摘要
目的探讨新疆喀什地区黑热病暴发流行的危险因素。方法采用病例对照研究,自制调查问卷,以基于利什曼原虫kDNA保守区PCR扩增的分子方法检测呈阳性感染的为病例组,按1∶3匹配选择年龄、性别、营养状况、职业、家庭收入与消费、受教育程度等方面差别无统计学意义(P>0.05),且利什曼原虫感染检测呈阴性的健康人为对照组,对性别、环境和行为等10个潜在危险因素进行单因素和多因素logistic回归分析。结果75份易感人血样感染利什曼原虫阳性率为82.67%(62/75)。单因素分析显示:户外被叮咬、户外露宿习惯、邻居有黑热病患者、蚊帐及趋避剂杀虫剂的使用与当地易感人群感染利什曼原虫关系密切,危险比(RH)值和95%可信区间(95%CI)依次为7.296,(3.102,1.16)、15.429(5.876,8.995)、75.6(26.6,214.9)、0.311(0.132,0.733)、0.491(0.292,0.672);多因素分析显示:户外被叮咬、邻居有黑热病患者是感染利什曼原虫的危险因素,使用蚊帐是保护性因素,RH值和95%CI为12.56(3.476,45.38)、140.987(37.59,528.8)、0.185(0.05,0.68)。结论在该地区易感人群感染利什曼原虫率较高的情况下,对当地居民普及黑热病的危害及防御措施,及时确诊并彻底诊治黑热病患者,尽量避免户外被叮咬,养成使用蚊帐习惯是预防控制当地人源型黑热病感染暴发的有效措施。
We investigated the risk factors of human-origin type Kala-azar outbreak in Kashi Prefecture,Xinjiang,China.A case-control study with self-made questionnaire was conducted.The case group included all cases of susceptible population who were positive Leishmaniainfection by PCR on account of the conserved region of Leishmaniakinetoplast DNA minicircles.The control group 1：3matched healthy human were no Leishmaniainfection and no significant difference（P0.05）at gender,age,nutritional status,occupation,the family income and consumption,and the education level.Ten potential risk factors such as gender,environment and behavior factors were analysed by single and multivariate logistic regression.The positive rate of 75 susceptible population samples was 82.67%（62/75）.The single-variable logistic regression analysis showed that the factors such as outdoor bite,outdoor sleep habit,Kala-azar patients near dwelling place,and pesticide and mosquito net use were all closely related to the human-origin type Kala-azar outbreak.The hazard ratio（HR）values and 95% confidence interval（95%CI）were 7.296（3.102,1.16）,15.429（5.876,8.995）,75.6（26.6,214.9）,0.311（0.132,0.733）,and 0.491（0.292,0.672）.Multivariate logistic regression analysis showed that outdoor bite and Kala-azar patients near dwelling place were the risk factor,the use of mosquito net was the protective factor to avoid the human-origin type Kala-azar outbreak,and the HR（95%CI）were 12.56（3.476,45.38）,140.987（37.59,528.8）,and 0.185（0.05,0.68）.Popularizing the harm of Kalaazar,diagnosis and treatment of Kala-azar patients thoroughly,no outdoor bite,and the broadly use of mosquito net are all effective measures for prevention and control of Kala-azar.
出处
《中国人兽共患病学报》
CAS
CSCD
北大核心
2015年第6期592-596,共5页
Chinese Journal of Zoonoses
基金
创新或共性平台技术项目(No.2008IPB202)~~
