国际医学寄生虫病杂志
國際醫學寄生蟲病雜誌
국제의학기생충병잡지
INTERNATIONAL JOURNAL OF MEDICAL PARASITIC DISEASES
2014年
6期
321-327
,共7页
王骏%梁松%陈颖丹%李华忠%汤林华
王駿%樑鬆%陳穎丹%李華忠%湯林華
왕준%량송%진영단%리화충%탕림화
蛔虫%钩虫%再感染%零膨胀%负二项%倾向性
蛔蟲%鉤蟲%再感染%零膨脹%負二項%傾嚮性
회충%구충%재감염%령팽창%부이항%경향성
Ascaris lumbricoides%Hookworm%Re-infection%Zero-inflated%Negative binomial%Predisposition
目的 应用零膨胀的负二项模型探索蛔虫与钩虫再感染的模式. 方法 在四川省宜宾市翠屏区邱场乡、江西省进贤县塘南乡和湖南省岳阳县三荷乡开展现场调查,调查内容包括:基线粪检与驱虫、一个月后复查、一年后复查及问卷调查.应用零膨胀的负二项模型拟合一年后个体虫卵计数数据,考察发生再感染以及再感染强度的影响因素. 结果 共计调查对象374人.治疗前蛔虫和钩虫感染率分别为38.08％ (139/365)和39.17％ (141/360),治疗后一年时蛔虫和钩虫再感染率分别为15.89％ (58/365)和8.89％ (32/360).蛔虫模型结果显示:治疗前感染度高,则发生再感染的风险高(OR=1.94,95％CI:1.33～2.81),家用电器档次高、不喝生水都是保护因素,15～44岁组与45 ～64岁组发生再感染风险显著低于5～14岁组;治疗前感染度越高,治疗后再感染获得高感染度的风险越大(OR=1.56,95％CI:1.10～2.23),与5～14岁组相比,15～44岁组与65 ～70岁组再感染获得高感染度的风险小;不喝生水获得高感染度的风险小.钩虫模型结果显示:治疗前钩虫感染度越高,发生再感染的风险越高(OR=3.97,95％CI:2.07～7.60).居住砖瓦房相对土坯房是再感染的保护因素;与5～14岁儿童相比,其他3个年龄组钩虫再感染获得高感染度的风险均较其高,其中45～64岁风险最高;接受中学教育较文盲或半文盲获得高感染度的风险低. 结论 零膨胀的负二项模型是拟合蛔虫和钩虫虫卵计数数据的最优模型,研究证实再感染过程中倾向性现象的存在,蛔虫和钩虫再感染的发生及强度与治疗前感染度、人口学特征、社会经济条件、环境及行为等因素相关.
目的 應用零膨脹的負二項模型探索蛔蟲與鉤蟲再感染的模式. 方法 在四川省宜賓市翠屏區邱場鄉、江西省進賢縣塘南鄉和湖南省嶽暘縣三荷鄉開展現場調查,調查內容包括:基線糞檢與驅蟲、一箇月後複查、一年後複查及問捲調查.應用零膨脹的負二項模型擬閤一年後箇體蟲卵計數數據,攷察髮生再感染以及再感染彊度的影響因素. 結果 共計調查對象374人.治療前蛔蟲和鉤蟲感染率分彆為38.08％ (139/365)和39.17％ (141/360),治療後一年時蛔蟲和鉤蟲再感染率分彆為15.89％ (58/365)和8.89％ (32/360).蛔蟲模型結果顯示:治療前感染度高,則髮生再感染的風險高(OR=1.94,95％CI:1.33～2.81),傢用電器檔次高、不喝生水都是保護因素,15～44歲組與45 ～64歲組髮生再感染風險顯著低于5～14歲組;治療前感染度越高,治療後再感染穫得高感染度的風險越大(OR=1.56,95％CI:1.10～2.23),與5～14歲組相比,15～44歲組與65 ～70歲組再感染穫得高感染度的風險小;不喝生水穫得高感染度的風險小.鉤蟲模型結果顯示:治療前鉤蟲感染度越高,髮生再感染的風險越高(OR=3.97,95％CI:2.07～7.60).居住磚瓦房相對土坯房是再感染的保護因素;與5～14歲兒童相比,其他3箇年齡組鉤蟲再感染穫得高感染度的風險均較其高,其中45～64歲風險最高;接受中學教育較文盲或半文盲穫得高感染度的風險低. 結論 零膨脹的負二項模型是擬閤蛔蟲和鉤蟲蟲卵計數數據的最優模型,研究證實再感染過程中傾嚮性現象的存在,蛔蟲和鉤蟲再感染的髮生及彊度與治療前感染度、人口學特徵、社會經濟條件、環境及行為等因素相關.
목적 응용령팽창적부이항모형탐색회충여구충재감염적모식. 방법 재사천성의빈시취병구구장향、강서성진현현당남향화호남성악양현삼하향개전현장조사,조사내용포괄:기선분검여구충、일개월후복사、일년후복사급문권조사.응용령팽창적부이항모형의합일년후개체충란계수수거,고찰발생재감염이급재감염강도적영향인소. 결과 공계조사대상374인.치료전회충화구충감염솔분별위38.08％ (139/365)화39.17％ (141/360),치료후일년시회충화구충재감염솔분별위15.89％ (58/365)화8.89％ (32/360).회충모형결과현시:치료전감염도고,칙발생재감염적풍험고(OR=1.94,95％CI:1.33～2.81),가용전기당차고、불갈생수도시보호인소,15～44세조여45 ～64세조발생재감염풍험현저저우5～14세조;치료전감염도월고,치료후재감염획득고감염도적풍험월대(OR=1.56,95％CI:1.10～2.23),여5～14세조상비,15～44세조여65 ～70세조재감염획득고감염도적풍험소;불갈생수획득고감염도적풍험소.구충모형결과현시:치료전구충감염도월고,발생재감염적풍험월고(OR=3.97,95％CI:2.07～7.60).거주전와방상대토배방시재감염적보호인소;여5～14세인동상비,기타3개년령조구충재감염획득고감염도적풍험균교기고,기중45～64세풍험최고;접수중학교육교문맹혹반문맹획득고감염도적풍험저. 결론 령팽창적부이항모형시의합회충화구충충란계수수거적최우모형,연구증실재감염과정중경향성현상적존재,회충화구충재감염적발생급강도여치료전감염도、인구학특정、사회경제조건、배경급행위등인소상관.
Objective Use zero-inflated negative binomial model for modeling the pattern of Ascoris lumbricoides and hookworm re-infection.Methods Field survey was carried out in three villages:Qiuchang in Yibin City of Sichuan Province,Tangnan in Jinxian County of Jiangxi Province,and Sanhe in Yueyang County of Hunan Province.The survey consisted of baseline stool examination and treatment,re-examination after one month and one year,and questionnaire survey.Zero-inflated negative binomial model was applied to fit the egg count data collected after one year,meanwhile,the risk factors for the re-infection occurrence and intensity were evaluated.Results Totally 374 subjects were recruited in the survey after one year.The prevalences of Ascaris lumbricoides and hookworm at baseline 38.08％(139/365) and 39.17％(141/360).The re-infection rates of Ascaris lumbricoides and hookworm one year after treatment were 15.89％ (58/365) and 8.89％ (32/360),respectively.A.lumbricoides model showed:the higher infection intensity before treatment,the higher risk of re-infection occurrence(OR=1.94,95％CI:1.33～2.81),high level of household electrical appliances and not drinking un-boiled water were protective factors.The risk of re-infection in age group 15～44 years and 45～64 years was lower than that in group 5～14 years significantly.The higher infection intensity before treatment,the higher risk of high re-infection intensity after treatment (OR=1.56,95％CI:1.10～2.23).Compared to age group 5～14 years,15～44 years and 65～70 years had low risk of getting high re-infection intensity.Not drinking unboiled water was also a protective factor for acquiring high intensity.Hookworm model showed:the higher infection intensity before treatment,the higher risk of re-infection occurrence (OR =3.97,95％CI:2.07～7.60),living in brick house opposed to adobe house was protective factor for re-infection.Compared to age group 5～14 years,the other 3 age groups had higher risk of getting high re-infection intensity,with age group 45～64 the highest.People receiving high school education had lower risk of acquiring high re-infection intensity,relative to illiterate or semi-illiterate people.Conclusion Zero-inflated negative binomial model is the optimal statistical model for fitting Ascaris lumbricoides and hookworm egg count data.This study proved the existence of predisposition phenomenon in the process of re-infection.The occurrence and intensity of re-infection were related with infection intensity before treatment,demographic,socio-economic,environmental and behavioral factors.
