摘要目的 了解甘肃省甘南藏族自治州(简称甘南州)包虫病流行现状,掌握人群、家畜和终宿主犬的患病情况,评价预防控制措施效果.方法 ①人群调查:2012年,根据《甘肃省包虫病流行情况调查项目技术方案》要求,在甘南州各个县(市),以行政村为单位,按牧区、半农半牧区、农区和城镇进行分层整群抽样,按各层人口数占全县(市)人口数的比例确定调查人数和调查村数,每个县(市)共抽取16个村,每村抽取200人(人数不足时从邻近村补足),通过B超法检测肝脏开展普查.②儿童血清调查:每个县(市)按牧区、半农牧区、农区和城镇分层,各抽取1所小学,以12岁以下儿童作为观察对象,采用B超法检查肝脏,并采用酶联免疫吸附试验(ELISA)检测儿童血清棘球蚴抗体.③传染源监测:在人群调查选中的村,每村抽取20个养犬户,采集犬粪,应用双抗体夹心ELISA法检测犬棘球绦虫抗原.④中间宿主监测:每个县(市)选取1 000只羊(或500头牛),解剖法检测包虫病.⑤健康教育调查:对居民进行包虫病防治知识的健康教育,并在教育前后以问卷调查形式进行包虫病防治知识和行为知晓情况调查.结果 包虫病人群检出率为0.10％(29/28 960),牧民检出率为0.13％(17/13 015),农民检出率为0.06％(8/12 780),12岁以下儿童感染率为2.64％(336/12 728),犬的感染率为3.90％(117/3 001),家畜感染率为1.72％(121/7027),其中牛、羊感染率分别为2.41％(38/1 574)和1.52％(83/5453);通过健康教育,农牧民群众包虫病防治知识知晓率由40％(720/1 800)上升到70％(1 260/1 800).结论 甘南州包虫病流行范围较广,患病人群以牧民为主,农民次之,包虫病流行因素与犬接触和生活陋习密切相关;农牧民群众对包虫病防治知识知晓低,包虫病防治知识缺乏,不良的生产、生活方式在短期内难以改变,需进一步加大防治措施.

abstractsObjective To understand the epidemic situation of hydatid disease in Gansu Tibetan Autonomous Prefecture(Gannan state) Gannan Province,and prevalence of the disease in population,livestock and final host dogs,and to evaluate the effectiveness of prevention and control measures.Methods In 2012:①An investigation was carried out according to the requirements of "Technical Solutions of Hydatid Disease Prevalence,Gansu Province"; in every county(city) of Gannan Prefecture,administrative villages were selected as survey units,by stratified cluster sampling based on the semi agricultural semi pastoral areas,pastoral areas,agricultural areas and towns.According to the proportion of the population of each layer to the population of each county,the number of people and the number of villages to be surveyed were determined.Sixteen villages were selected,and 200 people were selected in each village(from a neighboring village to make up the insufficient number in case of need),and B ultrasound method was used to carry out the census.②Children serum survey:stratification was done according to pastoral areas,semi agricultural semi pastoral areas,agricultural areas and towns population in each county(city),1 primary school was selected,children less than 12 years old were examined by B Ultrasound,and serum antibodies of Echinococcus granulosus were tested by enzyme-linked immunosorbent assay(ELISA).③ Surveillance of source of infection:in the selected villages,20 kennel households were selected in each village,dog feces was collected,and canine Echinococcus antigen was detected by double antibody sandwich ELISA method.④)Monitoring of intermediate host:1 000 sheep (or 500 cattle) were selected in each county(city),and hydatid disease was examined by anatomical method.⑤Investigation of health education was done in the form of a questionnaire survey of hydatid disease prevention knowledge and behavior survey on the awareness rate.Results The prevalence rate of population was 0.10％ (29/28 960); prevalence rate of herdsmen was 0.13％ (17/13 015); farmers prevalence rate was 0.06％(8/12 780); in children under 12 years of age,the infection rate was 2.64％ (336/12 728) ; dog infection rate were 3.90％ (117/3 001) ; livestock infection rate was 1.72％ (121/7 027); and the infection rates of cattle and sheep were 2.41％(38/1 574) and 1.52％(83/5 453),respectively.The rate increased from 40％(720/1 800) to 70％(1 260/1 800) of hydatid disease prevention knowledge awareness in farmers and herdsmen after health education.Conclusions The scope of hydatid disease in Gannan Prefecture is broad; the patient population mainly is herdsmen,and farmer is second.Epidemic factors include contact canine and vices; the farmers and herdsmen have low awareness of hydatid disease prevention knowledge.Poor production and lifestyle are difficult to change in the short term,we need to further strengthen the prevention measures.