长江中下游流域血吸虫病传播风险监测预警指标体系研究  

Construction of a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin

作　　者：江三红 王丽曼[1] 孙丽 刘涛[1] 刘雨薇 刘小利[1] JIANG Sanhong;WANG Liman;SUN Li;LIU Tao;LIU Yuwei;LIU Xiaoli(The First Department of Special Subject,Hunan Provincial Corps Hospital of Chinese People’s Armed Police Force,Changsha,Hunan 410006,China)

机构地区：[1]武警湖南总队医院特色专业一科,湖南长沙410006

出　　处：《中国血吸虫病防治杂志》2023年第5期486-491,共6页Chinese Journal of Schistosomiasis Control

基　　金：武警部队科研创新项目(ZZKY20222402)。

摘　　要：目的构建长江中下游流域血吸虫病传播风险监测预警指标体系,为建设敏感、高效的血吸虫病监测预警系统提供参考。方法以“血吸虫病”、“监测”、“预警”、“防控措施”等为关键词检索2008—2022年国内外相关文献,收集血吸虫病防治工作相关文件及法规,召开课题组专题小组讨论,初步构建长江中下游流域血吸虫病传播风险监测预警指标体系。通过德尔菲法对指标体系进行综合评分及筛选,采用层次分析法(analytic hierarchy process,AHP)和改进比例分配法确定各个指标权重。计算专家积极系数、权威系数、集中程度和协调程度等4项指标对德尔菲法可信度进行评价。结果通过两轮专家咨询,初步构建了包括3个一级指标、9个二级指标和41个三级指标的长江中下游流域血吸虫病传播风险监测预警指标体系。一级指标中,疫情、自然及社会因素、综合防控的归一化权重分别为0.6398、0.1456、0.2146;二级指标中,螺情(0.3213)、病情(0.3185)组合权重较高,社会因素组合权重(0.0304)最低;三级指标中,组合权重较高的指标分别为人群粪检阳性率(0.0419)、急性血吸虫病病例数(0.0415)、粪检阳性牛羊数(0.0411)及散养家畜感染率(0.0411)。两轮专家咨询中,专家积极系数均为100%,权威系数均≥0.9,两轮专家协调系数分别为0.338~0.441和0.426~0.565(χ^(2)=22.875~216.524,P均<0.05)。结论本研究构建的长江中下游流域血吸虫病传播风险监测预警指标体系具有一定的科学性、权威性,可望为我国“低流行率、低感染度”的血吸虫病流行态势下构建敏感、高效的血吸虫病监测预警系统提供参考。Objective To establish a surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin,so as to provide insights into creation of a sensitive and highly efficient surveillance and early warning system for schistosomiasis.Methods National and international publications,documents,laws and regulations pertaining to schistosomiasis control were retrieved with keywords including schistosomiasis,surveillance,early warning and control interventions from 2008 to 2022,and a thematic panel discussion was held to preliminarily construct surveillance and early warning index system for schistosomiasis transmission risk along the middle and lower reaches of the Yangtze River basin.The index system was then comprehensively scored and screened using the Delphi method,and the weight of each index was determined using analytic hierarchy process and the modified proportional allocation method.In addition,the credibility of the Delphi method was evaluated using positive coefficient,authority coefficient,degree of concentration and degree of coordination of experts.Results Following two rounds of expert consultation,a surveillance and early warning index system for schistosomiasis transmission risk in endemic areas along the middle and lower reaches of the Yangtze River basin was preliminarily constructed,including 3 primary indicators,9 secondary indicators and 41 tertiary indicators.The normalized weights of primary indicators epidemics,natural and social factors and comprehensive control were 0.6398,0.1456 and 0.2146,respectively,and among all secondary indicators,snail status(0.3213)and schistosomiasis prevalence(0.3185)had the highest combined weights,while social factors had the lowest combined weight(0.0304).Of all tertiary indicators,human egg⁃positive rate(0.0419),number of acute schistosomiasis cases(0.0415),number of stool⁃positive bovine and sheep(0.0411),and prevalence of Schistosoma japonicum in free⁃ranging livestock(0.0411)had the

关 键 词：血吸虫病 监测预警 指标体系 德尔菲法 长江流域 

分 类 号：R532.21[医药卫生—内科学]