2022年湖南省血吸虫病传播风险评估分析与应对策略  

Assessment on the risk of schistosomiasis transmission and its control strategies in Hunan Province,2022

作　　者：夏蒙[1] 周杰[1] 程湘晖 成伟 李广平[1] 胡本骄[1] 郑茂[1] 冯惊涛 邓奕[1] 唐叶 罗杨杨 XIA Meng;ZHOU Jie;CHENG Xianghui;CHENG Wei;LI Guangping;HU Benjiao;ZHENG Mao;FENG Jingtao;DENG Yi;TANG Ye;LUO Yangyang(Hunan Institute of Schistosomiasis Control,WHO Cooperation Center for Schistosomiasis Control and Prevention in Lake Region,Hunan Provincial Key Laboratory of Schistosomiasis Immunization and Transmission Control,Yueyang,Hunan 414000,China)

机构地区：[1]湖南省血吸虫病防治所,WHO湖区血吸虫病防治合作中心,血吸虫病免疫与传播控制湖南省重点实验室,湖南岳阳414000

出　　处：《实用预防医学》2023年第12期1445-1449,共5页Practical Preventive Medicine

基　　金：创新型省份建设专项资金项目湖南省重点研发项目(2021SK2032);湖南省卫生健康委指导课题(202112071586)。

摘　　要：目的评估湖南省2022年的血吸虫病传播风险,为制定下阶段防治策略提供依据。方法根据近三年湖南省血吸虫病疫情流行趋势,以及可能导致血吸虫病疫情的社会和环境变化因素等,在湖南省监测点内选择1个I类监测县和10个Ⅱ类监测县(市、区)具有代表性的2~3个疫区村作为监测村。收集当地疫情资料及主要防治措施开展情况,结合现场钉螺、人畜活动、野粪等调查情况,综合分析各监测村血吸虫病传播风险因素,制定具体防治策略。结果所有风险评估县近三年均未发现确诊病人、病畜和感染性钉螺。现场钉螺调查结果显示,有螺环境占环境总数的74.19%(46/62),活螺平均密度为0.19只/框;捡获的活螺镜检均阴性,环介导等温扩增(loop-mediated isothermal amplification,LAMP)核酸检测342例混检样本中,检出2例阳性。在有螺环境中,发现人群和家畜活动的环境分别为22.58%(14/62)和6.45%(4/62)。共捡获野粪160份,所有粪样进行尼龙绢袋集卵孵化法检测,均未发现阳性。调查区域普遍存在钉螺扩散风险、人畜感染风险、牛羊反弹情况以及能力建设不足等风险因素。结论目前湖南省血吸虫病传播风险处于较低水平,但传播扩散风险因素和各种困难仍然存在,需夯实基础,突出重点,积极应对风险评估发现的问题,稳步推进湖南省血吸虫病消除进程。Objective To evaluate the risk of schistosomiasis transmission in Hunan Province in 2022,and to provide a basis for formulating the prevention and control strategies in the next stage.Methods According to the trend of epidemic situation of schistosomiasis and the social and environmental changing factors that might contribute to schistosomiasis epidemic in Hunan Province in recent three years,we selected one Class I monitored county and 10 Class II monitored counties(cities or districts)in surveillance sites of Hunan Province,and then 2-3 representative villages were selected from each county to serve as the surveyed villages.Data about the local epidemic and the status of implementing main prevention and control measures were collected,and risk factors for schistosomiasis transmission in each surveyed village were comprehensively analyzed combined with the status of field survey of Oncomelania hupensis snails,humans and livestock activities and field feces survey.The specific prevention and control strategies were formulated.Results No confirmed patients,schistosome-infected animals and schistosome-infected snails were found in all surveyed counties in recent three years.The results of on-site snail survey revealed that the snail habitats accounted for 74.19%(46/62)of the total habitats,and the average density of living snails was 0.19 snails/0.11㎡.Microscopy detection showed that no Schistosoma japonicum(S.japonicum)infections were identified in all the living snails collected.Among 342 mixed samples with nucleic acid testing based on loop-mediated isothermal amplification(LAMP)technique,2 samples were positive.In the snail habitats,habitats with humans and livestock activities accounted for 22.58%(14/62)and 6.45%(4/62)respectively.A total of 160 field feces were collected,and no positives were found by means of egg hatching method after nylon mesh bag concentration.Risk factors like diffusion of Oncomelania snails,humans and livestock infections,livestock grazing in snail habitats and inadequate capacity bui

关 键 词：血吸虫病 传播风险 防治对策 钉螺 野粪 湖南省 

分 类 号：R532.21[医药卫生—内科学]