Zeng Qing-ren, Hou Jian-wei, He Yong-kang, Luo Xin-song, Zhang Shun-ke, Shu Heng-ping, Sima Yan-xiang, Yu Xin-lin, Li Yue-sheng
Laboratory of Schistosomiasis, Xiangya School of Medicine, Central South University, Changsha 410078, China.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2004 Aug;22(4):199-203.
To clarify and evaluate the morbidity of schistosome infection and the effectiveness of chemotherapy among fishermen on East Dongting Lake.
Information on water-contact, history of infection and of praziquantel (PZQ) treatment among fishermen was collected. Kato-Katz method and miracidium hatching test were applied to detect the pathogens in stool specimen. Serum antibodies against soluble egg antigen (SEA) were detected with ELISA and IHA. B-ultrasonic examination was used to determine the pathological changes of liver and spleen. Chemotherapy [PZQ 40 mg/(kg x d)] was given to the fishermen followed by a re-examination after a transmission season.
The first investigation (six months before chemotherapy) showed that among 268 people inquired, 90.7% were frequently or intermittently contacting water, 24.0% were treated with PZQ each year, 39.4% had never been treated in the recent five years. Stool positive rate was 68.1% (111/163) and the geometric mean eggs per gram feces (EPG) were 48.77. Males had a higher infection rate (76.0%) and intensity (62.97 EPG) compared with that of females (58.7% infection rate and 30.42 EPG). The highest positive rate (83.3%) was in the age group of 11 to 20 years old. The prevalence of those who frequently or intermittently contacted water and were never treated before was 76.3% (106/139) and 79.7% (51/64), respectively. Serological positive rate was 88.0% (IHA) or 78.7% (ELISA). B-ultrasound revealed 77.4% (82/106) of the fishermen showing pathological changes in liver and/or spleen due to schistosomiasis. 37.7% of the patients showed II-III stage liver fibrosis (male: 53.0%, female: 15%), 58.5% hepatomegaly and 19.8% splenomegaly. The second investigation (six months after chemotherapy with PZQ) showed a stool positive rate of 35.4% and an average EPG 36.13 in the treatment group which were considerably lower than 56.5% infection rate and 68.47 EPG in the group without treatment. In 39 patients treated, the reversion rate from egg positive to negative was 48.7%, pathological change in liver and spleen declined by 40.6%.
The prevalence and morbidity of schistosomiasis in fishermen on Dongting Lake were high due to frequent exposure to the affected water, and chemotherapy can effectively reduce the prevalence, the intensity of infection and morbidity of the fishermen.
阐明并评估东洞庭湖渔民血吸虫感染率及化疗效果。
收集渔民的水接触史、感染史及吡喹酮治疗史。采用加藤厚涂片法和毛蚴孵化法检测粪便标本中的病原体。用酶联免疫吸附试验（ELISA）和间接血凝试验（IHA）检测血清中抗可溶性虫卵抗原（SEA）抗体。采用B超检查确定肝脾的病理变化。对渔民采用化疗[吡喹酮40mg/(kg·d)]，在一个传播季节后进行复查。
首次调查（化疗前6个月）显示，在被调查的268人中，90.7%的人经常或间断接触疫水，每年接受吡喹酮治疗的占24.0%，近5年未接受治疗的占39.4%。粪便阳性率为68.1%（111/163），每克粪便虫卵几何均数（EPG）为48.77。男性感染率（76.0%）及感染度（62.97EPG）高于女性（感染率58.7%，EPG 30.42）。11～20岁年龄组阳性率最高（83.3%）。经常或间断接触疫水且既往未治疗者的患病率分别为76.3%（106/139）和79.7%（51/64）。血清学阳性率IHA为88.0%，ELISA为78.7%。B超显示77.4%（82/106）的渔民有血吸虫病所致肝和/或脾的病理改变。37.7%的患者有Ⅱ～Ⅲ期肝纤维化（男性：53.0%，女性：15%），58.5%肝肿大，19.8%脾肿大。第二次调查（吡喹酮化疗后6个月）显示，治疗组粪便阳性率为35.4%，平均EPG为36.13，显著低于未治疗组的感染率56.5%及EPG 68.47。在接受治疗的39例患者中，粪检由阳性转为阴性的转阴率为48.7%，肝脾病理改变减轻40.6%。
洞庭湖渔民因频繁接触疫水，血吸虫病患病率及发病率高，化疗可有效降低渔民的患病率、感染度及发病率。
