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中国人体旋毛虫病的流行现状。

Current epidemic situation of human toxocariasis in China.

机构信息

Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.

Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.

出版信息

Adv Parasitol. 2020;109:433-448. doi: 10.1016/bs.apar.2020.01.016. Epub 2020 Feb 5.

Abstract

Toxocariasis is a worldwide-distributed helminthic zoonosis, which mainly results from ascarid nematodes Toxocara canis and Toxocara cati. Humans become infected by accidental ingestion of infective eggs, raw or undercooked meat containing larvae. Keeping and contacting cats and dogs, and bad hygiene situations or habits are the main risk factors for Toxocara infection in China. The seroprevalence of Toxocara spp. is reported from 12.14% to 44.83%, and the overall seroprevalence in children was 12.14% in 1993 and elevated to 19.3% in 2015. Among the 103 cases reported in China during 1983-2019, ocular larva migrans (OLM), visceral larva migrans (VLM), and neural larva migrans (NLM) occupied 92.23%, 6.80%, and 0.97% of cases, respectively. The diagnosis of toxocariasis is mainly based on the history of exposure to infective eggs or larvae, clinical manifestations, laboratory examinations, and imaging studies. As most individuals who are infected with larval Toxocara, are unaware of their infections, patients with mild signs as described under covert toxocariasis (CT) can recover spontaneously, and treatment may not be necessary. Albendazole is the preferred treatment for patients with VLM; steroids, such as prednisolone combined with albendazole, are frequently used in treating patients with OLM, and surgery serves as an alternative treatment; thiabendazole is effective in treating patients with NLM. The true number of cases and prevalence of toxocariasis in China seems to be underestimated and neglected because of the lack of population-based epidemiological studies and insufficient clinical awareness of this disease, which are aspects that need to be improved by the Chinese government.

摘要

旋毛虫病是一种分布于全世界的寄生虫病,主要由犬弓首蛔虫和猫弓首蛔虫引起。人类通过意外摄入感染性虫卵、含有幼虫的生肉或未煮熟的肉而感染。饲养和接触猫和狗、不良的卫生条件或习惯是中国感染旋毛虫的主要危险因素。在中国,报道的旋毛虫血清流行率为 12.14%至 44.83%,1993 年儿童的总血清流行率为 12.14%,2015 年上升至 19.3%。在 1983 年至 2019 年期间中国报告的 103 例病例中,眼幼虫移行症(OLM)、内脏幼虫移行症(VLM)和神经幼虫移行症(NLM)分别占 92.23%、6.80%和 0.97%。旋毛虫病的诊断主要基于暴露于感染性虫卵或幼虫的病史、临床表现、实验室检查和影像学研究。由于大多数感染幼虫的旋毛虫的人并不知道自己的感染,描述为隐匿性旋毛虫病(CT)的轻症患者可自行恢复,可能不需要治疗。阿苯达唑是 VLM 患者的首选治疗药物;泼尼松龙联合阿苯达唑常用于治疗 OLM 患者,手术作为替代治疗;噻苯达唑对 NLM 患者有效。由于缺乏基于人群的流行病学研究和对该病的临床认识不足,中国的病例数和旋毛虫病的流行率似乎被低估和忽视,这是中国政府需要改进的方面。

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