基于全健康视角的贵州省从江县华支睾吸虫病流行特征及其社会网络影响因素

中国血吸虫病防治杂志（中英文） ›› 2026, Vol. 38 ›› Issue (4): 379-388.

基于全健康视角的贵州省从江县华支睾吸虫病流行特征及其社会网络影响因素

刘璐1，佘丹娅2，蔡姗2，张晨晟3，李松平4，卢丽丹2*，周晓农3, 5*

1国家卫生健康委员会寄生虫病预防与控制技术重点实验室、江苏省寄生虫与媒介控制技术重点实验室、江苏省血吸虫病防治研究所（江苏无锡 214064）；2 贵州省疾病预防控制中心（贵州贵阳 550000）；3 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）、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联合研究中心（上海 200025）；4 贵州省从江县疾病预防控制中心； 5 国家热带病研究中心⁃上海交通大学医学院全球健康学院、上海交通大学全健康研究中心（上海 200025）

出版日期:2026-08-25 发布日期:2026-09-09
通讯作者: 卢丽丹 lulidan426@163.com，周晓农 zhouxn1@chinacdc.cn
作者简介:刘璐，女，博士，助理研究员。研究方向：寄生虫病流行病学
基金资助:
江苏省疾病预防控制局科技计划项目（JSJK2026M00009）；贵州省科技支撑计划项目（黔科合支撑［2023］一般183）；海南省卫生健康科技创新联合项目（WSJK2024MS226）；海南省重点研发计划（ZDYF2024SHFZ083）；深圳医学研究基金（B2404002）

Epidemiological characteristics of clonorchiasis and factors affecting the social network of clonorchiasis in Congjiang County of Guizhou Province from a One Health perspective

LIU Lu1, SHE Danya2, CAI Shan2, ZHANG Chensheng3, LI Songping4, LU Lidan2*, ZHOU Xiaonong3 ,5*

1 National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China; 2 Guizhou Provincial Center for Disease Control and Prevention, Guiyang, Guizhou 550000, China; 3 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 Colloborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai 200025, China; 4 Congjiang County Center for Disease Control and Prevention, Guizhou Province, China; 5 School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 2000025, China

Online:2026-08-25 Published:2026-09-09

摘要/Abstract

摘要： 目的　从全健康视角出发，结合社会网络分析探讨贵州省从江县龙江村华支睾吸虫病流行特征、影响因素及社区饮食网络驱动因素，为实施精准防控措施提供依据。方法　选取贵州省从江县龙江村为调查点，采用随机抽样法选取128名6周岁常住居民作为调查对象，采集其粪便样本。此外，采集村内华支睾吸虫保虫宿主（家猫、犬）粪便样本（≥ 10份），中间宿主淡水螺（≥ 80只）、淡水鱼样本（≥ 200尾）。采用改良加藤厚涂片法（1粪2检）检测人群、家猫、犬粪便中的华支睾吸虫虫卵，分别采用压片法、逸蚴法进行淡水鱼囊蚴和淡水螺尾蚴检测。通过结构式问卷与半结构化深度访谈采集调查对象人口学特征，饮食、饮水卫生行为及食物分享关系等信息，对华支睾吸虫感染相关影响因素进行回归分析。以村内河流为界，将调查对象按南北方位分为a、b两组，对人群食物分享网络进行社会网络分析，并采用Louvain算法进行社区结构及关键点分析。结果　贵州省从江县龙江村居民华支睾吸虫总感染率为33.59%（43/128），淡水鱼华支睾吸虫囊蚴阳性率为7.63%（22/288），淡水螺未检出尾蚴。家猫华支睾吸虫感染率为7.69%（1/13），未检出阳性家犬。回归分析结果显示，25～< 45岁年龄组［调整比值比（adjust odds ratio，AOR）= 23.17，95%可信区间（confidence interval，CI）：（1.85，490.29）］、侗族人群［AOR = 26.80，95% CI：（1.54，1 105.09）］、经常饮用生水［AOR = 9.39，95% CI：（1.58，99.79）］及食用鱼生［AOR = 3.49，95% CI：（1.52，34.69）］是龙江村村民华支睾吸虫感染的独立危险因素（P均< 0.05）。社会网络分析显示，b组全局集聚系数（0.52）和平均局部集聚系数（0.52）均高于a组（0.16、0.16）（t ＝ 2.41，P ＝ 0.02）。b组内感染者度中心性（17.54）高于未感染者（4.26）（t ＝ 2.33，P ＝ 0.02）。b组内存在感染率高达45.83%的高风险自由社区S11，且该组内的高介数中心性感染者可能在食物分享网络中发挥“桥梁”作用，促进感染风险聚集和扩散。结论　饮用生水、食用鱼生等个人饮食习惯与家庭⁃邻里食物分享网络等社会文化因素促进了龙江村华支睾吸虫病的聚集性传播。此类地区华支睾吸虫防控策略应由以个体为中心的健康教育转向全健康框架下的综合干预，重点关注社会网络关键人群，协同水与环境管理，并通过社区参与提高防控措施的可接受性与持续性。

关键词: 华支睾吸虫病, 全健康, 流行特征, 影响因素, 社会网络分析, 食物分享, 龙江村, 侗族聚居区

Abstract: To investigate the epidemiological characteristics, influencing factors, and community dietary network drivers of clonorchiasis in Longjiang Village, Congjiang County, Guizhou Province using social network analysis from a One Health perspective, so as to provide insights into implementation of precision control measures. Methods　Longjiang Village, Congjiang County, Guizhou Province was selected as a survey point. A total of 128 permanent residents at ages of over 6 years were sampled using a random sampling method, and subjects' stool samples were collected. In addition, at least 10 fecal samples were collected from domestic cats and dogs, reservoir hosts of Clonorchis sinensis, and at least 80 freshwater snails and at least 200 freshwater fish, intermediate hosts of C. sinensis, were sampled in Longjiang Village. C. sinensis eggs were detected in human, domestic cat and domestic dog fecal samples using a modified Kato⁃Katz thick smear method (two slides for one stool sample) . The C. sinensis metacercariae were detected in freshwater fish with a compression method and the C. sinensis cercariae were detected in freshwater snails with a cercarial shedding method, respectively. Participants' demographic characteristics, dietary and drinking hygiene behaviors and food⁃sharing relationships were collected with structured questionnaires and semi⁃structured in⁃depth interviews, and factors affecting C. sinensis infection were identified using regression analysis. Based on the north⁃south orientation delineated by the village river, participants were divided into groups a and b. Subjects' food⁃sharing network was analyzed using social network analysis, and the Louvain algorithm was employed to investigate the community structure and key nodes of the network. Results　The overall prevalence of C. sinensis infection was 33.59% (43/128) among participants in Longjiang Village, Congjiang County, Guizhou Province. The detection of C. sinensis metacercariae was 7.63% (22/288) in freshwater fish, and no C. sinensis cercariae were detected in freshwater snails. The prevalence of C. sinensis infection was 7.69% (1/13) in domestic cats, and no infection was detected in domestic dogs. Regression analysis identified age groups of 25 to 45 years [adjusted odds ratio (AOR) = 23.17, 95% confidence interval (CI): (1.85, 490.29)], Dong ethnicity [AOR = 26.80, 95% CI: (1.54, 1 105.09)], frequent consumption of raw water [AOR = 9.39, 95% CI: (1.58, 99.79)], and consumption of raw fish [AOR = 3.49, 95% CI: (1.52, 34.69)] as independent risk factors for C. sinensis infection among villagers in Longjiang Village (all P values < 0.05). Social network analysis showed a significantly higher global clustering coefficient (0.52 vs. 0.16; t = 2.41, P = 0.02) and average local clustering coefficient (0.52 vs. 0.16; t = 2.41, P = 0.02) in Group b than in Group a, and a significantly higher degree centrality was found among C. sinensis⁃infected individuals than among uninfected individuals in Group b (17.54 vs. 4.26; t = 2.33, P = 0.02). There was a high⁃risk community S11 with a 45.83% prevalence rate of C. sinensis infection in Group b, and C. sinensis⁃infected individuals with high betweenness centrality in Group b might serve as critical "bridges" in the food⁃sharing network, which facilitated the aggregation and diffusion of the risk of C. sinensis infection in the community. Conclusions　Individual dietary behaviors, such as drinking raw water and consuming raw or undercooked fish, and sociocultural factors of household⁃neighborhood food⁃sharing networks, may contribute to the clustering transmission of clonorchiasis in Longjiang Village. The clonorchiasis control strategy is recommended to shift from individual⁃centered health education towards integrated interventions under a One Health framework in this region, which focus on key individuals within social networks, strengthen coordinated water and environmental management, and enhance community participation to improve the acceptability and sustainability of interventions.

Key words: Clonorchiasis, One Health, Epidemiological characteristic, Influencing factor, Social network analysis, Food sharing, Longjiang Village, Dong compact community

中图分类号:

R532.23

刘璐, 佘丹娅, 蔡姗, 张晨晟, 李松平, 卢丽丹, 周晓农. 基于全健康视角的贵州省从江县华支睾吸虫病流行特征及其社会网络影响因素[J]. 中国血吸虫病防治杂志（中英文）, 2026, 38(4): 379-388.

LIU Lu, SHE Danya, CAI Shan, ZHANG Chensheng, LI Songping, LU Lidan, ZHOU Xiaonong. Epidemiological characteristics of clonorchiasis and factors affecting the social network of clonorchiasis in Congjiang County of Guizhou Province from a One Health perspective[J]. Chinese Journal of Schistosomiasis Control, 2026, 38(4): 379-388.

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