Feng Yan, Yu Kegen, Chen Hualiang, Zhang Xuan, Lu Qiaoyi, Wang Xiaoxiao, Zhang Xueying, Yao Linong, Ruan Wei
Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China.
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NewYork, 10029, USA.
BMC Infect Dis. 2021 Nov 27;21(1):1195. doi: 10.1186/s12879-021-06879-x.
Extensive parasitic diseases epidemiology in Zhejiang province has not been carried out since the second national survey in 2004. Therefore, dynamics in prevalence and infection pattern of the major intestinal parasites should be explored.
The distribution of three parasites including soil-transmitted helminths (STH), intestinal protozoa and C. sinensis in Zhejiang from 2014 to 2015 were explored. Kato-Katz technique was used for STH and C. sinensis detection, whereas transparent adhesive paper anal swab was used for pinworm detection, and iodine smear was used for protozoa detection. A questionnaire survey on alimentary habits and sanitary behaviors was conducted in half of the studied counties.
This study recruited 23,552 participants: 19,935 from rural and 3617 from urban area. Overall prevalence of intestinal helminth infections was 1.80%. In this study, seven helminth species were identified including A. duodenale, N. americanus, Trichuris trichiura, Ascaris lumbricoides, C. sinensis, Fasciolopsis buski and pinworm. The average prevalence of STH infection was 1.71%: 1.94% in rural and 0.44% in urban area. Hookworm was the most prevalent infection at 1.58%: 1.79% in rural and 0.44% in urban area. Prevalence varied considerably in the studied counties. Prevalence was highest in Yongkang county at 10.25%. Only 2.79% of children from rural area were infected with pinworm. A proportion of 0.40% of rural participants were infected with protozoa, whereas Endolimax nana was the most prevalent at 0.23%. C. sinensis showed infection only in one man. Awareness on C. sinensis was 24.47% in rural and 45.96% in urban area, respectively.
Prevalence of STH and protozoa infections declined considerably whereas C. sinensis infections remained few in Zhejiang province compared with the prevalence reported in previous large scale surveys (19.56% for national STH infection in 2004, 18.66% and 4.57% for provincial STH and protozoa infection, respectively in 1999). The findings of this study showed that hookworm, mainly N. americanus remained a parasitic threat to population health, mainly in the central and western Zhejiang. Therefore, more health education regarding fertilization and farming habits is necessary in rural areas. The awareness concerning hookworm infection should be reinforced.
自2004年第二次全国调查以来，浙江省尚未开展广泛的寄生虫病流行病学调查。因此，应探索主要肠道寄生虫的流行率和感染模式的动态变化。
探讨2014年至2015年浙江省三种寄生虫的分布情况，包括土源性蠕虫（STH）、肠道原生动物和华支睾吸虫。采用Kato-Katz技术检测STH和华支睾吸虫，透明胶纸肛门拭子法检测蛲虫，碘涂片法检测原生动物。在一半的研究县进行了关于饮食习惯和卫生行为的问卷调查。
本研究共招募23552名参与者，其中农村19935名，城市3617名。肠道蠕虫感染的总体患病率为1.80%。本研究共鉴定出七种蠕虫，包括十二指肠钩虫、美洲板口线虫、鞭虫、蛔虫、华支睾吸虫、布氏姜片吸虫和蛲虫。STH感染的平均患病率为1.71%，农村为1.94%，城市为0.44%。钩虫感染最为普遍，患病率为1.58%，农村为1.79%，城市为0.44%。在所研究的县中，患病率差异很大。永康县患病率最高，为10.25%。农村地区只有2.79%的儿童感染蛲虫。0.40%的农村参与者感染原生动物，其中微小内蜒阿米巴最为普遍，为0.23%。华支睾吸虫仅在一名男性中发现感染。农村和城市地区对华支睾吸虫的知晓率分别为24.47%和45.96%。
与以往大规模调查报道的患病率相比（2004年全国STH感染率为19.56%，1999年浙江省STH和原生动物感染率分别为18.66%和4.57%），浙江省STH和原生动物感染率大幅下降，而华支睾吸虫感染仍较少。本研究结果表明，主要为美洲板口线虫的钩虫仍然对人群健康构成寄生虫威胁，主要集中在浙江中西部地区。因此，农村地区有必要加强关于施肥和耕作习惯的健康教育。应加强对钩虫感染的认识。
