水利血防综合治理对降低垸内型血吸虫病流行区疫情的效果研究  

Study of the effect on reduction of schistosomiasis endemic situation by water conservancy comprehensive measures in the area of embankment schistosomiasis endemic type

作　　者：张瑕[1] 薛靖波 胡合华 贺世豪 刘雄[1] 崔彩霞[1] 刘军[1] 邹萍[1] 曹淳力[2] 李石柱[2] 

机构地区：[1]湖北省江陵县血吸虫病预防控制所,中国疾病预防控制中心寄生虫病预防控制所湖沼型血吸虫病流行区防治实验基地,江陵434100 [2]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,世界卫生组织热带病合作中心,上海200025 [3]湖北省江陵县卫生和计划生育局,江陵434100

出　　处：《国际医学寄生虫病杂志》2015年第6期317-322,共6页International JOurnal of Medical Parasitic Diseases

基　　金：湖北省荆州市医药卫生科技计划项目(20121PE1-1;92013)~~

摘　　要：目的对西干渠流域水利血防综合治理后疫情变化进行效果评估，为垸内型血吸虫病流行区防治策略实施提供参考。方法江陵县西干渠流域500m内进行支渠水利血防治理的31个行政村为观察村．500m外的未进行水利血防治理的167个村为对照村。有螺河道水利血防治理采取先药物灭螺。再开挖疏浚并修建沉螺池。收集2006-2014年年报资料及各类防治资料，分析人、畜、螺感染率等疫情指标。结果江陵县2005年人、畜血吸虫病感染率11．83％、6．11％，钉螺感染率0．4187％。自水利血防综合治理工程实施起，完成药物浸杀灭螺380．50ha（1ha=10000m^2），河道疏挖4576400m^3，开新填旧完成土方开挖187000m^3、回填151200m^3。修建沉螺池12座．硬化渠道12km。2006—2014年观察村人、畜血吸虫病感染率分别从2006年的4．39％、11．75％下降至2014年的0．50％、0．降幅达88．56％、100％。观察村2011年阳性钉螺面积21600m^2．较2006年降幅达94.46％（2．16／39．00）。观察村2006-2009年人群感染率与对照村人群感染率差异有统计学意义（χ^2=64．06、52．94、36．01、6．96，P值均〈0．01），观察村人群血吸虫病感染率高于对照村。2010年后人群血吸虫病感染率差异没有统计学意义（χ^2=2．33、0．30、0．59，P值均〉0．05）。2006-2008年观察村与对照村钉螺感染率差异有统计学意义（χ^2=827．48、395．68、164．88、6．96，P值均〈0．01），观察村钉螺感染率为0．5221％、0．2833％、0．1670％，明显高于对照村的0．1598％、0．0885％、0．0643％。项目竣工后2009-2011年观察村与对照村钉螺感染率差异有统计学意义（χ^2=37．45、9．35、33．65．P值均〈0．01）。观察村钉螺感染率0．0448％、0．0454％、0．0070％，明显低于对照村的0．0971％、0．0659％、0．0330％。结论在垸内型血吸虫病流行区对主要灌溉水系进�Objective To evaluate the schistosomiasis endemic situation in the drainage area of Xigan Canal after control by water conservancy comprehensive measures in order to offer evidence for schistosomiasis control of embankment type. Methods In the drainage area of Xigan Canal around 500 m, 31 villages where the water conservancy comprehensive measures were complemented were selected as study sites, other 167 villages out of 500 m without water conservancy comprehensive measures were selected as control sites. The water conservancy comprehensive measures consisted of killing snail by molluscicide firstly, digging and dredging secondly, and setting up snail collection and killing pools thirdly. The data of schistosomiasis situation and control of 2006-2014 were collected, and the index of human, cattle and snail infection were analyzed. Results The schistosomiasis infection rate of people and livestock was 11.83% and 6.11% respectively, and the infection rate of snail was 0.418 7%. This comprehensive measures of water conservancy in schistosomiasis control projects an area of 380.50 ha （1 ha=10 000 m^2） was completed with molluscide treatment, 4 576 400 m^3 with excavation dredging, and 187 000 m^3 with earth excavation, and 151 200 m^3 with backfill, 12 snail-setting pools were built and 12 km channel hardened. From 2006 to 2014, the schistosomiasis infection rate of human decreased from 4.39% to 0, a decline rate of 88.56%, and the schistosomiasis infection rate of livestock fell from 11.75% to 0, a decline rate of 100% in the study villages. The area of positive snail shrank year by year, and it was 2.16 ha in 2011 in the study village, with a decline by 94.96% （2.16/39.00）. The difference of schistosomiasis infection rate of people between observation villages and control villages had statistic significance by Chi-square test（χ^2=64.06, 52.94, 36.01, 6.96, P〈0.01 ） during 2006- 2009, and the schistosomiasis infection rate of study villages was higher than that of control villages. But after 2010, the

关 键 词：血吸虫病 垸内型 水利血防 效果评估 

分 类 号：R532.21[医药卫生—内科学]