广西玉林市血吸虫病控制措施与效果  

The Steps and Effects of Controlling Schistosomiasis in Yuli,Guangxi

作　　者：梁炯明[1] 卢耀娟[1] 刘义威[1] 全信斌[1] 蒋海[1] 杜传[1] 

机构地区：[1]玉林市疾病预防控制中心,广西537000

出　　处：《医学动物防制》2010年第8期687-689,共3页Journal of Medical Pest Control

摘　　要：目的探索山丘型喀斯特地貌血吸虫病流行区的有效防控措施,以利巩固血吸虫病防治成果。方法分步实施控制措施:①消除传染源期(1983-1988年)重点采取查找病人病牛和查灭钉螺,有效阻断血吸虫病传播。②监测巩固期(1989-2000年)在前期措施基础上,增加居民血清学监测,强化有螺点的处理。③净化期(2001-2009年)对原疫区和毗邻的非疫区查螺由常规方案的有阳性钉螺的地区每年查螺1～2次、连续5年无发现钉螺的地方每3年查螺1次改为即使没有发现钉螺都坚持每年查螺1次以上,通过增加查螺次数加大钉螺发现率;查螺框距由常规的一般环境10～20m一框改为5～10m一框,复杂环境框距由常规的5～10m改为3m,缩短查螺框距保证查螺质量;一旦发现钉螺,把常规药物灭螺连续3年改为连续灭螺5年。结果在1983-2009年26年中根据不同的防治阶段特点,每年坚持查螺查病。其中消除传染源期(1983-1988年)总计查螺面积13684583m2(其中疫区5048541m2,非疫区查螺面积8636042m2),确定有螺面积425773m2,累计查出血吸虫感染551人,耕牛感染415头,野鼠阳性率6.71%,家犬阳性率11.76%,灭螺面积累计为2846877m2。巩固监测期(1989-2000年)疫区累计查螺面积10259772m2,其中1989年发现残存螺点60m2,钉螺平均密度14.3只/市尺2,经解剖无阳性;2000年发现残存螺点面积4240m2,钉螺密度4～5只/市尺2,解剖无阳性。对发现的2个残存螺点累计灭螺8次,对学生进行皮试阳性率0.57%,居民粪检795人全部阴性,动物查病全部阴性。非疫区查螺面积13740434m2,未发现钉螺。学生皮试阳性率为0%,居民粪检无阳性。净化期(2001-2009年)对疫区和非疫区反复查螺12次,其中疫区累计查螺面积4492616m2,未发现钉螺,非疫区累计查螺面积6508223m2,未发现钉螺,疫区居民血检2179人,抗体阳性率0.32%,阳性者粪检全部为阴性,对鼠、犬、牛调查无阳性,对非疫区居民血检1312Objective To find effective approaches for schistosomiasis prevention and control in the epidemic region with Karst Landform and strengthen the achievements in schistosomiasis control.Method Phase-based controls were preformed：①In infection sources-elimination phase,Schistosomiasis transmission was reduced by finding out patients and infected-cattle and by controlling snail.②In strengthened-surveillance phase,serological surveillance for local residents was carrying out,and the management of snail-spot was strengthened.③In snail-elimination phase,the strategy of snail control was strengthened.The snail surveillance must be performed more than once per year even in the areas where snails were not found in recent 5 years.The spacing between the snail-checking was also shortened by 3～5 meters.Moreover,the usage of chemicals against snails was prolonged by 5 years.Results Patient and snail surveillance had been carrying on during the 26 years,1983-2009,based on different phases.In infection sources-elimination phase （1983-1988）,the space of snails-invading was confirmed to be 425 773m^2 by checking a total of 13 684 583m^2,and the snails-controlled space added up to 2 846 877m^2.A total of 551 patients and 415 infected cattle were found,and positive rate reached 6.71% and 11.76% in wild rodents and in dogs.In strengthened-surveillance phase （1989-2000）,a total space of 10 259 772m^2 was checked in snail surveillance.A area of 60m^2 infected with the snail was found in 1989,where the snails density was 14.3/0.11m^2,and no infection was found in them;and in 2000,snails were found infected in a area of 4 240m^2,where the snails density was 4～5 0.11m^2,and also no cercariae-positive snails were found.The implementations of chemical against snails were carrying out 8 times in the 2 snails-reemerging areas.And the rate of positive with skin test was 0.57%,no eggs were found in stool from 795 local peoples,and also no animals infected were testified.In comparison,a total space of 13 740 434m^2 in normal

关 键 词：喀斯特地貌 血吸虫病 控制措施 

分 类 号：R532.21[医药卫生—内科学]