四川省藏族农区人群带绦虫病患病和血清抗囊尾蚴抗体水平调查

摘要/Abstract

摘要： 目的　了解四川省藏族农区带绦虫病及囊尾蚴病流行特征，为两种疾病防治提供科学依据。方法　2016—2022年在四川省甘孜藏族自治州、阿坝藏族羌族自治州、凉山彝族自治州藏族农区，分别抽取康定市、稻城县、得荣县、若尔盖县和木里藏族自治县5个县（市），每县（市）调查1～6个乡（镇）、每个乡（镇）调查4～7个村，整群抽取各村小学阶段儿童、随机抽取16周岁以上常住村民开展调查。同时通过问卷调查收集调查对象基本信息及近1年排绦史和囊尾蚴病相关临床症状、体征，并采集其粪便及静脉血样。采用直接涂片法检测粪便中带绦虫卵，采用槟榔和南瓜籽进行诊断性治疗，对排出的虫体样本采用多重PCR法鉴定带绦虫虫种，采用酶联免疫吸附试验检测患者血清抗囊尾蚴特异性IgG抗体。结果　共有5 249名调查对象参与问卷调查，其中603人（11.5%）自述近1年内有排节片史。共粪检3 976人，检出带绦虫虫卵阳性258人，阳性率为6.5%。对428人开展诊断性治疗，403例（94.2%）驱出虫体或节片。粪便检查和诊断性治疗共检出带绦虫病患者439例，带绦虫病平均患病率为10.9%（439/4 043）。不同性别、年龄、地区调查对象带绦虫病患病率差异均有统计学意义（[χ2] = 36.73、126.31、163.41，P均< 0.05）。对329例驱绦治疗者体内获得的虫体进行多重PCR检测，其中猪带绦虫感染41例（12.5%）、牛带绦虫感染197例（59.9%）、亚洲带绦虫感染91例（27.6%），不同虫种感染者地区分布差异有统计学意义（[χ2] = 45.39，P < 0.05）。共有4 933人行血清抗囊尾蚴特异性IgG抗体检测，其中阳性345例，抗体阳性率为7.0%；不同年龄、地区调查对象血清抗囊尾蚴IgG抗体阳性率差异均有统计学意义（[χ2] = 13.49、51.76，P均< 0.05）。结论　四川省藏族农区存在多种带绦虫感染，人群血清抗囊尾蚴IgG抗体阳性率较高，应加强监测和防治。

关键词: 带绦虫病, 囊尾蚴病, 藏族农区, 四川省

Abstract: Objective　To investigate the prevalence and epidemiological characteristics of taeniasis and cysticercosis among residents in Tibetan agricultural areas of Sichuan province, so as to provide insights for the prevention and control of taeniasis and cysticercosis. Methods　From 2016 to 2022, Kangding City, Daocheng County, Derong County, Ruoergai County and Muli Tibetan Autonomous County were sampled from Tibetan agricultural areas of Ganzi Tibetan Autonomous Prefecture, Aba Tibetan and Qiang Autonomous Prefecture and Liangshan Yi Autonomous Prefecture in Sichuan Province, and 1 to 6 townships were sampled from each county (district), followed by 4 to 7 villages sampled from each township. Primary school children were sampled using a cluster sampling method, and permanent residents at ages of over 16 years were randomly sampled from each village. Participants’ demographics, history of tapeworm excretion during the past year and clinical symptoms and signs of cysticercosis were collected through questionnaire surveys, and participants’ stool and venous blood samples were collected. Taenia eggs were detected in stool samples using the direct smear method, and deworming was performed among taeniasis patients with areca nut⁃squash seeds. The tapeworm species were identified using a multiplex PCR assay, and serum specific IgG antibody against cysticercus was detected using enzyme⁃linked immunosorbent assay (ELISA). Results　A total of 5 249 respondents participated in the questionnaire survey, including 603 respondents (11.5%) with a self⁃reported history of proglottids secretion during the past year. A total of 3 976 residents were subjected to stool examinations, and the detection of Taenia eggs was 6.5%. Of 258 participants undergoing deworming, there were 403 cases (94.2%) with excretions of Taenia worms or proglottids. The mean prevalence of taeniasis was 10.9% (439/4 043), and there were gender⁃, age⁃ and region⁃specific prevalence rates of taeniasis ([χ2] = 36.73, 126.31 and 163.41, all P values < 0.05). Multiplex PCR assays detected 41 cases with T. solium infections (12.5%), 197 cases with T. saginata infections (59.9%) and 91 cases with T. asiatica infections (27.6%) among 329 patients undergoing deworming, and there were region⁃specific prevalence rates of T. solium, T. saginata and T. asiatica infections ([χ2] = 45.39, P < 0.05). In addition, the sero⁃prevalence of anti⁃cysticercus IgG antibody was 7.0% (345/4 933), and there were age⁃ and region⁃specific sero⁃prevalence rates of anti⁃cysticercus IgG antibody ([χ2] = 13.49 and 51.76, both P values < 0.05). Conclusion　Multiple Taenia species are prevalent in Tibetan agricultural areas of Sichuan Province and the sero⁃prevalence of anti⁃cysticercus antibody is high among residents. Monitoring and control of taeniasis and cysticercosis should be strengthened.

Key words: Taeniasis, Cysticercosis, Tibetan agricultural area, Sichuan Province

中图分类号:

R532.3

陈兴旺, 黄琳, 喻文杰, 何伟, 李调英, 刘阳. 四川省藏族农区人群带绦虫病患病和血清抗囊尾蚴抗体水平调查[J]. 中国血吸虫病防治杂志, 2023, 35(6): 633-637,645.

CHEN Xingwang, HUANG Lin, YU Wenjie, HE Wei, LI Tiaoying, LIU Yang. Prevalence of taeniasis and sero⁃prevalence of anti⁃cysticercus antibody among residents in Tibetan agricultural areas of Sichuan Province [J]. Chinese Journal of Schistosomiasis Control, 2023, 35(6): 633-637,645.

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四川省藏族农区人群带绦虫病患病和血清抗囊尾蚴抗体水平调查

Prevalence of taeniasis and sero⁃prevalence of anti⁃cysticercus antibody among residents in Tibetan agricultural areas of Sichuan Province

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