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中国大陆 1959 年至 2012 年曼氏裂头蚴病的回顾性流行病学分析。

Retrospective epidemiological analysis of sparganosis in mainland China from 1959 to 2012.

机构信息

Department of Pathogen Biology,Hainan Medical College,Haikou,China.

出版信息

Epidemiol Infect. 2014 Dec;142(12):2654-61. doi: 10.1017/S0950268814000144.

Abstract

In this study, epidemiological factors of sparganosis cases reported in mainland China from 1959 to December 2012 were analysed. A total of 1061 valid cases were distributed throughout most of the provinces of mainland China, with most cases occurring in Southern and Eastern China. The average age of patients was 29 years (range 0-80 years). Modes of transmission to humans were via contact (54·6%), mainly by application of frog meat as a poultice, foodborne (33·8%), mainly through ingesting frogs or snakes, and waterborne (11·5%) through drinking raw water. The tissue/organs involved were subcutaneous/muscle (43·1%), eyes (31·0%), central nervous system (CNS) (17·9%), urogenital system (3·9%) and visceral organs (3·2%). Obvious differences existed in main risk factors for different areas. Close correlation was found between tissue/organs and risk factors. Main modes of transmission changed during the past decades, from contact (83·8% pre-1979) to foodborne (63·9% post-2000). The tissue/organs involved also changed at the same time. Cases involving eyes fell from 50·0% pre-1979 to 8·3% post-2000, and cases involving CNS increased from 0% pre-1979 to 47·8% post-2000. These results illustrate that China is one of the main epidemic countries of sparganosis in the world. Consumption of frog/snake meat was the main risk factor, although application of frog flesh as a poultice was the main risk factor before 2000. Sparganosis has become one of the neglected but important foodborne/waterborne parasitic diseases in mainland China.

摘要

本研究分析了 1959 年至 2012 年 12 月期间中国大陆报道的曼氏裂头蚴病病例的流行病学因素。共有 1061 例有效病例分布在中国大陆大部分地区,大多数病例发生在中国南方和东部。患者的平均年龄为 29 岁(0-80 岁)。向人类传播的方式包括接触(54.6%),主要是应用蛙肉作为敷贴;食源性(33.8%),主要是通过食用青蛙或蛇;以及水源性(11.5%),通过饮用生水。涉及的组织/器官有皮下/肌肉(43.1%)、眼部(31.0%)、中枢神经系统(CNS)(17.9%)、泌尿生殖系统(3.9%)和内脏器官(3.2%)。不同地区的主要危险因素存在明显差异。组织/器官与危险因素之间存在密切相关性。在过去几十年中,主要传播方式发生了变化,从接触(1979 年前为 83.8%)转变为食源性(2000 年后为 63.9%)。同时,涉及的组织/器官也发生了变化。1979 年前眼部受累病例占 50.0%,2000 年后降至 8.3%,CNS 受累病例从 0%增加到 47.8%。这些结果表明,中国是世界上曼氏裂头蚴病的主要流行国家之一。尽管 2000 年前应用蛙肉作为敷贴是主要的危险因素,但食用蛙/蛇肉是主要的危险因素。曼氏裂头蚴病已成为中国大陆被忽视但重要的食源性/水源性寄生虫病之一。

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