Abstract:

Objective To study the effectiveness of comprehensive control measures based on systematic ecological system construction to interrupt the transmission of schistosomiasis in hilly endemic regions in Sichuan Province， so as to provide the evidence for adjustment of schistosomiasis prevention and control strategies. Methods A high endemic area of schistosomiasis， Panao Township of Dongpo District in Meishan City， was selected as a demonstration area. The comprehensive measures for schistosomiasis control with focus on systematic ecological management were implemented， and the income of residents， indexes of schistosomiasis control effect and so on were investigated before and after the intervention and the results were compared. Results The project based on systematic ecological system construction started in 2009 and 317.351 million Yuan was put into the construction. The construction included economic forest plant base （1 866.68 hm2， 72.66% of the total farmland areas）， ecological protection gardens （585.35 hm2） and so on. Totally 97.04% of historical areas with Oncomelania hupensis snails were comprehensively improved. In 2015， the peasants' pure income per capita increased 4 938 Yuan， with the average annual growth rate of 14.69%. All the farm cattle were replaced by the machine. The benefit rate of water improvement was increased by 52.84% and the coverage rate of harmless toilets increased by 18.30%. The positive rate of serological tests for schistosomiasis decreased from 7.69% to 3.50%， and the positive rate of parasitological tests decreased from 1.18% to 0. The area with snails was decreased from 23.33 hm2 to 0. The awareness rate of schistosomiasis control knowledge and correct behavior rate of the residents increased from 85.50% and 82.60% to 95.70% and 93.90% respectively. Conclusions The comprehensive schistosomiasis control measures based on systematic ecological management are conform to the currently actual schistosomiasis prevention and control work in hilly endemic regions， and have good ecological economic benefit and schistosomiasis control effectiveness， which provide an effectively new model of prevention and control for advancing process， consolidating the effect， finally realizing goal of interruption and elimination of schistosomiasis in hilly endemic regions.

Key words: Schistosomiasis； Ecological system construction； Transmission interruption； Schistosomiasis elimination； Hilly endemic regions； Comprehensive control

摘要：

目的　研究四川省山丘地区依托系统化生态体系建设阻断血吸虫病传播的效果，为探索血吸虫病防治策略的调整提供依据。 方法　选择四川省眉山市东坡区山丘型血吸虫病历史重流行区盘鳌乡作为示范区，实施以系统化生态体系建设和血吸虫病防治工作相结合的综合治理措施，并对示范区项目实施后的居民经济收入、血防效果指标等进行比较和分析。 结果　综合示范区项目于2009年起实施，共投入生态园区建设经费31 735.10万元，建成了优质蜜柚和藤椒等果木为主的经济林种植基地1 866.68 hm2（占园区总耕地面积的72.66%），以及土地生态保护主题园区585.35 hm2，综合整治了历史钉螺分布环境面积的97.04%。到2015年示范区农民人均纯年收入增加4 938元，平均年增长率为14.69%。示范区淘汰了全部耕牛，实现了机械化耕作。居民改水受益率上升52.84%，无害化厕所覆盖率上升18.30%。人群血清学检测血吸虫阳性率从7.69%降至3.50%，病原学检测阳性率从1.18%降至0。查出有螺面积从23.33 hm2降为0。人群血防知识知晓率和行为正确率分别从85.50%、82.60%提高至95.70%、93.90%。结论　依托系统化生态体系建设的血吸虫病综合防治策略，符合当前山丘型流行区防治工作的实际，可发挥较好的生态、经济和血防综合效益和效果，为山丘型流行区推进血防工作进程、巩固防治成果、最终实现阻断和消除血吸虫病目标提供了有效的防治新模式。

关键词: 血吸虫病；生态体系建设；传播阻断；消除血吸虫病；山丘型流行区；综合治理