柬埔寨金边市toul roka村肠道寄生虫感染流行情况

J. Kobayashi, Kunihiko Chinen, Sim Samidt, K. Higa, M. Chinen, Yoshiya Sato, C. Yoshida
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引用次数: 1

摘要

肠道寄生虫感染是热带地区发展中国家居民的一个严重公共卫生问题。寄生虫病的控制活动不仅是一个重要的改善某一地区健康的问题,而且也是有效的公共保健活动的切入点,因为寄生虫病在居民中流行严重,而且它是一种源自环境的疾病(fereydown, 1984年)。此外,肠道蛔虫病可以通过粪便样本很容易地诊断出来,并可通过口服驱虫药治疗;它可以作为一项普通的公共卫生保健活动集中进行。此外,肠道寄生虫感染的发生与环境卫生状况密切相关;寄生虫控制计划可能直接关系到改善卫生条件的教育。对肠道寄生虫感染流行率的准确调查对于了解特定地区居民的健康状况也很重要。由于柬埔寨长期内战,有关近期肠道寄生虫流行情况的资料极少。在该国,1992年成立的柬埔寨-冲绳友好协会(COFA)是冲绳的一个非政府组织,在Toul Roka村建立了一个诊所,为村民的医疗保健作出贡献,并自1998年以来启动了寄生虫控制方案。进行这项研究是为了获得该村居民肠道寄生虫感染最近流行情况的基本资料。虽然该村位于金边市郊区,但该村的一般社会经济和卫生条件一直很差。村里61户,共有457名村民。调查在一九九八年十二月以粪便检查的方式进行。对于粪便检查,作者走访所有家庭,解释调查目的,并向所有家庭分发粪便容器。运送容器后,收集粪便样本,并采用Kato- katz厚涂片法(Kato和Miura, 1954)和福尔马林醚浓度法(Ritchie, 1948)进行检查。通过对每个家庭中具有代表性的成年人的访谈,调查了他们的生活习惯。在本次初步研究中,随机抽取了113名村民的粪便样本进行检测,占受试人口的24.7%。表1为大便检查结果。80.5%的村民检出寄生虫7种,原虫9种。67份样本(59.3%)存在一种或多种寄生虫感染。寄生虫种类中,蚓状蛔虫最常见,患病率为48.7%。15.9%的村民感染钩虫。另一方面,村民中毛滴虫感染较少,但其感染方式与蚓状拟虫基本相同。有趣的是,尽管村民经常食用生鱼,但肝吸虫的感染率仅为3.5%(4例)。以15岁为单位比较各年龄组的流行率,发现较年轻年龄组的蛔虫感染率较高,而15岁以上年龄组的钩虫感染率则相反。原生动物寄生虫方面,61例(54.0%)村民检出原生动物寄生虫9种;最常见的是人芽囊虫,阳性率为37 ~ 43%。溶组织内阿米巴
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PREVALENCE OF INTESTINAL PARASITE INFECTION IN TOUL ROKA VILLAGE, PHNOM PENH MUNICIPALITY CAMBODIA
Intestinal parasitic infection is a serious public health problem among the inhabitants in developing countries located in tropical areas. Control activities of parasitic diseases are not only an important health improvement problem in a given area but also an entry point for effective public health care activities because of its serious prevalence among inhabitants and its nature as an environment-derived disease (Fereydoun, 1984) . Also, intestinal helminthiasis can be easily diagnosed with fecal samples and are treatable by oral administration of anthelmintics; it can be performed intensively as an ordinary public health care activity. Additionally, intestinal parasitic infection occurs closely relating to the environmental sanitary condition; parasite control program may relate directly to the education for improvement of sanitary condition. Exact survey on the prevalence of intestinal parasite infection may also be important to know health status of the inhabitants in a given area. Due to the civil war for a long period in Cambodia, the information on the recent prevalence of intestinal parasites is extremely few. In the country, Cambodia-Okinawa Friendship Association (COFA) , founded in 1992 as a non-government organization (NGO) in Okinawa, has established a clinic in a village, Toul Roka Village, to contribute to health care of the villagers and started a parasite control program since 1998. The present study was undertaken to obtain basic information on the recent prevalence of intestinal parasitic infection among the inhabitants in the village. Although the village is located in suburban area of Phnom Penh Municipality, the general socio-economic and sanitary conditions were consistently poor in the village. A total of 457 villagers live in 61 households in the village. The survey was conducted by stool examination in December, 1998. For stool examination, the authors visited all households to explain the purpose of the survey and delivered stool containers to all families. After delivering the containers, stool samples were collected and examined both by Kato-Katz thick smear method (Kato and Miura, 1954) and formalin-ether concentration method (Ritchie, 1948) . Their life habits were also surveyed by the interview to the representative adults of each family. In the present preliminary study, stool samples from 113 villagers, accounting for 24.7% of the population subjected, were collected randomly for examination. Table 1 represents the results of the stool examinations. A total of 7 helminth and 9 protozoan species were diagnosed in 80.5% of the villagers examined. Sixtyseven samples (59.3%) were found harboring one or more helminth infections. Among the helminth species, Ascaris lumbricoides was the commonest parasite, showing 48.7% of prevalence rate. Hookworm infection was also demonstrated in 15.9% of the villagers. On the other hand, Trichuris trichiura infection was rare among the villagers, although their infection mode is almost the same to that of A. lumbricoides. Interestingly, the infection rate with Opisthorchis viverrini, liver fluke, were only 3.5% (4 cases) , in spite of frequent eating of raw fishes by the villagers. When the prevalence rates were compared between age groups divided by 15 years old, the infection rate of A. lumbricoides was higher in the younger age population, but it was reversed by the aged group over 15 years old in the case of hookworm infection. As to protozoan parasites, 9 species of protozoan parasite were detected in 61 (54.0%) villagers. The commonest species was Blastcystis hominis, showing positive rates of 37-43%. Entamoeba histolytica/ E.
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