Ross A G, Sleigh A C, Yuesheng L, Williams G M, Waine G J, Forsyth S J, Yi L, Hartel G F, McManus D P
Tropical Health Program, Australian Centre for International and Tropical Health and Nutrition, The University of Queensland and The Queensland Institute of Medical Research, Herston, Brisbane.
Acta Trop. 1998 Nov 30;71(3):229-36. doi: 10.1016/s0001-706x(98)00062-x.
In this study we examine the pathways to schistosomiasis exposure and infection among residents residing on two islands (large, Qingshan; small, Niangashan) in the Dongting Lake region (Hunan province) of China. An exposure model, based on activity diaries, was used to quantify an individual's square-metre-minute (sq.m.min) daily water contact. Subjects living on the small island had a significantly higher (P=0.0002) degree of exposure (mean+/-S.D., 13.2+/-11.0 sq.m.min) than individuals dwelling on the large island (mean+/-S.D., 5.5+/-7.1 sq.m.min). Participants identified as stool egg positive (mean+/-S.D., 8.3+/-10.4 sq.m.min) had higher exposures than for those never treated (mean+/-S.D., 2.2+/-3.4 sq.m.min) for schistosomiasis, and these high exposures rose steadily to peak at 35-49 years of age and decline after age 50. This exposure pattern differs markedly from those reported for African or South American schistosomiasis. The majority of human water contact occurs on the lake. Egg-positive subjects reported significantly higher (P < 0.05) episodes of water contact on the lake versus their egg-negative counterparts, who reported significantly higher (P < 0.01) exposure at the aquaculture ponds. The results of path analysis revealed that sex, age, island of residence and whether a fisherman or not were the most highly significant independent predictors of lake exposure. This accounted for approximately 40% (R2=0.39) of the total lake exposure. Exposure to lake water was a strong predictor (P=0.0006) of past infection and a modest predictor (P=0.05) of current infection.
在本研究中，我们调查了中国湖南省洞庭湖地区两个岛屿（大岛青山岛、小岛钱粮湖镇）居民接触和感染血吸虫病的途径。基于活动日记建立了一个接触模型，用于量化个人每日每平方米分钟（sq.m.min）的水接触量。居住在小岛上的居民接触程度（均值±标准差，13.2±11.0 sq.m.min）显著高于居住在大岛上的居民（均值±标准差，5.5±7.1 sq.m.min）（P = 0.0002）。被确定为粪便虫卵阳性的参与者（均值±标准差，8.3±10.4 sq.m.min）接触程度高于从未接受过血吸虫病治疗的参与者（均值±标准差，2.2±3.4 sq.m.min），这些高接触程度在35 - 49岁时稳步上升至峰值，50岁后下降。这种接触模式与非洲或南美洲血吸虫病的报道明显不同。大多数人与湖水接触。虫卵阳性受试者报告在湖中接触水的次数显著高于虫卵阴性受试者（P < 0.05），而虫卵阴性受试者报告在水产养殖池塘的接触程度显著更高（P < 0.01）。路径分析结果显示，性别、年龄、居住岛屿以及是否为渔民是湖水接触的最重要独立预测因素。这占湖水总接触量的约40%（R2 = 0.39）。接触湖水是过去感染的有力预测因素（P = 0.0006），也是当前感染的适度预测因素（P = 0.05）。
