National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China.
School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, Shanghai, China.
PLoS Negl Trop Dis. 2022 Jun 9;16(6):e0010405. doi: 10.1371/journal.pntd.0010405. eCollection 2022 Jun.
Hookworm disease is endemic in China and is widespread globally. The disease burden to humans is great.
The study described the national surveillance of hookworm implemented in 31 provinces/autonomous regions/municipalities (P/A/Ms) of China in 2019. Each P/A/M determined the number and location of surveillance spots (counties). A unified sampling method was employed, and at least 1000 subjects were investigated in each surveillance spot. The modified Kato-Katz thick smear method was employed for stool examination. Fifty samples positive with hookworm eggs were cultured in each surveillance spot to discriminate species between A. duodenale and N. americanus. Twenty-five soil samples were collected from each surveillance spot and examined for hookworm larva. The 2019 surveillance results were analyzed and compared with that of 2016-2018.
A total of 424766 subjects were investigated in 31 P/A/Ms of China in 2019, and the overall hookworm infection rate was 0.85% (3580/424766). The weighted infection and standard infection rates were 0.66% (4288357/648063870) and 0.67% (4343844/648063870), respectively. Sichuan province had the highest standard infection rate (4.75%) in 2019, followed by Chongqing (2.54%) and Hainan (2.44%). The standard infection rates of other P/A/Ms were all below 1%, with no hookworm detected in 15 P/A/Ms. The standard hookworm infection rate in the males and the females were 0.61% (2021216/330728900) and 0.71% (2267141/317334970), respectively, with a significant difference between different genders ([Formula: see text] = 17.23, P<0.0001). The highest standard hookworm infection rate (1.97%) was among age ≥ 60 years, followed by 4559 years (0.77%), 1544 years (0.37%), and 714 years (0.20%). The lowest standard infection rate was among the 06 years age group (0.12%). A significant difference was observed among different age groups ([Formula: see text] = 2 305.17, P<0.0001). The constitute ratio for N. americanus, A. duodenale, and coinfection was 78.70% (1341/1704), 2.03% (346/1704), and 1.00% (17/1704), respectively. The detection rate of hookworm larva from soil was 3.45% (71/2056).
The national surveillance showed that the hookworm infection rate has been decreasing annually from 2016 to 2019, and it is now below 1%. China has made significant progress in controlling hookworm. The national surveillance system is an important way to understand the endemic status and provide important information in this process and thus needs to be continually optimized.
钩虫病在中国流行，在全球广泛分布。对人类的疾病负担很大。
本文描述了 2019 年中国 31 个省、自治区、直辖市（P/A/Ms）实施的钩虫病国家监测情况。每个 P/A/M 确定了监测点（县）的数量和位置。采用统一的抽样方法，每个监测点调查至少 1000 人。采用改良加藤厚涂片法进行粪便检查。在每个监测点，将 50 份钩虫卵阳性的样本进行培养，以区分十二指肠钩虫和美洲板口线虫的种。从每个监测点采集 25 份土壤样本进行钩蚴检查。对 2019 年的监测结果进行了分析，并与 2016-2018 年的监测结果进行了比较。
2019 年，中国 31 个 P/A/M 共调查 424766 人，钩虫总感染率为 0.85%（3580/424766）。加权感染率和标准感染率分别为 0.66%（4288357/648063870）和 0.67%（4343844/648063870）。2019 年四川省标准感染率最高（4.75%），其次是重庆市（2.54%）和海南省（2.44%）。其他 P/A/M 的标准感染率均低于 1%，有 15 个 P/A/M 未检出钩虫。男性和女性的标准钩虫感染率分别为 0.61%（2021216/330728900）和 0.71%（2267141/317334970），性别间差异有统计学意义（[Formula: see text]=17.23，P<0.0001）。最高标准钩虫感染率（1.97%）见于年龄≥60 岁人群，其次为 4559 岁（0.77%）、1544 岁（0.37%）和 714 岁（0.20%）。06 岁年龄组的标准感染率最低（0.12%）。不同年龄组间差异有统计学意义（[Formula: see text]=2305.17，P<0.0001）。美洲板口线虫、十二指肠钩虫和混合感染的构成比分别为 78.70%（1341/1704）、2.03%（346/1704）和 1.00%（17/1704）。土壤钩蚴检出率为 3.45%（71/2056）。
全国监测显示，2016 年至 2019 年，钩虫感染率呈逐年下降趋势，现已降至 1%以下。中国在控制钩虫病方面取得了显著进展。全国监测系统是了解流行状况的重要途径，并在此过程中提供重要信息，因此需要不断优化。
