Abstract: Objective　To evaluate the effectiveness of the integrated schistosomiasis control programme in Wuhan City from 2005 to 2023, so as to provide insights into precision control and elimination of schistosomiasis.  Methods　The integrated measures for schistosomiasis control implemented by health, agriculture, water resources, and forestry departments of Wuhan City, and the epidemiological data of schistosomiasis in Wuhan City were collected from 2005 to 2023, and the prevalence of human schistosomiasis, prevalence of Schistosoma japonicum infections in humans and bovines, areas of S. japonicum⁃infected snail habitats, areas of snail habitats in inner embankments, and actual areas of snail habitats were retrieved. In addition, the trends in prevalence of schistosomiasis in humans and livestock and snail status were evaluated in Wuhan City from 2005 to 2023 using Mann⁃Kendall test and a Joinpoint regression model.  Results　Mann⁃Kendall test revealed a tendency towards a decline in the prevalence of human schistosomiasis (Z = -4.41, P < 0.01), prevalence of S. japonicum infections in humans (Z = -4.89, P < 0.01) and bovines (Z = -4.50, P < 0.01), areas of S. japonicum⁃infected snail habitats (Z = -3.91, P < 0.01), areas of snail habitats in inner embankments (Z = -2.28, P = 0.02), and actual areas of snail habitats (Z = -5.95, P < 0.01) in Wuhan City from 2005 to 2023. Joinpoint regression analysis showed an average annual reduction of 8.58% in the prevalence of human schistosomiasis in Wuhan City from 2005 to 2023 [average annual percent change (AAPC) = -8.58%, 95% confidence interval (CI): (-10.02%, -6.65%), P < 0.01], with two joinpoints in 2013 and 2016, respectively, and the tendency towards a decline showed statistical significance during the period from 2013 through 2016 [annual percent change (APC) = -34.41%, 95% CI: (-40.36%, -20.01%), P < 0.01]. The prevalence of S. japonicum human infections appeared an average annual reduction of 51.91% in Wuhan City from 2005 to 2023 [AAPC = -51.91%, 95% CI: (-58.12%, -44.25%), P < 0.01], with two joinpoints in 2014 and 2017, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.17%, 95% CI: (-99.17%, -90.87%), P < 0.01]. The prevalence of S. japonicum infections in bovines appeared an average annual reduction of 53.12% in Wuhan City from 2005 to 2023 [AAPC = -53.12%, 95% CI: (-59.65%, -42.44%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2014 through 2017 [APC = -98.63%, 95% CI: (-99.44%, -90.93%), P < 0.01]. The areas of S. japonicum⁃infected snail habitats appeared an average annual reduction of 47.09% in Wuhan City from 2005 to 2023 [AAPC = -47.09%, 95% CI: (-52.92%, -38.26%), P < 0.01], with two joinpoints in 2011 and 2014, respectively, and the tendency towards a decline showed statistical significance during the period from 2011 through 2014 [APC = -97.27%, 95% CI: (-98.65%, -88.06%), P < 0.01]. The areas of snail habitats in inner embankments appeared an average annual reduction of 4.45% in Wuhan City from 2005 to 2023 [AAPC = -4.45%, 95% CI: (-5.18%, -3.82%), P < 0.01], with three joinpoints in 2011, 2015 and 2018, respectively, and statistical significance was seen in the tendency towards a decline during the period from 2005 through 2011 [APC = -16.38%, 95% CI: (-20.15%, -14.25%), P < 0.01]. In addition, the actual areas of snail habitats appeared an average annual reduction of 2.65% in Wuhan City from 2005 to 2023 [AAPC = -2.65%, 95% CI: (-2.89%, -2.40%), P < 0.01], with a joinpoint in 2013, and the tendency towards a decline showed statistical significance during the period from 2013 through 2023 [APC = -4.06%, 95% CI: (-4.66%, -3.58%), P < 0.01]. Conclusions　The integrated schistosomiasis control programme achieved significant effectiveness in Wuhan City from 2005 to 2023, with a tendency towards a decline in morbidity due to schistosomiasis in humans and livestock and snail status. The integrated schistosomiasis control strategy with emphasis on management of the source of S. japonicum infections should continue to be implemented to consolidate the schistosomiasis control achievements and achieve the goal of schistosomiasis elimination in the city.

Key words: Schistosomiasis, Oncomelania hupensis, Mann?Kendall test, Joinpoint regression model, Wuhan City

摘要： 目的　分析2005—2023年武汉市血吸虫病综合防治效果，为血吸虫病精准防控与消除提供参考。方法　收集2005—2023年武汉市卫生、农业、水利、林业等相关部门历年血吸虫病综合防治措施资料和血吸虫病疫情资料，以居民血吸虫病患病率、居民血吸虫感染率、牛血吸虫感染率、感染性钉螺面积、垸内钉螺面积、实有钉螺面积为分析指标，采用Mann⁃Kendall检验和Joinpoint回归模型分析该市血吸虫病人群病情、家畜病情及螺情变化趋势。结果　Mann⁃Kendall检验结果显示，2005—2023年武汉市居民血吸虫病患病率（Z = -4.41，P < 0.01）、居民血吸虫感染率（Z = -4.89，P < 0.01）、牛血吸虫感染率（Z = -4.50，P < 0.01）、感染性钉螺面积（Z = -3.91，P < 0.01）、垸内钉螺面积（Z = -2.28，P = 0.02）、实有钉螺面积（Z = -5.95，P < 0.01）均呈现下降趋势。Joinpoint回归分析发现，2005—2023年武汉市居民血吸虫病患病率年均下降幅度为8.58%［平均年度变化百分比（annual average percent change，AAPC） = -8.58%，95%置信区间（confidential interval，CI）：（-10.02%，-6.65%），P < 0.01］，下降趋势在2013年和2016年出现2个连接点，其中2013—2016年下降趋势有统计学意义［年度变化百分比（annual percent change，APC）= -34.41%，95% CI：（-40.36%，-20.01%），P < 0.01］。2005—2023年武汉市居民血吸虫感染率年均下降幅度为51.91%［AAPC = -51.91%，95% CI：（-58.12%，-44.25%），P < 0.01］，下降趋势在2014年和2017年出现2个连接点，其中2014—2017年下降趋势有统计学意义［APC = -98.17%，95% CI：（-99.17%，-90.87%），P < 0.01］。2005—2023年武汉市牛血吸虫感染率年均下降幅度为53.12%［AAPC = -53.12%，95% CI：（-59.65%，-42.44%），P < 0.01］，下降趋势在2011年和2014年出现2个连接点，其中2011—2014年下降趋势有统计学意义［APC = -98.63%，95% CI：（-99.44%，-90.93%），P < 0.01］。2005—2023年武汉市感染性钉螺面积年均下降幅度为47.09%［AAPC = -47.09%，95% CI：（-52.92%，-38.26%），P < 0.01］，下降趋势在2011年和2014年出现2个连接点，其中2011—2014年下降趋势有统计学意义［APC = -97.27%，95% CI：（-98.65%，-88.06%），P < 0.01］。2005—2023年武汉市垸内钉螺面积年均下降幅度为4.45%［AAPC = -4.45%，95% CI：（-5.18%，-3.82%），P < 0.01］，下降趋势在2011、2015年和2018年出现3个连接点，其中2005—2011年下降趋势有统计学意义［APC = -16.38%，95% CI：（-20.15%，-14.25%），P < 0.01］。2005—2023年武汉市实有钉螺面积年均下降幅度为2.65%［AAPC = -2.65%，95% CI：（-2.89%，-2.40%），P < 0.01］，下降趋势在2013年出现1个连接点，其中2013—2023年下降趋势有统计学意义［APC = -4.06%，95% CI：（-4.66%，-3.58%），P < 0.01］。结论　武汉市血吸虫病综合防治效果显著，人畜病情和螺情均呈下降趋势。应继续实施以传染源控制为主的综合防治策略，以巩固防治成果，实现消除血吸虫病目标。

关键词: 血吸虫病, 钉螺, Mann?Kendall检验, Joinpoint回归模型, 武汉市