CAJ | 학술논문

目的：了解四川和贵州省贫困地区儿童土源性线虫感染情况及其主要影响因素，为制定土源性线虫病防治策略提供依据。方法采用分层随机抽样，选择贵州和四川两省6个贫困县的95个行政村及46所小学为调查点，每个样本村各选择11名3～5岁学龄前儿童及8～10岁就读于样本学校的儿童作为调查对象，收集其粪便，采用改良加藤厚涂片法进行检查。同时对各村村医和村干部进行问卷调查，了解该村2009年儿童驱虫情况及社会经济和卫生状况；采用Tobit估计多元统计方法分析儿童土源性线虫感染的影响因素。结果两省共粪检1707名儿童，贵州省样本村儿童土源性线虫感染率为46.1%，蛔虫、钩虫、鞭虫感染率分别为31.1%、4.1%、10.8%；四川省样本村儿童土源性线虫感染率为9.8%，上述3种寄生虫感染率分别为3.6%、3.5%、2.7%。两省共粪检890名学龄儿童，贵州省样本学校儿童土源性线虫和蛔虫、钩虫、鞭虫感染率分别为53.8%、32.7%、6.6%、14.4%，四川省分别为7.3%、2.2%、2.9%、2.2%。Tobit估计分析显示，儿童驱虫治疗和村水田比例是儿童土源性线虫感染的影响因素（P均<0.05）。结论我国西南贫困地区儿童土源性线虫感染率仍然较高。为有效降低贫困地区儿童的土源性线虫感染率，除构建长效驱虫工作机制和采取改水、改厕等措施外，还应加强健康教育，并将驱虫防治纳入新型农村合作医疗体系。
목적：료해사천화귀주성빈곤지구인동토원성선충감염정황급기주요영향인소，위제정토원성선충병방치책략제공의거。방법채용분층수궤추양，선택귀주화사천량성6개빈곤현적95개행정촌급46소소학위조사점，매개양본촌각선택11명3～5세학령전인동급8～10세취독우양본학교적인동작위조사대상，수집기분편，채용개량가등후도편법진행검사。동시대각촌촌의화촌간부진행문권조사，료해해촌2009년인동구충정황급사회경제화위생상황；채용Tobit고계다원통계방법분석인동토원성선충감염적영향인소。결과량성공분검1707명인동，귀주성양본촌인동토원성선충감염솔위46.1%，회충、구충、편충감염솔분별위31.1%、4.1%、10.8%；사천성양본촌인동토원성선충감염솔위9.8%，상술3충기생충감염솔분별위3.6%、3.5%、2.7%。량성공분검890명학령인동，귀주성양본학교인동토원성선충화회충、구충、편충감염솔분별위53.8%、32.7%、6.6%、14.4%，사천성분별위7.3%、2.2%、2.9%、2.2%。Tobit고계분석현시，인동구충치료화촌수전비례시인동토원성선충감염적영향인소（P균<0.05）。결론아국서남빈곤지구인동토원성선충감염솔잉연교고。위유효강저빈곤지구인동적토원성선충감염솔，제구건장효구충공작궤제화채취개수、개측등조시외，환응가강건강교육，병장구충방치납입신형농촌합작의료체계。
Objective To understand the infection status and the main risk factors of soil-transmitted nematodes in children in the poverty-stricken areas of Guizhou Province and Sichuan Province,so as to provide the evidences for making suitable control strategies in these areas. Methods A total of 95 villages and 6 primary schools in 6 poor counties in the two provinces were select-ed as investigation sites according to the stratified random sampling method. Eleven preschool children aged 3-5 years in each sam-ple village and 11 school children aged 8-10 years in each sample school were chose as investigation objectives,their feces were collected and examined by Kato-Katz technique. In addition,the village doctor and cadres in each village were investigated by a standardized questionnaire to understand the deworming condition of children and the social economy and sanitary status in 2009. Then the correlation between average soil-transmitted nematode infection rate and its influencing factors was analyzed by the Tobit model. Results A total of 1 707 children from 95 villages in the two provinces were examined. In Guizhou Province,the total in-fection rate of soil-transmitted nematodes in children was 46.1%,and the infection rates of Ascaris lumbricoides,Hookworm,and Trichuris trichiura were 31.1%,4.1% and 10.8% respectively,and the corresponding rates in Sichuan Provinces were 9.8%, 3.6%,3.5%,2.7%,respectively. In the dimension of school,a total of 890 school-aged kids from 46 schools in the two provinces were examined,the infection rates of soil-transmitted nematodes,Ascaris lumbricoides,Hookworm,and Trichuris trichiura in Guizhou Province were 53.8%,32.7%,6.6% and 14.4%,respectively,and the corresponding rates in Sichuan Province were 7.3%,2.2%,2.9% and 2.2%,respectively. The results from Tobit analysis indicated that the proportion of children accepted deworming treatment and the paddy field in the cultivated area were statistically correlated to the infections of soil-transmitted nematodes and Ascaris lumbricoides(all P < 0.05). Conclusions The soil-transmitted nematode infection rates of children are still at a high level in poor areas of southwest China. In order to decrease the infection rates,besides the long-term deworming, water supply and sanitary improvement,and the health education should be strengthened,and the treatment of soil-transmitted nematodes should be covered by the New Rural Cooperative Medical System.