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目的系统总结山丘型代表性地区血吸虫病的阶段性防治效果,为此类地区今后防治重点措施局部调整提供依据。方法采用随机抽样方法选择四川省眉山市东坡区4个行政村为研究对象,采用回顾性调查法收集2001-2010年血吸虫病疫情资料、干预措施及方法,并于2011年4～11月开展现场调查,采用问卷法调查当地学生与居民血吸虫病的防治知识、态度及行为情况。结果防治初期(2001-2004年),血吸虫病感染率各项指标均较高且疫情反复。综合治理期(2005-2008年),人、畜及钉螺感染情况得到有效遏制,感染率均控制在1%以下。维持阶段(2009-2011年),血防综合效果指数趋势上升明显。3种土源性寄生虫监测结果显示,蛔虫、鞭虫、钩虫人群感染率较2005年分别下降了82.32%、69.77%与64.26%。学生及妇女知识、态度、行为(KAP)问卷综合评分分析表明,在血吸虫病防治知识了解方面,4村当地学生掌握水平要好于妇女,差异均有统计学意义(均有P<0.05)。结论山丘型不同阶段血吸虫病防治措施的变化所带来的疫情明显下降,表明综合治理措施针对性与有效性。应高度注意影响山丘型血吸虫病重新流行潜在因素,因地制宜局部调整防治措施,巩固与维持防治效果将为此类地区率先实现消除血吸虫病提供可能。
Objective To systematically summarize the phased prevention and control of schistosomiasis in the representative area of hillsides and provide the basis for the local adjustment of key measures for prevention and control in such areas in the future. Methods A total of 4 administrative villages in Dongpo District, Meishan City, Sichuan Province were selected as the research objects by random sampling method. The data of schistosomiasis outbreaks, interventions and interventions during 2001-2010 were collected by retrospective survey and were carried out from April to November in 2011 Field survey, questionnaire survey of local students and residents of schistosomiasis control knowledge, attitude and behavior. Results In the early stage of prevention and treatment (2001-2004), all indexes of schistosomiasis infection rate were high and the epidemic situation was repeated. Comprehensive control period (2005-2008), people, livestock and snails infection has been effectively curbed, the infection rate were controlled below 1%. During the maintenance phase (2009-2011), the trend of the comprehensive anti-SARS index increased significantly. The monitoring results of three kinds of soil-borne parasites showed that the infection rates of roundworm, whipworm and hookworm decreased by 82.32%, 69.77% and 64.26% respectively compared with that of 2005. Comprehensive score analysis of knowledge, attitude and behavior (KAP) questionnaire showed that the mastery level of local students in 4 villages was better than that of women in schistosomiasis control knowledge (all P <0.05). Conclusion The epidemic situation caused by the change of schistosomiasis control measures in different stages of hillside obviously decreased, indicating the pertinence and effectiveness of comprehensive management measures. High attention should be paid to the potential impact of recurrent epidemic of schistosomiasis, local adjustment and prevention measures to local conditions, to consolidate and maintain the effectiveness of prevention and treatment for such areas will be the first to achieve the possibility of eliminating schistosomiasis.