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目的分析安徽省血吸虫病传播控制(传控)和传播阻断(传阻)地区达标前、后的疫情演变规律,为控制血吸虫病及巩固防治成果提供科学依据。方法选择安徽省已达血吸虫病传阻的天长市、达传阻后疫情回升的太湖县和达传控疫情回升的广德县,采用回顾性调查方法,以达到血吸虫病传控年为基点,收集各县传控前10年至2008年的血吸虫病疫情资料,分析比较血吸虫病流行区达标前、后病情与螺情变化规律及相关影响因素。结果天长市钉螺分布于局部湖滩,传控年有螺面积3.54 hm2,2008年消灭钉螺;除1993年发生58例急性感染外,其他年份无粪检阳性者,人群血检阳性率维持在0~1.55%的低水平。太湖县达传控的1971年钉螺面积为历史累计有螺面积的0.06%,1983年达传阻前连续3年无螺,传阻12年后疫情回升,发生血吸虫集体感染73例;有螺面积回升至历史累计有螺面积的2.91%,之后钉螺面积持续上升;人群血吸虫感染率为0~5.65%,耕牛粪检阳性率多>1%。广德县达传控年的有螺面积为历史累计钉螺面积的1.90%,之后呈逐年上升趋势,达传控后5年曾发生血吸虫急性感染病例,疫情出现回升。天长市人群血检阳性率、太湖县人群和耕牛粪检阳性率,与当地有螺面积均呈正相关(r=0.582,0.401,0.596,P均<0.05)。结论控制钉螺是实现血吸虫病传播达标和巩固防治成果的关键因素,应加快研究建立有效的螺情监控体系。
Objective To analyze the evolution of epidemic situation before and after the transmission control (transmission control) and transmission block (transmission resistance) of schistosomiasis in Anhui Province, and provide a scientific basis for controlling schistosomiasis and consolidating the prevention and treatment results. Methods Tianchang City, which has reached the resistance of schistosomiasis in Anhui Province, was established in Taihu County and Guangde County, where the epidemic rebounded after reaching the transmission resistance. The retrospective investigation method was adopted in Guangde County, which reached the transmission control year of schistosomiasis. The epidemic situation of schistosomiasis in the counties from 10 years ago to 2008 was collected. The changes of schistosomiasis prevalence before and after reaching the target of schistosomiasis prevalence and the related influencing factors were analyzed. Results The snails in Tianchang City were distributed in local lakes and beaches. The transmitting area was 3.54 hm2 in 2001 and the number of squirrels was 188 in 2008. In addition to 58 cases of acute infection in 1993, the positive rate of blood tests in other years remained at 0 ~ 1.55% low level. Taihu County Tatsu 1971 snail control area for the cumulative history of a spiral area of 0.06% in 1983 before the resistance for 3 consecutive years without snail, resistance 12 years after the epidemic picked up, the occurrence of schistosomiasis 73 cases of collective infection; snail area Rose to 2.91% of the total snail area in history, and then the snail area continued to rise. The prevalence of schistosomiasis in the population was 0-5.65%, and the positive rate of cattle dung was> 1%. The grazing area in Guangde County reached 1.90% of the cumulative snail area in history, and then showed an upward trend year by year. Cases of acute schistosomiasis occurred in the past five years after transmission and control, and the epidemic rebounded. The positive rate of blood test in Tianchang city, the positive rate of cattle population and cow dung in Taihu County were positively correlated with the local area (r = 0.582,0.401,0.596, P <0.05). Conclusion Controlling snails is the key factor to achieve the goal of schistosomiasis transmission and consolidate the prevention and cure results. It is necessary to speed up the research to establish an effective snail control system.