甘肃泡型包虫病流行与人行为危险因素
Approach to risk factor of human behavior on epidemic of alveolar echinococcosis
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摘要:目的 泡型包虫病的流行一般呈散发状态, 甘肃省漳县、岷县局部地区泡球蚴病高度流行。对流行区人群进行影象学和血清流行病学调查的同时, 进行当地人行为和生活方式的调查。探讨与疾病传播有关的因素。方法 对甘肃省漳县和岷县泡型包虫病(AE)流行区2485人, 经B超和泡球蚴抗原的血清流行病学调查, 以血清学和影像学检查均为阳性者诊断为泡型包虫病感染者。并对所有对象进行11项有关问题的询问调查。得出人群相应项目下包虫感染者和未感染人数之间构成比的组成, 应用完全随机秩和H检验, 由χ2界值表, 确定与流行有关的因素。结果 确诊为泡型包虫病感染者有86名, 绝大部分是农民, 经统计处理, 发现AE流行与养狗、猎狐、接触狐皮、生食蔬菜、食用自产蔬菜等活动无关(P > 0.05);与用狗粪作肥料, 和狗的密切接触有关(P < 0.05)。与养狗的数量、时间, 自由放养的方式高度相关(P < 0.01)。结论 多房棘球绦虫卵对环境污染是最主要的危险因素。少养狗或改变放养犬的不卫生习惯, 应是防治当地泡型包虫病的重要措施。Abstract:Objective Human alveolar echinococcosis was usually rare, but high AE prevalence appeared in Zhang county and Ming county of Gansu.A questionnaire was carried out there in order to approach risk factor involved AE transmission.Methods 86 patients with AE were confirmed by both Hepatic ultrasound massscreening with serological testing identification among 2 485 and their behavoir and life style were questioned.Questionnaire data for putative risk factors were analyzed by Kruskal-Wallis test statistic.Results Risk factors were relative to total number of dogs owned(P < 0.005), dogs faeces as fertilizer(P < 0.025), closely contact with dogs(P < 0.05)and scavenge of dog(P < 0.001), but not to a history of fox hunting(P > 0.6), contact foxskins(P > 0.9)and dog ownership(P > 0.35).Conclusion The most risk factor was the pollution of eggs of echinococcus multiocularis for environment.Important preventive measure against AE was to decrease dog number and change non-hygienic habit.
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