四川省山丘地区血吸虫病疫情回顾性调查

Retrospective investigation and analysis of endemic situation of schistosomiasis in hilly regions of Sichuan Province

目的分析四川省血吸虫病传播控制、传播阻断以及阻断后疫情反弹地区螺情与病情的变化规律。方法选择四川省青白江区、龙泉驿区和喜德县,采取回顾性调查方法,收集、记录3个县达到传播控制前10年-2008年的疫情资料,建立调查资料数据库,分析各县螺情病情变化趋势和规律。结果青白江区活螺密度增长与有螺面积增长呈正相关(r=0.74,P<0.01),居民感染率持续下降;龙泉驿区有螺面积呈逐年下降趋势;喜德县人群感染率分别与有螺面积、活螺密度呈正相关(r=0.53,P<0.01;r=0.42,P<0.05)。结论螺情反弹往往早于人群病情出现,提示在达标地区可将钉螺的回升作为疫情反弹预警的重要指标之一。开展有螺环境的综合治理和进一步消除潜在传染源是巩固防治成果的重要手段。

Objective To explore the rules of the changes of schistosomiasis infection and Oncomelania snails in areas where schistosomiasis transmission was controlled or interrupted or rebounded after interruption.Methods Qingbaijiang District,Longquanyi District and Xide County were selected and investigated retrospectively to collect schistosomiasis epidemiological information 10 years before they reached the criterion of transmission control and the subsequent years until 2008.The database of retrospective investigation was established for analyzing the trends and rules of changes of snail status and human infection status.Results In Qingbaijiang District,there was a positive correlation between density of living snails and snail area（r = 0.74,P 0.01）,and the infection rate of population was declining.In Longquanyi District,the snail area presented a declining trend.In Xide County,the human infection rate was positively correlated with snail area（R = 0.53,P 0.01） and the density of living snails（r = 0.42,P 0.05） respectively.Conclusions The rebound of snail situation is always prior to the emerging of human infection,and it prompts that the rebound of snail situation can be considered one of the important indicators of early warning of the rebound of human infection situation in those places where schistosomiasis transmission was controlled or interrupted.Implementing comprehensive control of the snail habitat,as well as eliminating the potential infectious source is an important measure to consolidate the achievement of schistosomiasis control.