中国血吸虫病防治杂志 ›› 2023, Vol. 35 ›› Issue (6): 626-632.

• 防治研究 • 上一篇    下一篇

2007—2022年甘肃省天祝藏族自治县中央补助地方棘球蚴病防治项目实施效果评价

李玉花1,张鹏1,孙晨清2,肖宁2,杨元成1,种宝林1,方春1,魁国香1,刘子婧3, 李凡3,杨诗杰2*,冯宇3*   

  1. 1 甘肃省武威市天祝藏族自治县疾病预防控制中心(甘肃 天祝 733200);2 中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心)、传染病溯源预警与智能决策全国重点实验室、国家卫生健康委员会寄生虫病原与媒介生物学重点实验室、WHO热带病合作中心、科技部国家级热带病国际研究中心(上海 200025);3 甘肃省疾病预防控制中心(甘肃 兰州 730000)
  • 出版日期:2023-12-20 发布日期:2024-02-06
  • 作者简介:李玉花,女,本科,主管护师。研究方向:卫生管理
  • 基金资助:
    国家重点研发计划(2021YFC2300800, 2021YFC2300804)

Effectiveness of the central government⁃funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022

LI Yuhua1, ZHANG Peng1, SUN Chenqing2, XIAO Ning2, YANG Yuancheng1, ZHONG Baolin1, FANG Chun1, KUI Guoxiang1, LIU Zijing3, LI Fan3, YANG Shijie2*, FENG Yu3*   

  1. 1 Tianzhu Tibetan Autonomous County Center for Disease Control and Prevention, Wuwei, Gansu 733200, China; 2 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Health Commission Key Laboratory on Parasite and Vector Biology, WHO Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai 200025, China; 3 Gansu Center for Disease Control and Prevention, Lanzhou, Gansu 730000, China
  • Online:2023-12-20 Published:2024-02-06

摘要: 目的 评价2007—2022年甘肃省天祝藏族自治县中央补助地方棘球蚴病防治项目实施效果,为进一步控制棘球蚴病疫情提供参考。方法 2007—2022年,于甘肃省天祝藏族自治县采用多阶段整群随机抽样法抽取行政村作为调查点,对12岁及以上居民进行棘球蚴病筛查;以学校为单位对12岁以下儿童进行整群抽样,对抽中学校所有学生进行棘球蚴病筛查;采用系统随机抽样法抽取养犬户,每户采集1份家犬粪便,并于村庄外采集流浪犬粪便样本,以酶联免疫吸附实验检测家犬及流浪犬粪便棘球绦虫抗原;于该县定点屠宰场,对绵羊和牛等家畜进行棘球蚴病筛查。采用Cochran⁃Armitage趋势检验对人群和家畜棘球蚴病检出率以及犬粪便棘球绦虫抗原阳性率进行趋势分析。2007—2022年,随机抽取棘球蚴病筛查对象进行棘球蚴病防治相关知识知晓率调查。结果 2007—2022年,甘肃省天祝藏族自治县累计开展12岁及以上人群棘球蚴病筛查290 356人·次,发现细粒棘球蚴病患者1 094人,12岁及以上居民棘球蚴病检出率呈逐年下降趋势([χ2] = 358.602,P < 0.001)。2007—2022年,天祝藏族自治县累计开展12岁以下儿童棘球蚴病筛查32 931人·次,发现棘球蚴病患儿296人,儿童棘球蚴病检出率呈逐年下降趋势([χ2] = 267.673,P < 0.001)。2007—2022年,天祝藏族自治县累计检测家犬粪便样本33 230份,发现棘球绦虫抗原阳性1 777份,家犬粪便棘球绦虫抗原阳性率呈下降趋势([χ2] = 2 210.428,P < 0.001),但2016—2022年家犬粪便棘球绦虫抗原阳性率呈上升趋势([χ2] = 37.745,P < 0.001)。2019—2022年,天祝藏族自治县流浪犬粪便棘球绦虫抗原阳性率未发现升高或降低趋势([χ2] = 0.315,P = 0.575)。2007—2022年,天祝藏族自治县累计开展绵羊棘球蚴病筛查10 973只,发现棘球蚴病病羊334只,绵羊棘球蚴病检出率呈下降趋势([χ2] = 53.579,P < 0.001),但2015—2022年检出率未发现升高或降低趋势([χ2] = 1.520,P = 0.218);2017—2022年,累计开展牛棘球蚴病筛查2 400头,发现棘球蚴病病牛231头,牛棘球蚴病检出率呈下降趋势([χ2] = 5.579,P < 0.05)。天祝藏族自治县12岁及以上居民及12岁以下儿童棘球蚴病知晓率分别自2007年的44.37%和52.50%上升至2022年的94.00%和92.50%。结论 自中央补助地方棘球蚴病防治项目实施后,甘肃省天祝藏族自治县人群、家畜棘球蚴病检出率及犬棘球绦虫抗原阳性率均有所下降,人群棘球蚴病知晓率升高;但仍需坚持实施各项防治措施,以进一步控制棘球蚴病疫情。

关键词: 棘球蚴病, 综合防治, 效果评价, 天祝藏族自治县

Abstract: Objective To evaluate the effectiveness of the central government⁃funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, so as to provide insights into echinococcosis control. Methods Administrative villages were sampled using a multi⁃stage cluster random sampling method from Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, and all residents at ages of 12 years and older in the sampled villages were screened for echinococcosis, and schools were sampled using a cluster sampling method, and all children at ages of 12 years and older in the sampled schools were screened for echinococcosis. Domestic dogs were sampled using a systematic random sampling method, and one domestic dog stool sample was collected from each household. Stray dog stool samples were collected outside the villages, and Echinococcus coproantigens were detected using enzyme⁃linked immunosorbent assay in domestic and stray dogs. In addition, echinococcosis was screened in sheep and cattle in designated slaughterhouses in Tianzhu Tibetan Autonomous County. The trends in the prevalence of echinococcosis in humans and livestock and the positive rate of Echinococcus coproantigens in dogs were examined with the Cochran⁃Armitage trend test. In addition, individuals screened for echinococcosis were randomly sampled from 2007 to 2022 for survey on the awareness of echinococcosis control knowledge. Results A total of 290 356 person⁃times were screened for echinococcosis among residents at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 094 residents detected with cystic echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years ([χ2] = 358.602, P < 0.001). A total of 32 931 person⁃times were screened for echinococcosis among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 296 children detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a gradual decline over years ([χ2] = 267.673, P < 0.001). A total of 33 230 domestic dog stool samples were tested for Echinococcus coproantigens in Tianzhu Tibetan Autonomous County, Gansu Province from 2007 to 2022, with 1 777 Echinococcus coproantigens⁃positive samples tested, and the positive rate of Echinococcus coproantigens appeared a tendency towards a decline in domestic dogs over years ([χ2] = 2 210.428, P < 0.001), while the positive rate of Echinococcus coproantigens showed a tendency towards a rise in domestic animals from 2016 to 2022 ([χ2] = 37.745, P < 0.001). The positive rate of Echinococcus coproantigens remained relatively stable in stray dogs in Tianzhu Tibetan Autonomous County, Gansu Province from 2019 to 2022 ([χ2] = 0.315, P = 0.575). A total of 10 973 sheep were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2007 to 2022, with 334 sheep detected with echinococcosis, and the detection of echinococcosis appeared a tendency towards a decline in sheep over years ([χ2] = 53.579, P < 0.001); however, there was no significant change in the detection of echinococcosis during the period from 2015 through 2022 ([χ2] = 1.520, P = 0.218). A total of 2 400 cattle were screened for echinococcosis in Tianzhu Tibetan Autonomous County from 2017 to 2022, with 231 cattle detected with echinococcosis, and the detection of echinococcosis showed a tendency towards a decline over years ([χ2] = 5.579, P < 0.05). The awareness of echinococcosis control knowledge increased from 44.37% in 2007 to 94.00% in 2022 among residents at ages of 12 years and older and from 52.50% in 2007 to 92.50% in 2022 among children at ages of 12 years and older in Tianzhu Tibetan Autonomous County, respectively. Conclusions  There has been a reduction in the detection of echinococcosis in humans and domestic animals and the positive rate of Echinococcus coproantigens in dogs and a rise in the awareness of the echinococcosis control knowledge following the implementation of the central government⁃funded echinococcosis control programme in Tianzhu Tibetan Autonomous County, Gansu Province; however, integrated echinococcosis control measures are still required for further control of the prevalence of echinococcosis.

Key words: Echinococcosis, Integrated control, Effectiveness evaluation, Tianzhu Tibetan Autonomous County

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