浙江省血吸虫病疫情纵向监测及防治策略探讨

Progress on Surveillance of Schistosomiasis and the Discussion on the Control Strategy in Zhejiang Province

分析1996～2009年浙江省血吸虫病疫情监测情况,为制定防治策略提供科学依据.采用5 m系统抽样结合环境抽查2框方法查螺,压碎镜检法检查钉螺感染情况,并采用土埋结合药物方法灭螺.对当地人群和家畜进行血清学筛查后,再用尼龙绢集卵孵化法进行病原学检查,阳性人（畜）进行吡喹酮治疗.建立血吸虫病防治工作年报数据库并进行分析.结果显示1996～2009年全省累计查螺投工2.10×106工,查螺面积1.04×109m2,查出有螺乡1 221个,有螺村4 171个,螺点21 344个,有螺面积1.13×107m2 累计解剖钉螺985 205只,未查获感染性钉螺 灭螺投工8.79×105工,灭螺面积1.06×107m2,扩大灭螺面积1.79×108m2.1996～2009年全省累计血吸虫查病2 929 195人（次）,其中血清学查病2 584 928人（次）,查出阳性者60 549人（次）,血清学阳性率为2.34%.粪检44 589人（次）,未查出内源性血吸虫病人,但发现输入性血吸虫病人174例.耕牛查病93 342头,均为阴性.结果标明,浙江省血吸虫病疫情稳定,但重新传播的流行因素仍然存在,今后应采取＂查灭残存钉螺和防控外来传染源为主的综合性防治策略＂.

To analyse the surveillance results of schistosomiasis in Zhejiang Province from 1996 to 2009, so as to provide the scientific strategy for schistosomiasis control, five meter synchronously systematic samplings combined with the environmental samplings were used for snail survey. The snails were dissected to determine the infection status and earth- covered method combined with drug treatment was used for snail elimination. Serological methods combined miracidium hatching method was used for examining schistosoma. Positive cases were treated by praziquantel. Annual report forms were established for analysis. The results showed that the totals of 2 103.0 thousand labor forces were put into the snail survey. The snails were found in 21 344 spot in 4 171 villages of 1 221 towns with area of 11 295.9 thousand meter square in Zhejiang province from 1996 to 2009. The totals of 879.0 thousand labor forces were put into the snail elimination and total 10 625.1 thousand meter square snails were eliminated. No infected snails were found among 985 205 living snails. There were 60 549 positive cases in 2 584 928 population which were examined by serological methods and the positive rate is 2.34%. 44 589 population were examined by feces examination and not autochthonic positive cases but 174 imported positive cases were found. No positive cases were found in 93 342 farm cattle. It is concluded that schistosomiasis status is stable in Zhejiang Province, however, the prevalence factor for re-emerging of schistosomiasis is still in existence. Comprehensive strategy including emphasizing on the control of the autochthonic snail and import case will be persevered for the future.