school students and preschoolers,which suggests that strengthened prevention and control is necessary.