南水北调东线一期工程血吸虫病监测预警研究 Ⅲ监测预警指标和风险评估研究

Study on surveillance and early-warning system of schistosomiasis in first phase of east route of South-to-North Water Diversion Project Ⅲ Indexes of surveillance and early-warning and risk assessment

目的建立南水北调东线工程血吸虫病监测预警指标体系,为东线工程血吸虫病传播风险评估和制订应急预案提供科学依据。方法采用专家咨询法和流行病学多维综合评价等方法对东线工程血吸虫病监测预警指标进行评估,以确定预警指标。结果评估研究了53个监测预警指标,其中一级指标3个,二级指标10个,三级指标40个。结果表明钉螺是南水北调东线工程血吸虫病监测预警的主要指标,其中又以钉螺孳生位置最为重要。据此建立了东线工程4个血吸虫病监测预警等级,分别为Ⅰ级:钉螺扩散进入输水河道渠首(一级泵站上);Ⅱ级:里运河钉螺扩散越过N 32°54;′Ⅲ级:里运河钉螺扩散越过N 33°03′或越过金湖站;Ⅳ级:钉螺扩散越过N 33°15′或越过洪泽站。同时确定了4个人畜感染指标为重要的指示性指标。根据各项指标间关系,确定了东线工程血吸虫病传播风险评估方法。结论初步确定了钉螺为主、人畜感染为辅的监测预警指标体系和东线工程血吸虫病传播风险评估方法。

Objective To establish the index system of surveillance and early-warning on schistosomiasis and to provide the scientific basis for risk assessment and emergency plan in first phase of east route of South-to-North Water Diversion Project.Methods The Delphi method and the multidimensional synthetic evaluation were used in the evaluation of indexes of surveillance and early-warning on schistosomiasis in the east route of the project.Results There were 53 indexes evaluated in the index system,and among them,there were 3 first grade indexes,10 second grade indexes and 40 third grade indexes.The indexes on Oncomelania snails were the most important.According to the habitation position of snails,the four grades on surveillance and early-warning of schistosomiasis were established in the east route.The grade I of the early-warning meant that snails crossed the first level of the pumping station.The grade Ⅱ meant that snails crossed N 32°54′.The grade Ⅲ meant that snails crossed N 33°03′ or Jinhu pumping station.The grade Ⅳ meant that snails crossed N 33°15′ or Hongze Station.Other 4 indexes on schistosome infection in people and livestock were confirmed as indicative indexes.According to the relationship among the indexes,the evaluation methods were determined on the risk of schistosomiasis transmission.Conclusions The index system of surveillance and early-warning and the methods of risk assessment of schistosomiasis have been confirmed in first phase of east route of South-to-North Water Diversion Project.The primary index is related to snails and the supplementary is related to schistosome infection in people and livestock in the system.