Chin J Schisto Control ›› 2015, Vol. 27 ›› Issue (5): 457-.DOI: 10.16250/j.32.1374.2015180

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

SHEN Xue-hui 1 |SUN Le-ping2* | LI Ye-fang1 |WANG Lin3 |CHEN Xiang-ping1 |WANG He-sheng1 | DAI Jian-rong2   

  1. 1 Dantu District Center for Disease Control and Prevention|Zhenjiang City|Jiangsu Province|Zhenjiang 212004|China;2 Ji? angsu Institute of Parasitic Diseases|Key Laboratory on Technology for Parasitic Disease Prevention and Control|Ministry of Health|Jiangsu Provincial Key Laboratory of Molecular Biology of Parasites|China;3 Zhenjiang Municipal Center for Disease Control and Prevention|China
  • Online:2015-10-21 Published:2015-10-21

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

神学慧1|孙乐平2*|李叶芳1|王琳3|陈祥平1|王和生1|戴建荣2   

  1. 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
  • 通讯作者: 孙乐平
  • 作者简介:神学慧| 男| 本科| 副主任医师。研究方向: 寄生虫病控制
  • 基金资助:
    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

Abstract: Objective Objective To evaluate the effectiveness of mid? and long?term schistosomiasis control plan and explore the con? solidation strategy in marshland endemic regions, so as to provide an effective approach for interrupting and eliminating schisto? somiasis in the regions. Methods Methods A prospective field study was designed. Dantu District of Zhenjiang City, a marshland schisto? somiasis 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 long? term plan for schistosomiasis prevention and control, and the changing trends of human, domestic animal and snail infections were plotted. Results Results During the implementation of the plan from 2005 to 2014, 16.84 km concrete and bank protection and 9 snail sinks were built, 10 culverts re?built, 3.85 hm2 fences were constructed, 29.5 thousand domestic animals were examined and treated, 170 cattle were eliminated, 4 930 hm2 fishing farms were built for snail control, 1 560.00 hm2 land were improved, and 376.00 hm2 forests were built for snail control. In addition, 19 364.80 hm2 snail areas were surveyed, 4 694.6 hm2 area re? ceived 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 es? tablished, and 5 435 slogans were pasted or hung. After the implementation of the mid? and long?term plan, the percentages of hu? man, 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 areas with snails and infected snails reduced from 284.34 hm2 and 55.10 hm2 in 2005 to 73.60 hm2 and 0 hm2 in 2014, with reduction rates of 74.12% and 100%, respectively. The infection rate of sheep appeared a fluc? tuation between 2005 and 2014, with the rate of 1.13% in 2005, 0 in 2007 and 2008, rising in 2009 and then between 0.25% and 0.95% from 2009 to 2012, and reducing to 0 in 2013 and 2014. During the 10?year period, the number of cattle reduced year by year from 2005 to 2010, and slightly increased after 2011, showing an overall stable level, while the number of sheep increased year by year after 2006, peaked in 2010, and appeared a decline tendency since 2011, which was almost consistent with the fluc? tuation of schistosome infection rate in sheep. Conclusions Conclusions The sustainable comprehensive control strategy with the“key vil? lage, key environments, and key water regions”is an effective approach for schistosomiasis control in marshland endemic re? gions. However, the endemic situation of schistosomiasis is extremely easy to repeat. The prevention and control of the impact of sheep and wild animals on schistosomiasis transmission should be strengthened in order to consolidate the schistosomiasis con? trol achievements gained.

Key words: Schistosomiasis;Mid ? and long ? term plan;Comprehensive control;Control effect;Consolidation strategy; Marshland region

摘要: 目的 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 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 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 hm2 , 开展家畜查治2.95万头次, 淘汰耕牛170头, 养鱼灭螺4 930 hm2 , 整理 与涝渍改良土地1 560.00 hm2 , 建设抑螺防病林376.00 hm2 , 开展钉螺调查19 364.80 hm2 , 药物灭螺4 694.60 hm2 , 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 hm2 和55.10 hm2 下 降到73.60 hm2 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 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, 必须加强防控羊和滩地野生动物等传染源对血吸虫病 传播的影响。

关键词: 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

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