An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China
An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China
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DOI：
10.1016/s0001-706x(00)00134-0
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发表时间：
2000-11-02
期刊：
影响因子：
2.7
通讯作者：
Vuitton, DA
中科院分区：
文献类型：
--
作者：
Craig, PS;Giraudoux, P;Vuitton, DA
人泡状棘球蚴病是一种罕见的高致病性人畜共患疾病，可在北方半球的狐狸和啮齿动物宿主之间传播。在中国，1965年描述了第一个病例，但此后很少进行流行病学研究。1991年确定甘肃南部为人类AE的严重疫源地后，1994年至1997年进行了详细的乡村社区和生态研究。肝脏超声肿块筛查和血清学检测（5项检测）确定了84/2482例新发AE病例（3%）。当包括以前的病例时，该地区的总体患病率为4.1%（135/3331）。仅基于血清阳性结果，在没有超声扫描指示的情况下，未发现其他AE病例。在进展性AE病例中，96%在至少一项检测中呈血清阳性，而高达15-20%的表现出肝钙化病变的个体和12-15%表现出肝结节性病变的个体对特异性Em 2或Em 18抗体呈血清阳性。村庄（n = 31）人群AE患病率范围为0 - 15.8%。问卷调查结果表明，养犬总数是危险因素（P < 0.006），而猎狐史不是危险因素（P > 0.6）。啮齿动物生态学研究显示，一方面，田鼠（Microtus limnophilus）的密度指数和村庄AE患病率之间存在关联，另一方面，村庄景观的特征是灌木丛/草地占总面积的比例超过50%（P < 0.005）。甘肃南部农民多房棘球绦虫的长期传播和人畜共患病感染的风险可能最终与农业驱动的森林砍伐过程有关。这反过来可能导致为作为中间宿主物种的啮齿动物（如M。limnophilus）和随后发展的一个围家庭周期涉及狗。(C)2000 Elsevier Science B. V.保留所有权利。
Human alveolar echinococcosis (AE) is usually a rare, highly pathogenic zoonotic disease, transmitted across the northern hemisphere between fox and rodent hosts. In China the first cases were described in 1965: however very few epidemiological studies have been undertaken since. Following identification in 1991 of a serious focus of human AE in south Gansu province, detailed village-based community and ecological studies were carried out between 1994 and 1997. Hepatic ultrasound mass screening with serological testing (five tests) identified 84/2482 new AE cases (3%). An overall prevalence of 4.1% (135/3331) was recorded for the area when previous cases were also included. Based on a seropositive result only, without an ultrasound scan indication, no additional AE cases were identified. Of the evolutive AE cases, 96% were seropositive in at least one test, while up 15-20% of individuals who exhibited hepatic calcified lesions and 12-15% exhibiting hepatic nodular lesions were seropositive for specific Em2 or Em18 antibodies. Village (n = 31) human AE prevalence rates varied from 0 to 15.8%. Questionnaire analysis indicated that total number of dogs owned over a period was a risk factor (P < 0.006), but not a history of red fox hunting (P > 0.6). Rodent ecology studies revealed an association between density indices of voles (Microtus limnophilus) and village AE prevalence rates, on the one hand, and village landscape characterised by a ratio of scrub/grassland to total area above 50% (P < 0.005). Long-term transmission of Echinococcus multilocularis and risk of zoonotic infection of south Gansu farmers may be related ultimately to a process of deforestation driven by agriculture. This in turn probably results in creation of optimal peri-domestic habitats for rodents that serve as intermediate host species (such as M. limnophilus) and subsequent development of a peri-domestic cycle involving dogs. (C) 2000 Elsevier Science B.V. All rights reserved.