宁夏包虫病时间地域分布调查

发布时间：2018-05-05 19:33

本文选题：包虫病 + 住院病例　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：目的：本研究通过流行病学调查方法对宁夏回族自治区2002年—2013年包虫病住院病例进行回顾调查，揭示我区包虫病流行的三间分布特征，及患病住院情况。并与上个十年（1992年—2001年）已有资料的包虫病病例分布进行对比，比较两个时间段的变化。选择西吉县进行泡型包虫病中间宿主的调查，对西吉县4-18岁人群泡型包虫病感染状况和中间宿主进行调查，分析泡型包虫病的流行传播模式。为卫生行政部门制定包虫病防治策略提供科学依据。方法：对全区县级及以上医院2002年—2013年包虫病住院病例进行收集，对1992年—2001年历史流调资料进行拷贝和整理。对西吉且15个乡25个村4-18岁人群采集血液，对抗泡型包虫病抗体进行ELISA检测。对西吉县泡型包虫病中间宿主啮齿类动物进行捕捉和种类鉴定和分布密度调查。结果：共收集2002年—2013年包虫病住院病例调查病例2334份，平均住院病例率为3.09/10万人口。整理1992年—2001年包虫病住院病例2271份。从年份来看，病例数呈逐年上升然后下降趋势。两个时间段包虫病病例均主要分布在同心县、原州区和海原县。包虫病病例主要集中在青壮年，不同性别间，不同民族间，不同年龄组间均有统计学差异（P 0.05）。西吉县泡型包虫病4-18岁人群感染情况调查共采集血样1772份，血清阳性率为6.72%，泡型病血清阳性率分布最高的乡为兴平乡（12.4%），其次为沙沟乡（10.9%）。分布最多的区域为西南区（8.9%），其次为西北区（8.8%）。不同性别间血清阳性率有统计学差异（P 0.05），不同民族、不同年龄组间没有统计学差异（P0.05）。啮齿类动物的调查共布设鼠夹2244个，捕获到啮齿类动物133只，鼠夹捕获率为5.9%。捕获到啮齿类动物最多的是长尾仓鼠（65.4%），优势种长尾仓鼠分布最多的区为西北区（30%），其次为西南区（27%）。中间宿主密度的调查观察到较多的仓鼠和鼢鼠，，与2003年相比黄鼠种群的数量减少而鼢鼠种群可能增加。结论：我区包虫病感染普遍，全区各县市均有包虫病病病例分布，其流行特点为南部山区高发。泡型包虫病住院病例数在2009年以后逐步下降，它是经济发展、移民政策、包虫病防治项目实施等多方面作用的结果。泡型包虫病在西吉县儿童青少年中感染率较高，长尾仓鼠为西吉县的优势鼠种，长尾仓鼠密度大的区域人血清阳性率也高，说明在相应区域内存在活跃的泡型包虫病传播循环。当地泡型包虫病传播模式可能为啮齿动物—犬间循环，有待进一步证实。
[Abstract]:Objective: to investigate retrospectively the hospitalized cases of hydatid disease in Ningxia Hui Autonomous region from 2002 to 2013 by means of epidemiological investigation. Compared with the distribution of hydatidosis cases in the last decade (1992-2001), the changes of the two periods were compared. The infection status and intermediate host of alveolar echinococcosis were investigated in Xiji county, and the epidemic transmission pattern of alveolar hydatid disease was analyzed. To provide scientific basis for health administrative department to formulate strategy of preventing and controlling hydatid disease. Methods: the hospitalized cases of hydatid disease were collected from 2002 to 2013 in hospitals at county level and above in the whole district. The data of historical flow from 1992 to 2001 were copied and sorted out. Blood was collected from 25 villages of Xiji and 25 villages, and the antibody against alveolar hydatid disease was detected by ELISA. The rodents of alveolar echinococcosis in Xiji County were captured, species identified and their distribution density investigated. Results: a total of 2334 cases of hydatid disease were investigated from 2002 to 2013, with an average hospitalization rate of 30.9% -100 000. 2271 cases of hydatid disease were collected from 1992 to 2001. From the point of view of year, the number of cases increased year by year and then decreased. The cases of hydatid disease were mainly distributed in Tongxin County, Yuanzhou District and Haiyuan County. The cases of hydatid disease were mainly concentrated in young adults, different sexes, different nationalities, different age groups, there were statistical differences (P 0.05). A total of 1772 blood samples were collected from the population aged 4-18 years old in Xiji County. The positive rate of serum was 6.722.The highest distribution of serum positive rate of alveolar echinococcosis was Xingping County 12.4D, followed by Shagou Township 10.9%. The most distributed area is the southwest area, and the second is the northwest area. There was a significant difference in serum positive rate among different genders (P 0.05), but there was no significant difference in serum positive rate among different nationalities and different age groups (P 0.05). A total of 2244 rodent clamps were set up and 133 rodents were captured. The capture rate of rodents was 5.9%. The most common rodents were the long-tailed hamsters (65.4m), the most dominant species was the northwestern part of the Hamster, and the second was the southwest area. More hamsters and zokors were observed in the investigation of intermediate host density. Compared with 2003, the number of yellow rat population decreased, but the zokor population may increase. Conclusion: hydatidosis infection is common in our region, and there are cases of hydatidosis in all counties and cities of our region, and its epidemic characteristic is high incidence in southern mountainous area. The number of hospitalized cases of alveolar echinococcosis decreased gradually after 2009, which is the result of economic development, immigration policy and the implementation of echinococcosis control projects. The infection rate of alveolar echinococcosis was higher in children and adolescents in Xiji County. The long tailed hamster was the dominant species in Xiji county, and the positive rate of human serum in the area with high density of long tailed hamster was also high, which indicated that there was an active circulation of transmission of vesicular hydatid disease in the corresponding area. The transmission pattern of local alveolar hydatid disease may be rodent-dog circulation, which needs further confirmation.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R532.32

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