Li Zhongjie, Xin Hualei, Qian Men-Bao, Sun Junling, Yang Yichao, Chen Yingdan, Yu Jianxing, Chen Yu, Huang Zhuoxin, Hay Simon I, Jiang Zhihua, Li Shi-Zhu
Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
J Infect Dis. 2022 Feb 1;225(3):481-491. doi: 10.1093/infdis/jiab403.
To understand Clonorchis sinensis reinfection and the determinants of reinfection in endemic areas is important in establishment of control measures.
A prospective cohort study was implemented in Hengxian County, Guangxi, China. Individuals with C. sinensis infection were completely treated, and those cured were enrolled as study subjects and followed up for 3, 6, and 12 months. The reinfection frequency and incidence were calculated, and a multivariable Cox proportional hazard model was constructed to capture reinfection determinants.
Among 635 enrolled subjects, 436 (68.7%) completed follow-up. Of these, 177 (40.6%) were reinfected; 133 (75.1%) were reinfected once, 41 (23.2%) twice, and 3 (1.7%) three times. The incidence of reinfection was 64.0 per 100 person-years. Men (adjusted hazard ratio [aHR], 1.67; 95% confidence interval [CI], 1.14-2.44), those with underlying diseases (aHR, 1.41; 95% CI, 1.02-1.95), and those with moderate- or heavy-intensity infections (aHR, 1.45; 95% CI, 1.14-1.85) had increasing reinfection probabilities.
C. sinensis reinfection is high in endemic areas. Men and high-intensity infection are important determinants of reinfection. Repeated chemotherapy is necessary to control reinfection and its associated morbidities, especially in high-risk individuals. In addition, behavioral education is advised to decrease overall reinfection in endemic areas.
了解华支睾吸虫病流行地区的再感染情况及其再感染的决定因素对于制定控制措施很重要。
在中国广西横县开展了一项前瞻性队列研究。对华支睾吸虫感染个体进行了彻底治疗，治愈者被纳入研究对象并随访3、6和12个月。计算再感染频率和发病率，并构建多变量Cox比例风险模型以确定再感染的决定因素。
在635名登记的研究对象中，436名（68.7%）完成了随访。其中，177名（40.6%）发生了再感染；133名（75.1%）再感染一次，41名（23.2%）再感染两次，3名（1.7%）再感染三次。再感染发病率为每100人年64.0例。男性（调整后风险比[aHR]，1.67；95%置信区间[CI]，1.14 - 2.44）、患有基础疾病者（aHR，1.41；95%CI，1.02 - 1.95）以及中度或重度感染者（aHR，1.45；95%CI，1.14 - 1.85）再感染概率增加。
华支睾吸虫病流行地区的再感染率很高。男性和高强度感染是再感染的重要决定因素。有必要进行重复化疗以控制再感染及其相关疾病，特别是在高危个体中。此外，建议开展行为教育以降低流行地区的总体再感染率。
