流动渔船民血吸虫病防治措施的研究Ⅱ渔船民粪便管理为主的综合措施控制血吸虫病的效果

Study on schistosomiasis control measures in mobile boat fishermen Ⅱ Effect of comprehensive measures with emphasis on management of boat fishermen feces for schistosomiasis control

目的评价流动渔船民粪便管理为主的综合防治措施对控制血吸虫病的效果,为实施传染源控制策略提供有效防治措施。方法收集记录对策实施情况,采用现场调查的方法,每年对渔船民集散地采用系统抽样法进行螺情调查,并对渔船民进行病情调查,比较对策实施前后集散地螺情指标和渔船民病情指标变化趋势以及扬州市血吸虫病疫情变化。结果2006～2008年在扬州市53个渔船民集散地建造三格式无害化公厕103座,对22处集散地实施了安全用水,发放粪便收集容器1907只,发放防蚴霜8159支,开展集散地药物灭螺2316.74hm2,渔船民查病9698人次,2006年淘汰处理耕牛91头。2005～2008年共捕获解剖钉螺40434只,发现感染性钉螺36只,各年查出感染性钉螺面积分别为55.11、9.00、9.00hm2和2.00hm2,钉螺感染率为0.133%、0.132%、0.052%和0.035%,4年共开展渔船民查病11680人次,查出粪检阳性15例,各年渔船民血吸虫感染率分别为0.36%、0.08%、0.14%和0。对策实施3年后,集散地感染性钉螺面积、钉螺感染率和渔船民血吸虫感染率分别下降了96.37%、73.77%和100%。全市感染性钉螺面积、钉螺感染率和居民血吸虫病患病率分别由110.03hm2、0.111%和0.13%下降到4.00hm2、0.012%和0.03%,分别下降了96.36%、89.19%和76.92%。结论在全面实施"以机代牛"的沿江地区,实施渔船民粪便管理为主的综合防治措施能够逐步控制血吸虫病流行。

Objective To evaluate the effect of comprehensive measures with emphasis on management of boat fishermen feces for schistosomiasis control,so as to provide the effective control measures for implementing the strategy of infectious source control. Methods The implementation status of the measures was investigated and the data were recorded. The snail status was surveyed by using the systematic sampling,and the schistosomiasis morbidity of the boat fishermen was surveyed from 2006 to 2008 at the anchor spots. The changes of the snail status,the morbidity of the boat fishermen at the anchor spots and the endemic situation of schistosomiasis in Yangzhou City before and after the implementation of the measures were compared. Results From 2006 to 2008,in Yangzhou City,a total of 103 harmless public toilets with 3-inner-part excrement pools were built at 53 anchor spots of the boat fishermen,safe water was set up at 22 anchor spots,a total of 1 907 sanitation facilities and 8 159 anti-cercaria cream were handed out,the snail control area with molluscicides was 2 316.74 hm2,and a total of 9 698 persons were examined for schistosomiasis. In 2006,91 head of cattle were eliminated completely. From 2005 to 2008,a total of 40 434 snails were collected,among which 36 snails were infected with schistosome,and the areas with infected snails and the infection rate of snails were 55.11,9.00,9.00,2.00 hm^2,and 0.133%,0.132%,0.052% and 0.035%,respectively. A total of 11 680 boat fishermen were examined for schistosomiasis,among which 15 were positive for stool examination,and the infection rate of boat fishermen were 0.36%,0.08%,0.14% and 0,respectively from 2005 to 2008. The reduction rates of the areas with infected snails,infection rate of snails and infection rate of schistosome in boat fishermen were 96.37%,73.77% and 100%,respectively at anchor spots 3 years after implementation of the measures. The areas with infected snails reduced from 110.03 hm^2 to 4.00 hm^2,the infection rate of snails from 0.111% to 0.012% ,and the prevalence rate of schistosomiasis in residents from 0.13% to 0.03% in Yangzhou City 3 years after implementation of the measures,and the reduction rates were 96.36%,89.19% and 76.92%,respectively. Conclusion In the areas along the Yangtze River where the strategy of ＂replacement of cattle with machines＂ is implemented completely,the comprehensive measures with emphasis on management of boat fishermen feces can control the transmission of schistosomiasis step by step.