Abstract: Objective　To investigate the effectiveness of the integrated schistosomiasis control programme in Sichuan Province during the stage moving from transmission interruption to elimination (2015—2023), so as to provide insights into formulation of the schistosomiasis control measures during the post⁃elimination stage. Methods　Schistosomiasis control data were retrospectively collected from departments of health, agriculture and rural affairs, forestry and grassland, water resources, and natural resources in Sichuan Province from 2015 to 2023, and a database was created to document examinations and treatments of human and livestock schistosomiasis, and snail survey and control, conversion of paddy fields to dry fields, ditch hardening, rivers and lakes management and building of forests for snail control and schistosomiasis prevention. The completion of schistosomiasis control measures was investigated, and the effectiveness was evaluated. Results　A total of 20 545 155 person⁃times received human schistosomiasis examinations in Sichuan Province during the period from 2015 to 2023, and 232 157 person⁃times were seropositive, with a reduction in the seroprevalence from 2.10% (44 299/2 107 003) in 2015 to 1.12% (9 361/837 896) in 2023 ([χ2] = 7.68, P < 0.001). The seroprevalence of human schistosomiasis appeared a tendency towards a decline in Sichuan Province over years from 2015 to 2023 (b = -8.375，t = -10.052，P < 0.001); however, no egg positive individuals were identified during the period from 2018 to 2023, with the prevalence of human Schistosoma japonicum infections maintained at 0. Expanded chemotherapy was administered to 2 754 515 person⁃times, and medical assistance of advanced schistosomiasis was given to 6 436 person⁃times, with the treatment coverage increasing from 46.80% (827/1 767) in 2015 to 64.87% (868/1 338) in 2023. Parasitological tests for livestock schistosomiasis were performed in 35 113 herd⁃times, and expanded chemotherapy was administered to 513 043 herd⁃times, while the number of fenced livestock decreased from 121 631 in 2015 to 103 489 in 2023, with a reduction of 14.92%. Snail survey covered 433 621.80 hm2 in Sichuan Province from 2015 to 2023, with 204 602.81 hm2 treated by chemical control and 4 637.74 hm2 by environmental modifications. The area of snail habitats decreased from the peak of 5 029.80 hm2 in 2016 to 3 709.72 hm2 in 2023, and the actual area of snail habitats decreased from the peak of 8 585.48 hm2 in 2016 to 473.09 hm2 in 2023. The mean density of living snails remained low across the study period except in 2017 (0.62 snails/0.1 m2). Schistosomiasis control efforts by departments of agriculture and rural affairs in Sichuan Province included conversion of paddy fields to dry fields covering 153 346.93 hm2, hardening of 6 110.31 km ditches, building of 70 356 biogas digesters, replacement of cattle with 227 161 sets of machines, and captive breeding of 21 161 070 livestock from 2015 to 2023, and the control efforts by departments of water resources included rivers and lakes management measuring 5 676.92 km and renovation of 2 331 irrigation areas, while the control efforts by departments of forestry and grassland included building of forests for snail control and schistosomiasis prevention covering 23 913.33 hm2, renovation of snail control forests covering 8 720 hm2 and newly building of shelterbelts covering 764 686.67 hm2. All 63 endemic counties (cities and districts) had achieved the criterion for schistosomiasis elimination criteria in Sichuan Province by the end of 2023. Conclusion　Following the integrated control efforts from 2015 to 2023, remarkable achievements have been obtained in the schistosomiasis control programme in Sichuan Province, with all endemic counties successfully attaining the schistosomiasis elimination target at the county level.

Key words: Schistosomiasis, Prevention and control, Transmission interruption, Elimination, Sichuan Province

摘要： 目的　分析2015—2023年四川省血吸虫病从传播阻断到消除阶段的综合防治效果，为制定消除后血吸虫病防治措施提供科学依据。方法　收集2015—2023年四川省卫生健康、农业农村、林草、水利、自然资源等部门血吸虫病防治相关资料，统计人群、家畜查治病和流行区查灭螺，以及水田改旱、沟渠硬化、河流湖泊治理、抑螺防病林建设等数据，分析各项血吸虫病防治措施完成情况，并评价防治效果。结果　2015—2023年四川省累计开展人群查病20 545 155人·次，血检阳性232 157人·次，血检阳性率从2015年的2.10%（44 299/2 107 003）下降至2023年的1.12%（9 361/837 896），差异有统计学意义（[χ2] = 7.68，P < 0.001）；各年血检阳性率呈逐年下降趋势（b = -8.375，t = -10.052，P < 0.001）。2018—2023年均未发现病原学阳性病人，人群血吸虫感染率持续为0。9年来共开展人群扩大化疗2 754 515人·次，救治晚期血吸虫病病人6 436人·次，救治人数占比从2015年的46.80%（827/1 767）上升至2023年的64.87%（868/1 338）；共开展家畜病原学检查35 113头·次，完成扩大化治疗513 043头·次，家畜存栏量从2015年的121 631头降至2023年的103 489头，下降了14.92%。2015—2023年四川省累计查螺433 621.80 hm2，药物灭螺204 602.81 hm2，环境改造灭螺4 637.74 hm2，查出有螺面积从2016年的5 029.80 hm2下降至2023年的3 709.72 hm2，实有钉螺面积从2019年的8 585.48 hm2下降至2023年的473.09 hm2；2017年活螺平均密度为0.62只/0.1 m2，其余年份均在较低水平波动。2015—2023年四川省农业部门累计完成水田改旱153 346.93 hm2，沟渠硬化6 110.31 km，沼气池建设70 356座，以机代牛227 161台（套），家畜圈养21 161 070头（只）；水利部门累计开展河流湖泊治理5 676.92 km，灌区改造2 331处；林草部门累计建设抑螺防病林23 913.33 hm2，抑螺林改造8 720 hm2，新建防护林764 686.67 hm2。截至2023年底，全省63个流行县（市、区）全部达到血吸虫病消除标准。结论　2015—2023年四川省实施各项血吸虫病综合防治措施后，全省血吸虫病防治效果显著，以县为单位实现了消除血吸虫病目标。

关键词: 血吸虫病, 防治, 传播阻断, 消除, 四川省