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摘要:
目的 了解和掌握2016—2021年黑龙江省华支睾吸虫人群感染状况及空间分布特征，为制定防控策略提供科学依据。 方法 收集2016—2021年黑龙江省华支睾吸虫病监测数据，对华支睾吸虫感染人群分布特征进行描述性分析，结合空间自相关分析和核密度估计等空间流行病学统计方法探索研究区域华支睾吸虫病的空间分布特征。 结果 2016—2021年黑龙江省华支睾吸虫病监测覆盖71个县（市、区）、417个村（社区），华支睾吸虫总感染率为3.91%（4 488/114 905）。 感染人群以男性（64.46%，2 893/4 488）、40～59岁（58.53%，2 627/4 488）、初中文化（52.01%，2 334/4 488）、汉族（95.45%，4 284/4 488）、农（牧、渔）民（92.96%，4 172/4 488）为主。 男性（4.92%，2 893/58 764）感染率高于女性（2.84%，1 595/56 141）；40～49岁组、50～59岁组人群感染率分别为5.71%（1 358/23 785）、5.32%（1 269/23 867）；初中、高中人群感染率分别为4.00%（1 553/38 812）、4.52%（2 334/51 582）；农（牧、渔）民人群感染率为5.11%（4 172/81 614）；朝鲜族、蒙古族人群感染率分别为12.85%（163/1 268）、9.26%（34/367）；不同性别、年龄组、文化程度、职业、民族感染率差异有统计学意义（χ2=331.598，χ2=855.526，χ2=281.391，χ2=1522.040，χ2=337.219，均P<0.05）。 以县（市、区）为单位对华支睾吸虫人群感染率进行全局空间自相关分析显示，研究区域存在呈聚集性分布（Moran's I =0.414，Z=5.115， P=0.001）；局部空间自相关分析显示，高–高聚集区域主要是分布于省内东北部。 以村（社区）为单位进行全局空间自相关分析显示研究区域华支睾吸虫感染存在聚集性分布（Moran's I =0.437，Z=15.897，P=0.001）；局部空间自相关分析显示，呈高–高聚集的村（社区）数为43个，主要分布于省内东北部及西南部，呈高–低聚集的村（社区）数为1个，分布于省内东北部。 核密度估计显示，核密度高值区纵向分布于省内东北–西南部，主要呈现沿松花江流域分布的特征。 结论 黑龙江省华支睾吸虫病分布具有明显的空间聚集性和人群分布差异。 应结合区域特点，对重点地区和重点人群，制定具有针对性的防治策略。 Abstract:Objective To understand the population and spatial distributions of Clonorchis sinensis infection in Heilongjiang province from 2016 to 2021, and provide scientific evidence for the prevention and control of Clonorchiasis. Methods The surveillance data of Clonorchiasis in Heilongjiang from 2016 to 2021 were collected for a descriptive analysis on the distribution of the population infected with Clonorchis sinensis. Spatial autocorrelation analysis and nuclear density estimation were used to explore the spatial distribution of Clonorchis sinensis infection in the study area. Results The surveillance for Clonorchiasis covered 71 counties (districts) and 417 villages (communities) in Heilongjiang from 2016 to 2021. The overall infection rate of Clonorchis sinensis was 3.91% (4 488/114 905). The infection cases were mainly men (64.46%, 2 893/4 488), people aged 40−59 years (58.53%, 2 627/4 488), people with junior high school education (52.01%, 2 334/4 488), people in Han ethnic group (95.45%, 4 284/4 488) and farmers (herdsmen, fishers) (92.96%, 4 172/4 488). The infection rate in men (4.92%, 2 893/58 764) was higher than that in women (2.84%, 1 595/56 141). The infection rates were 5.71% in age group 40−49 years (1 358/23 785) and 5.32% in age group 50−59 years (1 269/23 867). The infection rates in junior high school and senior high school students were 4.00% (1 553/38 812) and 4.52% (2 334/51 582), respectively. The infection rate in farmers (herdsmen and fishers) was 5.11% (4 172/81 614). The infection rates in Chinese Korean and Mongolian populations were 12.85% (163/1 268) and 9.26% (34/367), respectively. There were significant differences in infection rate of Clonorchis sinensis among different sex, age, education level, population and ethnic groups (χ2=331.598, χ2=855.526, χ2=281.391, χ2=1522.040, χ2=337.219, all P<0.05). The global spatial autocorrelation analysis on the infection rate of Clonorchis sinensis in population showed that there was clustering at county level in the study area (Moran's I =0.414, Z=5.115, P=0.001). Local spatial autocorrelation analysis showed that the high-high clustering areas were mainly distributed in the northeast of the province. The global spatial autocorrelation analysis showed that there were clustering of Clonorchis sinensis infection at village (community) level in the study area (Moran's I=0.437, Z=15.897, P=0.001). Local spatial autocorrelation analysis showed that 43 villages (communities) with high-high clustering were mainly distributed in the northeast and southwest of the province, while 1 village (community) with high-low clustering was distributed in the northeast of the province. The estimation of kernel density shows that the high value area of kernel density was distributed longitudinally in the northeast and southwest of the province, mainly along the Songhua River basin. Conclusion The distribution of Clonorchiasis infection in Heilongjiang showed obvious spatial clustering and distinct population distribution characteristics. It is necessary to develop targeted prevention and control strategies based on the population and spatial distributions of Clonorchis sinensis infection. -
Key words:
- Clonorchiasis /
- Infection /
- Population /
- Spatial distribution /
- Heilongjiang province
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图 1 2016－2021年黑龙江省华支睾吸虫人群感染空间分布
Figure 1. Spatial distribution of Clonorchis sinensis infection in Heilongjiang, 2016−2021
图 2 2016－2021年黑龙江省以县（市、区）为单位的华支睾吸虫感染局部空间自相关分析
Figure 2. Local spatial autocorrelation analysis on Clonorchis sinensis infection at county (district) level in Heilongjiang, 2016−2021
图 3 2016－2021年黑龙江省以村（社区）为单位的华支睾吸虫感染局部空间自相关分析
Figure 3. Local spatial autocorrelation analysis on Clonorchis sinensis infection at village (community) level in Heilongjiang, 2016−2021
图 4 2016－2021年黑龙江省以村（社区）为单位的华支睾吸虫感染核密度估计
Figure 4. Estimated nucleus density of Clonorchis sinensis infection at village （community） level in Heilongjiang, 2016−2021
表 1 2016－2020年黑龙江省华支睾吸虫感染人群分布情况
Table 1. Population distribution of Clonorchis sinensis infection in Heilongjiang, 2016−2020
项目特征 检查人数 感染人数 感染率（%） 性别 男性 58 764 2 893 4.92 女性 56 141 1 595 2.84 年龄组（岁） <10 5 897 20 0.34 10～ 9 756 78 0.80 20～ 7 676 221 2.88 30～ 17 001 586 3.45 40～ 23 785 1 358 5.71 50～ 23 867 1 269 5.32 60～ 18 525 741 4.00 70～ 8 398 215 2.56 文化程度 文盲或半文盲 3 585 130 3.63 学龄前儿童 3 739 5 0.13 小学 38 812 1 553 4.00 初中 51 582 2 334 4.52 高中、中专 10 932 351 3.21 大专、大学及以上 6 255 115 1.84 职业 农（牧、渔）民 81 614 4 172 5.11 学生 12 480 81 0.65 工人 2 734 42 1.54 家务及待业 2 642 19 0.72 机关事业单位职员 3 384 109 3.22 商业及服务业 3 021 15 0.50 其他 9 030 50 0.55 民族 汉族 112 065 4 284 3.82 朝鲜族 1 268 163 12.85 满族 977 3 0.31 蒙古族 367 34 9.26 其他 228 4 1.75 
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