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目的了解杭州市莱姆病的感染状况、流行病学特征,分析影响感染率的因素,提出杭州市莱姆病防治对策。方法选择余杭区、临安市和建德市等三地部分林场的职工和山村的居民进行血清流行病学调查。用间接免疫荧光方法(IFA)检测人血清抗莱姆病螺旋体抗体(IgG),对莱姆病抗体检测阳性血清进行钩端螺旋体和梅毒螺旋体交叉试验,以排除钩体和梅毒螺旋体的交叉感染。结果932份进行莱姆病抗体检测以及梅毒和钩体鉴别试验的血清标本中,判定为莱姆病感染的为111份,感染率为11.91%。男性的莱姆病感染率略高于女性,但经统计学检验,差异无统计学意义(P>0.05)。除10~岁组和70~岁组两个年龄组的感染率略低外,其余各年龄组间的感染率较为接近,且经统计学检验,各年龄组之间的感染率差异无统计学意义(P>0.05)。杭州市不同地区间的莱姆病感染率存在差异,经检验差异有统计学意义(P<0.05),余杭区的感染率最高,而建德市的感染率最低。山村居民的莱姆病感染率略高于林场职工,但经统计学检验,两者间的差异无统计学意义(P>0.05)。结论杭州市林场职工和山村居民中普遍存在莱姆病的感染,且感染率较高。人群对莱姆病普遍易感,不论年龄、性别、林场职工或山村居民,只要经常有接触传播媒介的机会,不做好防护而被蜱叮咬,就有可能被感染。提示在杭州市的山区和林场开展莱姆病的防治工作是非常有必要的。
Objective To understand the infection status and epidemiological characteristics of Lyme disease in Hangzhou and to analyze the factors affecting the infection rate and to propose the prevention and control measures for Lyme disease in Hangzhou. Methods Residents of three forest farms in Yuhang District, Lin’an City and Jiande City were selected for serological epidemiological investigation. Human serum anti-Lyme disease spirochetes (IgG) were detected by indirect immunofluorescence assay (IFA), and Leptospira interrogans and Treponema pallidum were tested for cross-infection with leptospiral antibodies against Treponema pallidum. Results Among the 932 serum specimens tested for Lyme disease and syphilis and leptospirosis, 111 were identified as Lyme disease and the infection rate was 11.91%. The prevalence of Lyme disease in males was slightly higher than that in females, but the difference was not statistically significant (P> 0.05). In addition to the 10-year-old group and 70-year-old group of two age groups slightly lower infection rate, the infection rates among the rest of the age groups are closer, and the statistical test, the infection rates between the age groups no statistical difference Significance (P> 0.05). There were differences in the rates of Lyme disease among different regions in Hangzhou. The difference was statistically significant (P <0.05), the highest in Yuhang and the lowest in Jiande. The prevalence of Lyme disease in mountain villages was slightly higher than that of forestry workers, but the difference was not statistically significant (P> 0.05). Conclusion The prevalence of Lyme disease among forest workers and mountain residents in Hangzhou City is high, and the infection rate is high. The population is generally susceptible to Lyme disease. Regardless of age, gender, farm workers or village inhabitants, as long as there is a constant chance of getting in touch with the media, they are likely to be infected if they are bitten by ticks without protection. It is very necessary to carry out the prevention and cure of Lyme disease in the mountainous areas and forest farms in Hangzhou.