摘要目的 了解浙江南部(简称浙南)山区钩虫高感染率地区感染者的人口学特征及临床表现,调查其感染的危险因素,为制定钩虫感染防控措施提供依据.方法 2018年,根据浙江省上一年的土源性线虫监测结果,在浙南山区青田县抽取3个钩虫感染者相对较多的村为调查点,每个调查点抽取10例以上钩虫感染者为调查对象.采用浙江省疾病预防控制中心传染病防制所自行设计的个案调查表对所有调查者进行面对面问卷调查,收集感染者及其家庭一般情况、既往诊断史、临床症状及感染危险因素等信息.采集感染者便样,经改良加藤厚涂片法检测其感染情况,评价上一年药物驱虫效果.结果 共调查钩虫感染者33例,其中男性18例、女性15例;年龄范围为33～85岁,主要集中在60～ 79岁,共23例(69.7％).曾被诊断为钩虫病的有10例(30.3％);发生过钩蚴性皮炎类似症状的有19例(57.6％);近3年出现消化道症状的有12例(36.4％).每年在田地劳作时间超过1个月的有31例(93.9％),家中直接采用新鲜粪便施肥的有18例(54.5％),习惯赤脚在田地劳作的有6例(18.2％),习惯穿拖鞋在田地劳作的有30例(90.9％).共复检了32例感染者的便样,钩虫卵仍阳性的有4例(12.5％).结论 采用新鲜粪便施肥、赤脚或穿拖鞋在田地劳作是钩虫感染可能的危险因素,单纯采取一轮药物驱虫尚不能完全消除人群感染状态.建议继续实施控制传染源、粪便无害化处理,同时开展个人行为干预与环境卫生整治相结合的综合性防控措施.

abstractsObjective To understand the demographic characteristics and clinical features of hookworm infectors in high infection area in South Mountain area of Zhejiang Province,and to find the risk factors of infection,so as to provide the evidence for formulating prevention and control measures.Methods In 2018,according to the soil-borne nematode monitoring results of the previous year in Zhejiang Province,three villages with relatively more hookworm infections were selected from Qingtian County in South Mountain area of Zhejiang Province,and more than 10 cases of hookworm infection were selected from each survey site.A face to face questionnaire survey was conducted by all investigators using a questionnaire designed by the Center for Infectious Disease Control and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,and information on the general condition,past diagnosis history,clinical symptoms and risk factors of infection of infected persons were collected.The stool samples were collected and tested for infection by modified Kato-Katz method to evaluate the drug deworming effect in the previous year.Results A total of 33 cases of hookworm infection were investigated,including 18 males and 15 females;the age ranged from 33-85 years old,mainly concentrated in 60-79 years old,a total of 23 cases (69.7％).Ten cases (30.3％) had been diagnosed with hookworm disease;19 cases (57.6％) had similar symptoms of hooky dermatitis;and 12 cases (36.4％) had gastrointestinal symptoms in the past three years.There were 31 cases (93.9％) worked in the field for more than one month each year,18 cases (54.5％) used fresh manure directly at home,6 cases (18.2％) were used to working barefoot in the field,and 30 cases (90.9％) used to wearing slippers in the field.A total of 32 eligible stool samples were examined,and 4 case (12.5％) were still positive for hookworm eggs.Conclusions Among the infectors,fertilizing with fresh stool,working barefoot or wearing slippers in the field may serve as the risk factors.There is a certain failure proportion to eliminate the infection status when adopting only one round anthelminthic treatment.For prevention and control hookworm infections,comprehensive intervention measures including infection source management,harmless treatment of stools,individual behavior intervention and environment improvement are suggested.