administrators, teachers, students, and people with low educational level.
The investigation results appropriately reflected the current status of echinococcosis epidemic in Sichuan Province. Basing on the results, there were still about 10,000 patients out there who had not been found yet. The detection of echinococcosis patients must be strengthened, and the efficiency and the ranges of the screening must be enhanced. According to the results, the endemic intensity of echinococcosis was severer in the west than the east, severer in the high altitude regions than the low altitude regions, severer in the plateau than the basin. We suggest to target the 12 heavy epidemic towns mentioned above as the key of the prevention and treatment work of echinococcosis in future, and give priority to where have a higher severity of endemic intensity.
2. Prevalence and infection in children. The prevalence of echinococcosis in children aged 6-12 years was 0.13%, of which Ganzi was 0.24%. The prevalence of children in Shiqu (0.85%), Baiyu (0.79%), and Seda (0.37%) were the top 3 in the 35 towns. The seropositive rate in children aged 6-12 years was 1.95%, of which Aba, Ya’an, Ganzi, and Liangshan were 3.40%, 1.21%, 0.66%, and 0.56% respectively. The seropositive rates of Ruo’ergai (7.80%), Lixian (5.81%), and Jiuzaigou (5.38%) were the highest in all the 35 towns. Seda, Shiqu, Xiangcheng and other 4 towns under Ganzi did not take any serum samples, or take only less than 10.
Since the endemic regions of echinococcosis in Sichuan Province are the ethnic minority areas, a strong religious atmosphere is prevailing in the districts. The majority of the local inhabitants have a strong feeling of resistance about taking serum samples, especially from children. It’s extremely hard for some of the towns to work with the serology tests. In this survey, 7 towns from Ganzi, especially some of the heavy epidemic towns such as Shiqu and Seda, did not have the serology tests, or only take less than 10 serum samples. Therefore, the seropositive rate in children aged 6-12 years in Ganzi was low.
3. Infection in dogs. The positive rate of copro-antigen test for dogs was 2.96%. Aba had the highest positive rate of 6.61%, and Liangshan, Ganzi, Ya’an were 0.94%, 0.87%, 0%, respectively. The top 9 towns of the positive rates were all from Aba, including Hongyuan 15.63%, Rangtang 11.56%, Songpan 9.38%, Wenchuan 9.38%, Jinchuan 7.5%, Maoxian 7.19%, Lixian 5.94%, Ruo’ergai 4.69%, and Aba 4.38%. Batang, Baoxing, Jiulong, Luohuo, Tianquan, and Xiangcheng did not find any positive results of copro-antigen test.
Due to the obviously ups and downs of the positive rate in different months in the endemic areas, the results of copro-antigen test for dogs in this survey are more likely to represent the level of infection in the month that the survey was conducted, and cannot be used to indicate the average level of the dogs’ infection for a whole year, yet.
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4. Prevalence in sheep (cattle). 17,550 domestic animals were examined, and 775 of them were found suffered from echinococcosis. The prevalence was 4.42%. Ganzi had the highest prevalence up to 7.13%, and the prevalence in Aba and Ya’an were 2.30% and 0.08%, respectively. Liangshan did not find any domestic animals with echinococcosis. The prevalence of domestic animals in Shiqu was 51.4%, and it was the highest in all the 35 towns. And then Xinlong 15.75%, Ganzi 13.40%. 14 towns such as Daocheng, Heishui, Jinchuan, Jiulong, did not find any domestic animals with echinococcosis.
In the survey areas, there were 8.56 sheep and 16.93 cows per family. Some of the towns had a extremely high prevalence of echinococcosis in domestic animals. Management on livestock slaughter must be strengthened, and harmless treatment of sick animals’ organs must be appropriately accomplished.
5. Infection in small mammals. The infection rate in Ganzi and Aba was 2.42%. Aba examined 2000 rodents (unclassified), and none of them were found infected. Shiqu and Seda were the only 2 towns under Ganzi that found infected small mammals, which indicated that the transmission of echinococcosis in the 2 towns was highly active.
6. Knowledge and behaviors about prevention and treatment of echinococcosis. A total of 26,365 questionnaires were issued, and 19,510 of them were eligible. The eligible rate of the questionnaires was 74.00%. The eligible rates in Ya’an, Aba, Ganzi, and Liangshan were respectively 85.75%, 80.61%, 69.72%, and 54.37%. Jinchuan’s eligible rate, which up to 99.47%, was the highest in all 35 towns, followed by Maoxian, Rangtang, Songpan, Ma’erkang, and Baoxing, the eligible rates of which were 98.46%, 98.10%, 94.20%, 93.10%, and 90.34% respectively. The 6 towns above had the highest eligible rates which all over than 90%. The 3 lowest eligible rates in all 35 towns came from Yajiang (38.97%), Daofu (42.26%), and Muli (48.22%). The eligible rates of the 3 towns were all under 50%.
Health education about prevention and treatment of echinococcosis must be further strengthened. Highly individualized health education shall be carried out, especially for the key populations such as the females, children, the religionists, and the herdsman, thus popularizing the knowledge about echinococcosis and promoting the awareness of the knowledge and behaviors about prevention and treatment of echinococcosis.
Conclusion: The epidemic statue of echinococcosis in Sichuan Province is very grave. The endemic areas of echinococcosis are Tibetan regions of western Sichuan, with a vast territory, extremely harsh conditions, and a strong religious atmosphere. The prevention and control of echinococcosis is very hard. We suggest to make greater efforts to find, report, manage, and treat patients to get an early detection, diagnosis and treatment. In order to decrease the risk of echiococcosis transmission, the routine
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de-worming practice for domestic dogs in rural areas and vaccination of livestock must be done appropriately, quarantine of animals and animal products shall be kept under strict supervision, and prevention and control of rodent damage ought to be done in the right way. Health education must be strengthened to improve the level of knowledge and behaviors of humans, and to prevent the disease enter through mouth.
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目 录
第一部分 调查计划和实施细则 ....................................................................... 1
1.调查范围 ............................................................................................................................................ 3 2.调查对象和抽样 ................................................................................................................................ 3 3.调查内容与方法 ................................................................................................................................ 4 4数据整理与分析 ................................................................................................................................ 5 5质量控制 ............................................................................................................................................ 6
第二部分 调查结果 ........................................................................................... 7
1.调查地区基本情况 ............................................................................................................................ 9 2.人群患病情况 .................................................................................................................................. 11
2.1地区分布 ............................................................................................................................... 11 2.2人群分布 ............................................................................................................................... 14 2.3流行影响因素分析 ............................................................................................................... 18 3.儿童感染和患病情况 ...................................................................................................................... 19 4.犬感染情况 ...................................................................................................................................... 22
4.1养犬情况 ............................................................................................................................... 22 4.2犬感染率 ............................................................................................................................... 22 5.羊（牛）患病情况 .......................................................................................................................... 23
5.1羊（牛）饲养及宰杀情况 ................................................................................................... 23 5.2羊（牛）患病率 ................................................................................................................... 27 6.小型哺乳类动物感染情况 .............................................................................................................. 27 7.防治知识和行为问卷应答情况 ...................................................................................................... 28
第三部分 小结与讨论 ..................................................................................... 31
1.人群包虫病流行现状 ...................................................................................................................... 33
1.1流行概况与特征 ................................................................................................................... 33 1.2流行影响因素 ....................................................................................................................... 33 2.儿童感染和患病情况 ...................................................................................................................... 34 3.犬感染情况 ...................................................................................................................................... 35
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4.羊（牛）患病情况 .......................................................................................................................... 35 5.小型哺乳类动物患病情况 .............................................................................................................. 36 6.包虫病防治知识和行为情况 .......................................................................................................... 36
第四部分 建议 ................................................................................................. 37 第五部分 调查统计表 ..................................................................................... 41
表5-1 人群调查对象一般人口学特征 ........................................................................................... 43 表5-2 儿童调查对象一般人口学特征 ........................................................................................... 45 表5-3 问卷应答对象一般人口学特征 ........................................................................................... 46 表5-4 35个流行县人群包虫病检出率及推算患病率 .................................................................. 47 表5-5 各调查村人群包虫病检出率 ............................................................................................... 48 表5-6 不同特征人群包虫病检出率 ............................................................................................... 81 表5-7 包虫病流行可能影响因素的变量赋值 ............................................................................... 83 表5-8 35个流行县儿童包虫病患病率和血清学阳性率 .............................................................. 84 表5-9 不同特征儿童包虫病患病率和血清学阳性率 ................................................................... 85 表5-10 35个流行县调查户犬饲养情况 ........................................................................................ 86 表5-11 各调查村调查户犬饲养情况 ............................................................................................. 87 表5-12 35个流行县犬感染率 ...................................................................................................... 118 表5-13 各调查村犬感染率 ........................................................................................................... 119 表5-14 35个流行县调查户羊（牛）饲养和宰杀情况 .............................................................. 151 表5-15 各调查村调查户羊（牛）饲养和宰杀情况 ................................................................... 152 表5-16 35个流行县羊（牛）患病率 .......................................................................................... 185 表5-17 各调查村羊（牛）患病率 ............................................................................................... 188 表5-18 7个调查县小型哺乳类动物感染率 ................................................................................ 234 表5-19 各调查村小型哺乳类动物感染率 ................................................................................... 235 表5-20 35个流行县问卷应答合格率 .......................................................................................... 244 表5-21 各调查村问卷应答合格率 ............................................................................................... 245
第六部分 附录 ............................................................................................... 279
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