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目的:我国血吸虫病的传播与自然生态环境和社会经济等因素关系密切,采取以前的防治策略难以控制湖沼型血吸虫病的传播。研究旨在探索以控制传染源为主的湖沼型血吸虫病流行区综合防治新策略的效果。方法:选取了江西省鄱阳湖地区、每年常规实施化疗防治措施的2个干预村和2个对照村进行现场研究。新的干预措施于2005年全面实施,主要措施包括封洲禁牧、“以机代牛”、改水改厕、渔船民粪便管理等措施,并强化健康教育措施,以降低人和耕牛作为钉螺传染源的作用。并于2005—2008年间连续观测了人群感染率、钉螺感染率以及哨鼠感染率的变化情况。结果:干预措施实施后,经3个传播季节后干预组的血吸虫人群感染率降到1.0%以下,其中爱国村从11.3%降到0.7%,新和村从4.0%降到0.9%(两两比较均P<0.001),且在第4个传播季节后分别持续下降至0.2%和0%。而对照组人群感染率出现上下波动,但仍维持在原来的基线水平。干预组一个草洲上的感染性钉螺密度在4个传播季节后分别从2.2%和0.3%下降到0%(两两比较均P<0.01),而暴露于水体中的哨鼠感染率从79.3%降至0%(P<0.001)。结论:以传染源控制为主综合性防治策略能有效地降低日本血吸虫病在耕牛、人群和钉螺间的传播,这一策略现已被采纳为中国新的血吸虫病防治策略。
OBJECTIVE: The transmission of schistosomiasis in China is closely related to the natural ecological environment and socio-economic factors. It is difficult to control the spread of schistosomiasis in lakes and marshes with the previous prevention and treatment strategies. The aim of this study is to explore the effect of a new strategy of comprehensive prevention and control in the endemic area of lakes and swamp schistosomiasis with predominant source of infection. Methods: Two intervention villages and two control villages routinely carrying out chemoprevention and control measures were selected in Poyang Lake area of Jiangxi Province to carry out on-site research. The new interventions were fully implemented in 2005. The main measures include ban on animal husbandry, animal husbandry on the one hand, water management on the other hand, management of manure on fishing boats, and health education measures to reduce man and farm work Cattle as a snail infection source role. In 2005-2008, the infection rate, snail infection rate and the infection rate of sentinel infection in the population were continuously observed. Results: After the implementation of the interventions, the infection rate of schistosomiasis in the intervention group fell below 1.0% after 3 transmission seasons. Among them, Patriotic Village fell from 11.3% to 0.7% and Xinhe Village dropped from 4.0% to 0.9% P <0.001), and continued to decline to 0.2% and 0% respectively after the fourth propagation season. The infection rate in the control group fluctuated up and down, but remained at the original baseline level. Infected snail density on a turfgrass declined from 2.2% and 0.3% respectively to 0% after 4 seasons (P <0.01 for any pairwise comparison), while the infection rate of the sentinel in water exposed from 79.3 % To 0% (P <0.001). CONCLUSION: The integrated control strategy based on infection source control can effectively reduce the spread of schistosomiasis japonica among cattle, people and snails. This strategy has been adopted as a new prevention and control strategy for schistosomiasis in China.