摘要
目的掌握江西省瑞昌市血吸虫病疫情动态,为今后开展精准防控提供参考。方法采用回顾性调査法收集瑞昌市2009-2017年血吸虫病防治工作报表及相关数据,主要包括每年人群査病、治疗及晚期血吸虫病(简称晚血)患者情况,家畜査病情况,以及中间宿主钉螺的控制情况,以乡(镇)为单位建立针对人、畜疫情及螺情的数据库,统计人群血检阳性率、家畜粪检阳性率、有螺面积及有螺框出现率和活螺密度等主要指标,并进行相应的处理与分析。结果2009-2017年,全市累计査病736216人次,血清学检查703121人次,血清学抗体阳性者合计6404例,血检阳性率为0.40%~1.48%,各年间差异有统计学意义(P<0.01)。2016年水灾后,人群血检抗体阳性率升高,2017年升至1.45%(701/48458),与2015年的0.40%(357/90271)差异有统计学意义(P<0.01)。累计粪检107318人次,阳性者292例,人群粪检阳性率为0~1.24%,各年间差异有统计学意义(P<0.01)。粪检阳性者主要分布在夏畈(25.68%,75/292)、范镇(21.23%,62/292)、码头(15.75%,46/292)、桂林(12.33%,36/292)、高丰(11.99%,35/292)、横岗(8.90%,26/292)、南阳(3.42%,10/292)等7个乡(镇)。9年间无急性血吸虫病病例报告,自2015年后全市未发现粪检阳性者。瑞昌市现存晚血患者209例,主要分布在夏畈(73例,34.93%)、高丰(51例,24.40%)、范镇(24例,11.48%)、黄金(22例,10.53%)和码头(15例,7.18%)等5个乡(镇)。2009-2017年共计査牛36460头次,査出病牛258头,治疗262头次,扩大化疗29750头次,病牛主要分布在夏畈(87头,33.72%)、高丰(48头,18.60%)、黄金(62头,24.42%)、武蚊(29头,11.24%)等4个乡(镇)。2009-2015年全市钉螺面积呈逐年下降趋势,2015年降至584.11 hm^2,但与2009年的615.99 hm^2比较差异无统计学意义(P>0.05)。有螺框出现率从20.56%下降至10.78%(P<0.01),钉螺密度从0.34只/框下降至0.16只/框(P<0.05)。受2016年水灾影响,瑞昌市有螺面积大幅度增加,较2015年增加了43.60%(838.76 hm^2,P<0.01),灾后当年(2016年)有螺框出现率、钉螺密度变化不大,2017年有螺框出现率达27.94%、钉螺密度达0.56只/框,均高于2015年的10.78%和0.16只/框(P<0.01)。桂林、码头、高丰、夏畈、范镇、横岗、南阳、武蚊和黄金等9个乡(镇、街道)的有螺面积、有螺框出现率和活螺密度均在水灾后呈上升趋势。相关性分析结果显示,人和牛粪检阳性率、人群血检抗体阳性率与査出钉螺面积、有螺框出现率及活螺密度等指标两两之间相关系数较低(r为-0.199~0.202),无相关性。结论瑞昌市血吸虫病疫情呈逐年下降趋势,但码头、高丰、范镇、夏畈、横岗、桂林街道仍是血吸虫病传播风险较高乡(镇)。钉螺控制受水灾等自然因素影响较大,防治成果不易巩固,因此亟需建立灾后应急预案与良好的灾后篮测体系,防止疫情回升。
Objective To analyze the endemic situation of schistosomiasis in Ruichang,Jiangxi Province from 2009 to 2017,so as to provide reference for formulating the corresponding prevention and control measures and strategies.Methods The annually reported data related to the prevention and control of schistosomiasis in Ruichang were collected from 2009 to 2017.These data mainly include the annual examination of schistosomiasis in the population,the treatment for the advanced schistosomiasis patients,status for livestock infection and snail control.Then a database related to the Schistosoma infections of humans,livestock and snail was established accordingly by using township as calculated units.The serological positive rate in humans,the fecal egg positive rate in livestock,the area with snail,the occurrence rate and the density of living snails were analyzed based on the database.Results A total of 736216 individuals received examination for schistomiasis including 703121 received serological test.Total 6404 were serologically positive with positive rate of 0.40%〜1.48%,which was statistical difference between the years(P<0.01).The serological positive rate increased after flood in 2016 and reached to 1.45%(701/48458)in 2017,with a significant difference compared with 2015(0.40%,357/90271).Total 107318 individuals received fecal examination with 292 egg positive,with positive rate ranging from 0 to 1.24%,with statistical difference between different years(P<0.01).The egg positive patients were mainly distributed in 7 townships including Xiafan(25.68%,75/292),Fanzhen(21.23%,62/292),Matou(15.75%,46/292),Guilin(12.33%,36/292),Gaofeng(11.99%,35/292),Henggang(8.90%,26/292)and Nanyang(3.42%,10/292).There was no acute schistosomiasis patient found in consecutive 9 years.There was no fecal positive patient since 2015.However,there were still 209 cases of advanced schistosomiasis in Ruichang region mainly distributed in the town of Xiafan(73,34.93%),Gaofen(51,24.40%),Fanzhen(24,11.48%),Huangjin(22,10.53%)and Matou(15,7.18%).The total number of 36460 cattle were examined from 2009 to 2017,in which 258 confirmed with infection of Schistosoma,most of them distributed in Xiafan(87,33.72%),Gaofeng(48,18.60%),Huangjin(62,24.42%)and Wujiao(29,11.24%).Total 262 infected cattle received anthelmintic treatment and the mass administration of anthelmintic expanded to 29750 cattle.The area with snails decreased year by year since 2009(615.99 hm^2),and reached to the lowest level of 584.11 hm^2 in 2015,however,the difference in area with snail between 2015 and 2009 was no significant.The incidence of frames with snails decreased from 20.56% in 2009 to 10.78% in 2015,with statistical differences between the years(P<0.01).Similarly,the density of snail decreased from 0.34/frame in 2009 to 0.16/frame in 2015,with statistical difference between the two years(P<0.05).Affected by the flood in 2016,the area with snail increased 43.60%(838.76 hm2)compared to that in 2015 with significant difference(P<0.01),however,there was no significant change for the occurrence rate with snail in frames and the density of snail.In 2017,the incidence of frames with snails reached to 27.94%,and the density of snails reached to 0.56/frame,which were significantly higher than that in 2015(10.78%,0.16/frame)(P<0.01).This increase happened in main nine towns of Ruichang.The correlation coefficient between serological positive rate in people,fecal egg positive rates in human and cattle and the area with snail,snail density,percentage of frames with snail was low(r=-0.199-0.202),without significance.Conclusion The endemic situation of schistosomiasis in Ruichang region was decreasing year by year since 2009.However,Matou,Gaofeng,Fanzhen,Xiafan,Henggang and Guilin are still the main areas with high risk of schistosomiasis transmission and the major areas for the disease control.Snail control is difficult to be consolidated and greatly affected by flood and other natural factors.Therefore,it is critical to establish emergent plan and the monitoring system after flood to prevent rebound of schistosomiasis in the flooded area.
作者
吕超
周理源
陈锐
幸小英
陈涛
柯寒臣
张智勇
祝红庆
许静
LV Chao;ZHOU Li-yuan;CHEN Rui;XING Xiao-ying;CHEN Tao;KE Han-chen;ZHANG Zhi-yong;ZHU Hong-qing;XU Jing(National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention,Chinese Center for Tropical Diseases Research,WHO Collaborating Centre for Tropical Diseases,National Center for International Research on Tropical Diseases,Ministry of Science and Technology,Key Laboratory of Parasite and Vector Biology,Ministry of Health,Shanghai 200025,China;Ruichang City Station for Schistosomiasis Control,Ruichang 332200,China)
出处
《中国寄生虫学与寄生虫病杂志》
CAS
CSCD
北大核心
2019年第6期658-664,共7页
Chinese Journal of Parasitology and Parasitic Diseases
基金
国家重点研发计划项目(No.2016YFC1202000)
国家科技重大专项(No.2018ZX10101002-002)~~
关键词
血吸虫病
疫情分析
江西省
瑞昌市
Schistosomiasis
Endemic status analysis
Jiangxi Province
Ruichang
