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目的 掌握西藏自治区儿童棘球蚴病患病情况,分析其影响因素,为西藏自治区棘球蚴病防治策略的制定提供资料. 方法 2016年8-10月,采用分层整群抽样的方法,在西藏自治区70个县(区)选择调查村,每个村随机抽查200人进行腹部B超筛查,对疑似病例辅以血清学检查.采用随机数字表法,每个村抽取20名当地村民;每个县抽取1所县完全小学4～6年级学生,每个年级不少于50名学生,采用一对一问答式进行防治知识和行为调查.每村采用随机数字表法抽取20户养犬户,每户仅采集1条犬的粪样(1～3 g),ELISA检测犬粪棘球绦虫抗原.对所调查对象中的儿童采用SPSS 21.0统计学软件进行统计分析. 结果 共调查儿童13 651人,棘球蚴病检出率为0.40％ (55/13 651);在调查的70个县(区)中,仅25个县发现有儿童棘球蚴病患者,其中23个县发现细粒棘球蚴病病例;5个县发现多房棘球蚴病病例.儿童患病检出率排名前5位的依次为昌都市左贡县(11.84％,9/76)、阿里地区措勤县(1.84％,4/218)、日喀则市仲巴县(1.59％,3/189)、山南市浪卡子县(1.50％,2/133)、阿里地区改则县(1.37％,4/293).检查女童6 660人,检出棘球蚴病患者32例,检出率为0.48％;男童6 991人,检出棘球蚴病患者23例,检出率为0.33％.＜6岁儿童6 770人,检出棘球蚴病患者13人,检出率为0.19％ (13/6 770);7～12岁儿童6 881人,检出棘球蚴病患者42人,检出率为0.61％ (42/6 881),两年龄段的检出率差异有统计学意义(x2=13.86,P＜ 0.05).以3岁为一个年龄段进行分组,各年龄组均有病例分布,棘球蚴病检出率随着年龄的增长而升高(x2=17.69,P＜ 0.05).对影响因素的分析表明,犬粪棘球绦虫抗原阳性率为首要危险因素(OR=3250.2,P＜0.05),然后依次为年龄和养犬率,问卷合格率则为保护因素. 结论 儿童棘球蚴病检出率较低,与年龄、养犬和生活习惯有关.“,”Objective To understand the prevalence of hydatid disease in children in Tibet Autonomous Region and analyze the influencing factors of the disease.Methods A stratified cluster sampling method was used to select 364 villages in 70 counties (distict) from August to October,2016.In each village,200 residents including children were randomly selected for B ultrasound examination,accompanied by a serological test for those suspected.In each village,20 local residents were selected using a random number table method,and in each county,a primary school was selected,from which 50 students of grades 4-6 were selected.Their knowledge and behaviors on hydatid disease control were surveyed by face-to-face Q & A.In each village,20 dog-raising households were selected randomly and in each household,fecal sample (1-3 g) was collected from only one dog.Statistical analysis was carried out using SPSS 19.0 statistical software.Results A total of 13 651 children were examined,with a prevalence of 0.40％ (55/13 651) for hydatid disease.In the 70 counties (district) surveyed,child cases were found in only 25 counties (district),of which 23 had children with cystic hydatid disease and 5 had children with alveolar hydatid disease.The top 5 counties with regard to the prevalence were Zuogong County in Changdu City (11.84％,9/76),Cuoqin County in Ali Prefecture (1.84％,4/218),Zhongba County in Shigatse City (1.59％,3/189),Langkazi County in Shannan City (1.50％,2/133),and Gaize County in Ali Prefecture (1.37％).Among 6660 girls examined,32 were detected with hydatid disease (0.48％),and among 6 991 boys examined,23 were detected with hydatid disease (0.33％).Among 6 770 children under 6 years,13 were found with hydatid disease (0.19％)(13/6 770),and among 6 881 children aged 7-12 years,42 were found with hydatid disease (0.61％)(42/6 881) (x2 =13.86,P ＜ 0.05).By setting 3 years as an age subgroup,each subgroup had cases of hydatid disease,and the prevalence showed a trend of increase with age (x2 =17.69,P ＜ 0.05).The antigen positive rate of dog feces was a leading risk factor (OR =3250.2,P ＜ 0.05),followed by age and the rate of dograising,and the qualified rate of questionnairing was the protective factor.Conclusion Hydatid disease in children is related to age,dog-raising and daily hygienic habits.