Objective: To investigate the current prevalence of human intestinal protozoal infections in Tibet Autonomous Region, so as to provide the scientific basis for the development of the future control strategy.
Methods: The study sites were sampled using a stratified cluster random sampling method in different ecological zones and different geographical locations of Tibet Autonomous Region in 2015. Fecal samples were collected from the permanent residents at ages of 3 years and older for the detection of intestinal protozoa cysts and trophozoites. The region-, gender-, age-, occupation- and education level-specific prevalence of human intestinal protozoal infections was estimated and compared.
Results: A total of 70 study sites were sampled from 23 counties (districts) in 3 ecological zones of Tibet Autonomous Region in 2015. Among 17 939 subjects surveyed, there were 1 117 residents infected with intestinal protozoa, with a prevalence of 6.23%. There were 9 species of intestinal protozoa identified, and Entamoeba coli (3.59%), Giardia lamblia (0.74%) and Blastocystis hominis (0.72%) were found to have a high in- fection rate. The prevalence of human intestinal protozoal infections was 7.20%, 6.39% and 4.48% in the southern, eastern and northern Tibetan ecological zones, respectively. Among the 23 counties (districts), the highest human prevalence was seen in Baingoin (13.56%) and Amdo counties (12.77%), and there were significant differences in the prevalence of human intestinal pro- tozoal infections among the three ecological zones (χ2 = 33.909, P < 0.01) and 23 counties (districts) (χ2 = 580.511, P < 0.01). There was no gender-specific prevalence of human intestinal protozoal infections (men, 6.08%; women, 6.35%; χ2 = 0.542, P > 0.05); however, there was age-specific human prevalence (χ2 = 44.377, P < 0.01), and a higher prevalence was seen in residents at ages of 60－69 years (8.51%) and 50－59 years (7.67%). In addition, there were occupation- (χ2 = 37.568, P < 0.01) and education level-specific prevalence rates of human intestinal protozoal infections (χ2 = 14.659, P < 0.01), and a higher prevalence was seen in farmers (7.17%) and herdsmen (5.28%), and in residents with a primary school education (6.62% and illiterate resi- dents (6.33%).
Conclusions: The prevalence of human intestinal protozoal infections remains high in Tibet Autonomous Region. The health education pertaining to intestinal parasitic disease control requires to be intensified among farmers and herds- men in rural areas.
［摘要］ 目的 了解西藏自治区人体肠道原虫感染现状, 为制定防治对策提供科学依据。方法 2015年采取分层整群 随机抽样方法, 在西藏自治区不同类型生态区和不同地理方位抽取调查点, 采集≥ 3周岁常住居民粪便样本, 检测肠道原 虫包囊和滋养体, 对检测结果进行描述性流行病学分析。结果 2015年, 西藏自治区共在3个生态区抽取了23个县 (区) 70个调查点。共调查居民17 939人, 发现各类肠道原虫感染者1 117例, 人群肠道原虫感染率为6.23%。共检出9种 原虫, 其中以结肠内阿米巴、蓝氏贾第鞭毛虫、人芽囊原虫感染率较高, 分别为3.59%、0.74%和0.72%。藏南山地生态 区、藏东-川西生态区和藏北高原高寒生态区人群肠道原虫感染率分别为7.20%、6.39%和4.48%; 不同县 (区) 中, 以斑戈 县和安多县人群感染率较高, 分别为13.56%和12.77%。不同生态区和不同县 (区) 人群肠道原虫感染率差异均有统计学 意义 (χ2 = 33.909、580.511, P 均＜ 0.01) 。男性和女性肠道原虫感染率分别为6.08%和6.35%, 差异无统计学意义 (χ2 = 0.542, P > 0.05) ; 不同年龄组人群感染率差异有统计学意义 (χ2 = 44.377, P ＜ 0.01), 其中以60～、50～岁组人群感染率较 高, 分别为8.51%和7.67%。不同职业和文化程度人群感染率差异均有统计学意义 (χ2 = 37.568、14.659, P 均＜ 0.01), 其 中分别以农民和牧民、小学和文盲人群感染率较高, 分别为7.17%和5.28%、6.62%和6.33%。结论 西藏自治区人群肠 道原虫感染率仍然较高, 今后应进一步加强对农村等重点地区、农牧民等重点人群的健康教育工作。.
Keywords: Cross-sectional study; Intestinal protozoa; Tibet Autonomous Region.