我国血吸虫病防治的成就及面临的问题

Achievements and Challenges in Schistosomiasis Control in China

新中国成立以来,我国坚持了因地制宜的综合性防治血吸虫病策略,取得举世瞩目的成绩。至2008年底,全国有血吸虫病流行的12个省(市、区)中5个已阻断传播,454个流行县(市、区)中有265个已阻断传播,97个已控制传播;全国血吸虫病病例数由防治初期的1000余万例降至41.3万例。目前,尚未控制传播的92个县(市、区)均分布在湖沼和高原山区,防治工作难度很大。由于环境和社会经济因素影响,综合性防治策略无法实施。以控制传染源为主的策略虽可迅速降低血吸虫病的感染率和感染度,但由于钉螺分布广泛,传染源种类众多,难以控制再感染。应改变传统的生物医学防治模式,坚持以社会措施为主导的综合防治策略,将血吸虫病防治纳入当地的社会经济发展规划,改变传统的生活、生产习惯,逐步减少血吸虫病感染的机会,以消除血吸虫病传播的危险因素,直至控制和阻断血吸虫病的传播。只有这样,血吸虫病防治才能持续发展。

Achievements for schistosomiasis control have been gained by implementation of integrated control strategies according to local conditions since the founding of the People＇s Republic of China. By the end of 2008, 5 of the 12 provinces reached the criteria of transmission interruption. Among 454 endemic counties, transmission was interrupted in 265 counties while 97 counties reached the criteria of transmission control. The number of schistosomiasis cases decreased from 10 million in history to 413 000. Currently, there still left 92 counties where the disease is endemic and mainly distributed in lake and mountainous regions. Limited by the environmental and socioeconomic factors, integrated control strategies could not be carried out in these places. Although the strategies based on reducing the roles of humans and cattle as resources of infection decreased the infection rate and intensity quickly, re-infection occurred frequently due to the spread of snails and numerous animal reservoirs. Chemotherapy alone could not interrupt the transmission. By changing the traditional bio-medical control model, applying integrated control strategy mainly with social measures, integrating disease control with local social and economic development programs, changing the traditional life styles and agricultural production patterns, and eliminating the risk factors for schistosmiasis transmission, schistosomiasis control can be developed sustainably and reach the criteria of transmission interruption finally.