中缅边境学生疟疾合并蠕虫感染情况调查研究

发布时间：2018-11-21 18:47

【摘要】：[目的]探究中缅边境地区克钦青少年疟疾蠕虫混合感染情况及G6PD缺乏症情况。[方法]实验分为现场样本收集和实验检测两部分,现场样本收集主要是收集中缅边境两所学校学生的粪便及指血样本。实验室中将收集的粪便标本采用改良加藤法对每份粪便样本进行“一粪三检”,经镜检确定寄生虫虫卵类型并且对各种虫卵分别进行计数,指血分别用来PCR鉴定疟疾感染类型以确定疟疾亚微观感染,G6PD缺乏症测定及血红蛋白测定。[结果]1.对云南中缅边境地区L1与N2两所学校学生共1032例样本进行直接滤纸血PCR鉴定,得出间日疟33例,恶性疟8例。镜检疟原虫发现间日疟18例。直接滤纸血IPCR方法检测疟原虫感染的检出率高于传统镜检方法(间日疟：p=0.03,χ2=4.52,恶性疟：p=0.005,f=8.03)2.对这1032例样本利用改良加藤法诊断粪便蠕虫后我们发现钩虫感染率为最高(31.30%),蛔虫(1.36%)、蛲虫(1.16%)、鞭虫(0.29%)列为其后。其中除发现疟原虫与钩虫共同感染外,未见与其他蠕虫的共同感染。3.对不同年龄段学生进行分组,经过数据统计分析,我们发现钩虫感染率在高年龄组明显高于低年龄组(p0.001),鞭虫的感染率在高年龄组也明显高于低年龄组(p=0.04)。其中疟原虫与钩虫合并感染占总疟原虫感染人数的36.59%。4.调查地区女性蠕虫和疟原虫感染率均稍高于同龄男性,但是并没有统计学意义。5.发现贫血与G6PD缺乏症相关(p=0.047),与蠕虫感染也有关(p=0.01),与钩虫关系最为明显(p=0.02)。不同程度的贫血与G6PD缺乏症、蠕虫和疟原虫的关系不显著。6.参与调查的L1与N2学校学生相比而言,N2学校学生蠕虫和疟原虫感染率较高,其中蠕虫感染率显著高于L1学校学生(p0.001),且血红蛋白和BMI水平显著N2学校学生低于L1(p0.001)。[结论]1.直接滤纸血PCR方法检测疟原虫类型与传统镜检方法相比有明显优势且与传统DNA提取后进行PCR相比,节省资金和时间,值得推广使用。2.对不同年龄段青少年分组进行分析后得出高年龄组钩虫及鞭虫感染显著高于低年龄组。总体来看高年龄组岁组寄生虫感染率均较高,但其他感染无统计学差异。3.发现贫血与G6PD缺乏症有关系显著,与蠕虫感染也有显著关系,其中与钩虫关系最为明显。4.参与调查的N2学校学生蠕虫感染率明显高于L1学校,血红蛋白水平N2学校学生明显低于L1学校, N2学校学生BMI也明显低于L1学校。
[Abstract]:Objective: to investigate the mixed infection of malaria worm and G6PD deficiency in Kachin adolescents in the border area of China and Myanmar. [methods] the experiment is divided into two parts: field sample collection and experimental examination. The collection of field samples mainly consists of collecting feces and finger blood samples of students in two schools along the border between China and Myanmar. The fecal specimens collected in the laboratory were collected by modified Kato method to carry out "one fecal triple examination" for each fecal sample. The type of parasite eggs was determined by microscopic examination and the eggs were counted separately. Finger blood was used to identify the type of malaria infection by PCR in order to determine submicroscopic malaria infection, G6PD deficiency and hemoglobin determination. [result] 1. A total of 1032 samples from L _ 1 and N _ 2 schools in the border area of China and Myanmar in Yunnan Province were identified by direct filter paper blood PCR. 33 cases of vivax malaria and 8 cases of falciparum malaria were obtained. 18 cases of Plasmodium vivax were detected by microscope. The detection rate of Plasmodium falciparum infection by direct filter paper blood IPCR method was higher than that by traditional microscopic method (vivax malaria: p0. 03, 蠂 2: 4. 52, falciparum malaria: p0. 005 FU 8. 03) 2. The infection rate of hookworm (31.30%), Ascaris (1.36%), Enterobius vermicularis (1.16%) and Trichuris (0.29%) were found to be the highest (31.30%). Except for the co-infection of Plasmodium and hookworm, there was no co-infection with other worms. According to the statistical analysis, we found that the infection rate of hookworm in the high age group was significantly higher than that in the low age group (p0.001), and the infection rate of Trichuris in the high age group was significantly higher than that in the low age group (p0. 04). Among them, the co-infection of Plasmodium and hookworm accounted for 36.59.4. The infection rates of female worms and malaria parasites were slightly higher than those of men of the same age, but there was no statistically significant difference between them. It was found that anemia was associated with G6PD deficiency (p0. 047), worm infection (p0. 01), and hookworm (p0. 02). The relationship between anemia and G6PD deficiency, worm and malaria parasite was not significant. 6. 6%. The infection rate of worm and malaria parasite in N2 school was higher than that in L1 school (p0.001). The levels of hemoglobin and BMI were significantly lower in N 2 school than in L 1 (p 0. 001). [conclusion] 1. The direct filter paper blood PCR method has obvious advantages compared with the traditional microscopic method in detecting Plasmodium parasites. Compared with the traditional DNA extraction method, it saves money and time, and is worth popularizing. 2. The analysis of different age groups showed that the infection of hookworm and Trichuris in the high age group was significantly higher than that in the low age group. In general, the parasite infection rate was higher in the age group, but there was no significant difference in other infections. It was found that anemia had a significant relationship with G6PD deficiency and worm infection, especially hookworm. The infection rate of helminth in N2 school was significantly higher than that in L1 school, the hemoglobin level in N2 school was significantly lower than that in L1 school, and the BMI in N2 school was significantly lower than that in L1 school.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R531.3;R532

【相似文献】