Abstract: Objective To analyze the main obstacles existing in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source in hilly endemic regions，and to find out the current priority issues in schistosomiasis prevention and control，so as to provide the evidence for further solutions. Methods Two typical hilly schistoso? miasis endemic regions in Sichuan Province，including Pujiang County of Chengdu City and Dongpo District of Meishan City， were selected as research areas. A framework of obstacle factors in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infectious source in hilly endemic regions was built by literature review，and the management and technical personnel who worked on schistosomiasis prevention and control in eight different industries（health，agriculture， forestry and so on）and five levels（provincial，city，county，township and village levels）were investigated by questionnaires in the way of nominal group. Results One hundred and fifty?three management and technical personnel in different industries and different levels were investigated. The questionnaire recovery rate（experts’positive coefficient）was 100%. The results showed that the first four problems needing to be concerned in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source were eliminating Oncomelania hupensis snails by projects，health education，examina? tion and treatment for schistosomiasis persons，and harmless treatment of night?soil and safe water supply. The focuses of two counties in the implementation of integrated strategy measures were different. The harmless treatment of night?soil and safe wa? ter supply was the most important measure in Pujiang County，while the elimination of snails by projects was the most in Dong? po District. Conclusions As the differences in the situation of epidemic areas and the existed condition of the prevention and treatment progress，the comprehensive schistosomiasis control measures should be adjusted according to the local conditions in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source.

Key words: Schistosomiasis； Transmission control；Integrated control； Obstacle factor；Hilly region

摘要： 目的 目的 分析山丘型流行区实施以传染源控制为主的血吸虫病综合防治策略过程中存在的主要障碍， 了解当前血 吸虫病防控工作应优先解决的问题， 为进一步探索解决方法提供参考依据。方法 方法 选择四川省有代表性的山丘型流行区 成都市蒲江县和眉山市东坡区作为研究试点。采用文献回顾方法建立 “山丘地区实施以传染源控制为主的血吸虫病综合 防治策略中的障碍因素” 框架， 结合选题小组方法， 对卫生、 农业、 林业等8个部门中处于省、 市、 县、 乡、 村5个层次的血防 管理和技术人员进行问卷调查。 结果 结果 调查涉及不同部门、 不同层次的血防专业人员153名， 问卷回收率 （专家积极系 数） 为100%。结果显示， 在实施以传染源控制为主的血吸虫病综合策略过程中， 四川省面临工程灭螺、 健康教育、 人查治 病、 改水改厕等4个需重点关注的问题。成都市蒲江县和眉山市东坡区在执行以传染源控制为主的血吸虫病综合防治策 略具体措施上侧重点有所不同， 蒲江县最重要的措施是改水改厕， 东坡区更需要开展工程灭螺。结论 结论 在山丘型流行区 实施以传染源控制为主的血吸虫病综合防治策略过程中， 各流行区疫情状况和现有防治措施进展情况不尽相同， 需因地 制宜地开展综合防控工作。

关键词: 血吸虫病； 传播控制； 综合防治； 障碍因素； 山丘型地区