青海省儿童棘球蚴病的地域分布

目的分析2000-2010年青海省辖区内不同地形区儿童棘球蚴病的流行状况,明确儿童棘球蚴病的地域分布。方法对青海省青南高原、祁连山地-河湟谷地和柴达木盆地等3类地形区的6～15岁儿童采用ELISA和B超进行棘球蚴病感染和患病情况的调查。结果共B超调查20 730名儿童,总患病率为1.5%(320/20 730),其中细粒棘球蚴病患病率为1.0%(206/20 730),多房棘球蚴病患病率为0.6%(114/20 730);ELISA检测血清总阳性率为6.5%(1 024/15 762)。青南高原、祁连山地-河湟谷地和柴达木盆地的血清阳性率和患病率分别为9.5%(707/7 453)和2.3%(269/11 618)、3.8%(289/7 544)和0.6%(50/8 275)、3.7%(28/765)和0.1%(1/837)。而青南高原儿童棘球蚴病的血清阳性率和患病率明显高于其他2个地形区,三者间的差异有统计学意义(P<0.01)。儿童多房棘球蚴病仅在青南高原发现,患病率为1.0%(114/11 618);直线回归分析表明,不同平均海拔与儿童棘球蚴病血清阳性率(r=0.96,P<0.05,R2=0.93)和患病率(r=0.82,P<0.05,R2=0.67)之间存在正相关关系。结论儿童棘球蚴病的流行在青海省具有明显地域分布特征。

Geographical distribution of echinococcosis among children in Qinghai Province

Objective To analyze the epidemiological status of echinococcosis among children in three different zones of Qinghai Province.Methods B-ultrasound and ELISA were used in the survey to evaluate echinococcus infection among 6～15 year old children in the three zones,namely,Qinghai southern plateau,Qilian mountain-Hehuang valley and Chaidamu basin.Results The prevalence of echinococcus infection scanned by B-ultrasound and sera positive rate detected by ELISA in children were 1.5%(320/20 730)and 6.5%(1024/15 762)respectively,and the prevalence of cystic echinococcosis and alveolar echinococcosis by ultrasound were 1.0%(206/20 730)and 0.6%(114/20 730),respectively.The prevalence and sera positive rate were 9.5%(707/7 453)and 2.3%(269/11 618) in Qinghai southern plateau,3.8%(289/7 544) and 0.6%(50/8 275) in Qilian mountain-Hehuang valley,and 3.7%(28/765)and 0.1%(1/837) in Chaidamu basin,respectively.The southern plateau showed the highest prevalence,with a significant statistical difference among the three areas(P<0.01).The prevalence of alveolar echinococcosis was 1.0%(114/11 618)in the southern plateau,but no alveolar echinococcosis patients were found in other two areas.Correlation analysis showed that the prevalence increased with the altitude(rs-e=0.96,P<0.05,R2=0.93;rp-e=0.82,P<0.05,R2=0.67).Conclusion The prevalence of echinococcosis among children shows an apparent geographical difference in Qinghai Province.