“以机代牛”等传染源综合治理措施防治血吸虫病的效果评价  

Evaluation of the Comprehensive Schistosomiasis Control Measures with Emphasis on Infection Source of Replacing Cattle with Machine

作　　者：柳伟[1] 曹淳力[1] 陈朝[2] 李石柱[1] 唐丽[3] 肖瑛[3] 张华明 杨志强 王易 苏尚洋 王立英[2] 王强[1] 徐俊芳[1] 鲍子平[1] 黄希宝[3] 周晓农[1] 

机构地区：[1]中国疾病预防控制中心寄生虫病预防控制所,卫生部寄生虫病原与媒介生物学重点实验室,世界卫生组织疟疾,血吸虫病和丝虫病合作中心,上海200025 [2]卫生部疾病预防控制局,北京100044 [3]湖北省疾病预防控制中心血吸虫病防治研究所,武汉430000 [4]湖北省江陵县血吸虫病防治所,江陵434100 [5]湖北省监利县血吸虫病防治所,监利433300 [6]湖北省荆州区血吸虫病防治所,荆州434000 [7]湖北省石首市血吸虫病防治所,石首434400

出　　处：《中国寄生虫学与寄生虫病杂志》2013年第3期206-211,共6页Chinese Journal of Parasitology and Parasitic Diseases

摘　　要：目的评价"以机代牛"等传染源综合治理措施对血吸虫病的防治效果。方法2011年在湖北省血吸虫病重度流行区选取6个已实施"以机代牛"等传染源综合治理措施的行政村(即荆州区的李埠镇杨井村和太湖管理区岳台村、监利县的新沟镇顺丰村和程集镇张马村、江陵县的马家寨乡金旗村和资市镇玉古村)为干预组,2个未实施该措施的行政村(即石首市的小河口镇老洲岭村和大垸镇中岭子村)为对照组进行效果评估。内容包括,采用整群随机抽样调查人群感染情况,采用改良加藤法检查粪便,每个村调查人数不少于300人;调查全部耕牛感染情况,采用塑料杯顶管孵化法检查粪便。采用系统抽样法调查钉螺感染情况,并在钉螺调查环境中调查野粪的感染情况(用塑料杯顶管孵化法,1粪3检)。分别对2007年(基线情况)、2009年(干预前)和2011年(干预后)干预组和对照组的防治效果进行比较分析。结果干预组,人群的血吸虫感染率由实施"以机代牛"等综合治理措施前(2007年、2009年)的3.6%(135/3 772)和2.0%(63/3 116)降至2011年的0.9%(21/2 396)(χ2=43.411,χ2=11.840,P<0.05);至2011年已无存栏耕牛;2010-2011年人群和耕牛的血吸虫感染率下降幅度分别为52.6%和100%。对照组,2007、2009和2011年的人群感染率分别为4.5%(64/1 410)、2.6%(34/1 294)和1.8%(24/1 320),2007和2011年间的差异有统计学意义(χ2=16.178,P<0.05),但2009和2011年间的差异无统计学意义(P>0.05);2007、2009和2011年耕牛感染率分别为5.1%(8/158)、1.6%(3/187)和1.6%(3/189)(χ2=3.387,P>0.05);2010-2011年人群和耕牛感染率的下降幅度分别为25.0%和5.9%。2011年的调查结果显示,干预组和对照组人群感染率的差异有统计学意义(χ2=6.309,P<0.05);两组调查点均未查到感染性钉螺;干预组未查到阳性野粪,对照组野粪阳性率为7.5%(3/40)。结论实施"以机代牛"等传染源综合治理措施可有效阻断血吸虫病的�Objective To evaluate the effect of comprehensive measures with an emphasis on schistosomiasis infection source control by replacing cattle with machine. Methods In 2011, 2 villages from each of Jingzhou District,Jianli County and Jiangling County, Hubei Province, were selected as intervention group where the comprehensive measures were implemented, while 2 villages from Shishou City served as control with routine control activities. A cluster random sampling was carried out in the 8 villages with more than 300 people in each village were sampled. Stool examination using modified Kato-Katz was applied for identification of the infected persons and hatching test for cattle survey. The systemic sampling was applied for snail survey, fecal specimens from the field were examined by hatching test. Each sample was examined three times. Data were collected for the analysis of control effect between intervention and control groups in 2007 （baseline）, 2009 （before implemention of comprehensive measures） and 2011 （post-intervention）. Results In intervention villages, the overall prevalence in human reduced significantly from 3.6% （135f3 772） in 2007 and 2.0% （63/3 116） in 2009 to 0.9% （21/2 396） in 2011 （X2=43.411, X2=11.840, P〈0.05）. Until 2011, there were no cattle in intervention group; the prevalence decreased by 52.6% in huamn and about 100% in cattle from 2010 to 2011. In control group, the infection rate in residents in 2007, 2009 and 2011 was 4.5% （64/1 410）, 2.6% （34/1 294） and 1.8% （24/1 320）, respectively （x=16.178, P〈0.05）, and 5.1%（8/158） in 2007, 1.6% （3/187） in 2009 and 1.6%（3/189） in 2011 in cattle, respectively （x2=3.387, P〉0.05）. The infection rate in human and cattle fell by 25.0% and 5.9% from 2010 to 2011, respectively. There was a significant difference in human infection rate between the intervention and control groups after intervention （2（2=6.309, P〈0.05）. No infected snails were detected in intervention and control groups. N

关 键 词：血吸虫病 传染源 以机代牛 感染率 

分 类 号：R532.21[医药卫生—内科学]