广西富川县班氏丝虫病传播阻断后残存疫点的发现  

Discovery of a Residual Focus of Bancroftian Filariasis after Declaration of its Transmission Interruption in Guangxi

作　　者：黎学铭[1] 杨益超[1] 黄铿凌[1] 许洪波[1] 谢祖英[1] 麦富珍[1] 商少明[1] 苏爱荣[1] 李树林[1] 区方奇[1] 吴钦华[1] 伍卫平[2] 朱雪花[2] 蒋智华[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁530028 [2]中国疾病预防控制中心寄生虫病预防控制所,世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海200025

出　　处：《中国寄生虫学与寄生虫病杂志》2008年第6期404-408,共5页Chinese Journal of Parasitology and Parasitic Diseases

摘　　要：目的阐述广西富川县班氏丝虫病残存疫点发现过程及其处理措施和效果,揭示其流行病学特征。方法2007年8月至2008年3月,在广西富川县朝东镇和麦岭镇的5个行政村(长塘、黄沙、茶山、福溪和长春)开展丝虫病疫点调查。采用厚血膜双片法检测首发患者所在的疫点长塘村及其毗邻的黄沙和茶山村居民,阳性者再作个案调查。疫点长塘村外出返乡人员以及毗邻的福溪和长春村居民,先用快速免疫色谱测试卡(ICT卡)进行血清学检测,阳性者再用厚血膜双片法确诊。在疫点长塘行政村的干上和印山自然村进行人房捕蚊、解剖致倦库蚊,观察幼丝虫感染情况。查阅富川县防治丝虫病历史资料,走访村民了解20世纪70年代接受丝虫病检查和服用乙胺嗪(海群生)药盐防治丝虫病具体情况。结果检查富川县长塘行政村居民1052人,微丝蚴血症者19例(干上村16例、印山村3例),微丝蚴率为1.81%(干上村为5.90%、印山村为1.42%),平均微丝蚴密度为17.4/60μl血。对毗邻的4个行政村扩大调查4119人,均为阴性。19例微丝蚴血症者分布于12户家庭,其中13例有亲属关系,在空间和家庭分布上有相对集中的趋势。年龄分布以20～29岁和50～59岁为主,其中50岁以上占微丝蚴血症者总数的57.9%。解剖疫点村致倦库蚊54只,未发现幼丝虫阳性蚊。长塘行政村当年丝虫病纵向或横向监测,以及干上自然村丝虫病疫情和相关的防治资料均未查到。走访长塘行政村60岁以上村民及村医27人,均未曾食用乙胺嗪(海群生)药盐。结论广西富川县的干上和印山自然村为班氏丝虫病残存疫点,属低度流行区,流行范围局限,中老年患者居多,平均微丝蚴密度偏低。Objective To describe the discovery of a residual loci of bancrofiian filariasis in Fuchuan County where the disease was announced to have been eliminated, and reveal its epidemiologic feature. Methods The investigation was carried out from August 2007 to March 2008 among residents in Changtang village where the first case of filariasiswas found and the neighboring villages. They were screened with two thick blood smears. Immunochromato- graphic technology （ICT） was conducted for those going out but returned and those in surrounding areas. Vector mosquitoes were collected and dissected to find filaria larvae, Historical documents were reviewed and relevant people were interviewed. Results In Changtang administrative village, 1 052 residents were screened and 19 cases with microfilaremia were found in 2 natural villages, with a Mr-positive rate of 1.8% （5.1% in Gangshang and 1.4% in Yinshan respectively）. No Mf-positive case was found in 4 119 residents screened in other 3 villages. The average microfilaria density in the 19 cases was 17.37/60μl blood. All the 19 cases belonged to 12 families, and 13 cases were relatives to each other, which showed a feature of spatial clustering and family clustering. More patients were identified in the age groups of 20-29 and 50-59, and 57.9% of them were older than 50 years. No larvae were found in 54 Culex pipiens fatigans dissected. Conclusion The Changtang village is identified as a residual focus of hancroftian filariasis with a low, limited endemicity. More cases have been among the elderly with a low average microfilaremia.

关 键 词：丝虫病 残存疫点 微丝蚴血症 消除 

分 类 号：R532.152[医药卫生—内科学]