江滩流行区中长期规划血吸虫病控制效果及其巩固对策探讨  

Effect of mid- and long-term schistosomiasis control plan and discussion of consolidation strategy in marshland endemic regions

作　　者：神学慧 孙乐平[2] 李叶芳[1] 王琳[3] 陈祥平[1] 王和生[1] 戴建荣[2] 

机构地区：[1]江苏省镇江市丹徒区疾病预防控制中心,镇江212004 [2]江苏省血吸虫病防治研究所,卫生部寄生虫病预防与控制技术重点实验室,江苏省寄生虫分子生物学重点实验室 [3]江苏省镇江市疾病预防控制中心

出　　处：《中国血吸虫病防治杂志》2015年第5期457-462,共6页Chinese Journal of Schistosomiasis Control

基　　金：国家科技支撑计划(2009BAI78B07);江苏省临床医学科技专项(BL2014021);江苏省科教兴卫工程高技术平台(ZX201108);江苏省卫生厅项目(X200902;X201408;X201410);镇江市社会发展科技项目(FZ201116);镇江市丹徒区科技计划项目

摘　　要：目的评价江滩型流行区实施血防中长期规划控制血吸虫病的效果,探讨进一步巩固血防成果的对策,为江滩地区阻断和消除血吸虫病提供有效路径。方法采用前瞻性现场研究方法,选取江滩型血吸虫病流行区镇江市丹徒区,根据其血吸虫病流行程度,实施渐进式的＂重点村→重点环境→重点水域＂血防综合治理。连续开展居民病情、家畜病情和环境螺情调查,并收集防治措施实施情况。分析比较实施中长期规划前后病情和螺情控制效果,并绘制居民感染率、家畜感染率和钉螺感染率的变化图。结果 2005-2014年丹徒区共实施河道混凝土硬化护坡16.84 km,修建沉螺池9个,改建涵闸10座,建设家畜圈养畜舍3.85 hm^2,开展家畜查治2.95万头次,淘汰耕牛170头,养鱼灭螺4 930 hm^2,整理与涝渍改良土地1 560.00 hm^2,建设抑螺防病林376.00 hm^2,开展钉螺调查19 364.80 hm^2,药物灭螺4 694.60 hm^2,查、治病20.79万人次,建造三格式无害化厕所6.91万座,发放血防宣传材料28.22万份,防护用品1.97万人份,树立血防警示标志958个,张贴或悬挂血防宣传标语5 425条。血防中长期规划项目实施后居民感染率、牛感染率和钉螺感染率呈逐年下降态势,分别由2005年的0.08%、1.28%和0.13%下降为0;钉螺面积和感染螺面积由2005年的284.34 hm^2和55.10 hm^2下降到73.60 hm^2和0,分别下降了74.12%和100%。2005-2014年羊的感染率呈波动状态,2005年粪检阳性率为1.13%,2007-2008年为0,2009-2012年回升到0.25%~0.95%,2013-2014年为0。2005-2010年牛的存栏数逐年减少,2011年后小幅增加,总体平稳;2006年后羊的存栏数逐年增加,到2010年达最高峰,2011年起呈下降趋势,与当地羊的血吸虫感染率波动基本一致。结论江滩地区采取持续、渐进式的＂重点村→重点环境→重点水域＂血防综合治理是控制血吸虫病的有效路径,但这类地区疫情极易反复,要进一步巩固血防成果Objective To evaluate the effectiveness of mid- and long-term schistosomiasis control plan and explore the consolidation strategy in marshland endemic regions, so as to provide an effective approach for interrupting and eliminating schistosomiasis in the regions. Methods A prospective field study was designed. Dantu District of Zhenjiang City, a marshland schistosomiasis endemic region, was selected, and the＂key village, key environment, and key water regions＂comprehensive control strategy was implemented according to the endemic level of schistosomiasis. The morbidity due to schistosomiasis in humans and domestic animals, and Oncomelania hupensis snails were surveyed, and the data of the implementation of control measures were collected. The schistosomiasis morbidity and snail status were compared before and after the implementation of the mid- and longterm plan for schistosomiasis prevention and control, and the changing trends of human, domestic animal and snail infections were plotted. Results During the implementation of the plan from 2005 to 2014, 16.84 km concrete and bank protection and 9snail sinks were built, 10 culverts re-built, 3.85 hm^2 fences were constructed, 29.5 thousand domestic animals were examined and treated, 170 cattle were eliminated, 4 930 hm^2 fishing farms were built for snail control, 1 560.00 hm^2 land were improved,and 376.00 hm^2 forests were built for snail control. In addition, 19 364.80 hm^2 snail areas were surveyed, 4 694.6 hm^2 area received molluscicide, 207.9 thousand of people（person-times） received the examination and treatment, 69.1 thousand of harmless toilets were built, 282.2 thousand health education materials and protection materials were allocated, 958 warning signs were established, and 5 435 slogans were pasted or hung. After the implementation of the mid- and long-term plan, the percentages of human, bovine and snail infections appeared decline tendencies year by year, and reduced from 0.08%, 1.28% and 0.13% in 2005 to 0 in 2014, respectively, while the

关 键 词：键词]血吸虫病 血防中长期规划 综合治理 控制效果 巩固对策 江滩地区 

分 类 号：R532.21[医药卫生—内科学]