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综合防治干预对中国东南部江西省土源性蠕虫感染的影响。

Effect of integrated control intervention on soil-transmitted helminth infections in Jiangxi province in southeast China.

作者信息

Zeng Xiao-Jun, Jiang Wei-Sheng, Xie Shu-Ying, Chen Ying-Dan, Gu Xiao-Nan, Ge Jun, Hang Chun-Qin, Li Zhao-Jun, Chen Hong-Gen

机构信息

Jiangxi Provincial Institute of Parasitic Diseases, Nanchang 330096, China.

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 20025, China.

出版信息

Acta Trop. 2019 Jun;194:148-154. doi: 10.1016/j.actatropica.2019.04.001. Epub 2019 Apr 2.

Abstract

Soil transmitted helminths (STHs) burden was enormous in China several decades ago, however, rigorous control efforts have been successful with appreciable reduction in diseases burden. Here, we assessed provincial-level data derived from cross sectional surveys, executed in 1989, 2002 and 2014, on the prevalence of STHs among populations in Jiangxi province, China. This study, also, reported STHs integrated control intervention aimed at reducing STHs transmission and worm burden among population at county-level. The intervention strategies included mass drug administration (MDA), health education, improved water supply for drinking, improved sanitary facilities and environmental modification in Guixi municipality. The overall infection rate of STHs in Jiangxi province decreased from 77.7% (1989) to 6.3% (2014), while Ascaris lumbricoides, hookworm and Trichuris trichiura decreased from 71.1%, 17.6% and 17.0% (1989) to 0.9%, 4.7% and 1.0% (2014), respectively. STHs infection rates in female population were higher than male in the three surveys. Reduction in STHs prevalence was observed in all age groups, but the decline was less in higher age group. STHs prevalence in Guixi intervention region indicated remarkable reduction from 31.8% (2006) to 6.1% (2009) (χ=255.22, P<0.01). A. lumbricoides, hookworm and T. trichiura infection rates decreased from 10.4%, 17.0% and 7.1% (2006) to 0.1%, 4.1% and 2.2%, respectively (2009) (X = 110.23, P<0.01; X = 103.57, P < 0.01; X = 32.0, P < 0.01). A. lumbricoides infection rate declined the most of all STHs. Following control efforts with integrated control intervention strategies, STHs prevalence in Jiangxi province experienced remarkable trend in decline between 1989 and 2014. Consolidating control efforts with sustained integrated control strategies is, therefore, important to achieving STHs elimination in China.

摘要

几十年前,中国土壤传播的蠕虫(STH)负担巨大,然而,严格的防控措施取得了成功,疾病负担显著减轻。在此,我们评估了1989年、2002年和2014年在中国江西省进行的横断面调查得出的省级数据,以了解人群中STH的流行情况。本研究还报告了旨在减少县级人群中STH传播和蠕虫负担的STH综合防控干预措施。干预策略包括群体药物治疗(MDA)、健康教育、改善饮用水供应、改善卫生设施以及在贵溪市进行环境改造。江西省STH的总体感染率从1989年的77.7%降至2014年的6.3%,而蛔虫、钩虫和鞭虫分别从1989年的71.1%、17.6%和17.0%降至2014年的0.9%、4.7%和1.0%。在这三次调查中,女性人群的STH感染率均高于男性。所有年龄组的STH流行率均有所下降,但年龄较大组的下降幅度较小。贵溪干预地区的STH流行率从2006年的31.8%显著降至2009年的6.1%(χ=255.22,P<0.01)。蛔虫、钩虫和鞭虫的感染率分别从2006年的10.4%、17.0%和7.1%降至2009年的0.1%、4.1%和2.2%(X = 110.23,P<0.01;X = 103.57,P < 0.01;X = 32.0,P < 0.01)。蛔虫感染率在所有STH中下降幅度最大。通过综合防控干预策略进行防控后,1989年至2014年期间江西省的STH流行率呈现出显著下降趋势。因此,通过持续的综合防控策略巩固防控成果对于中国实现消除STH至关重要。

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