眉山市马来丝虫病防治后期流行趋势

Epidemic Trends of Later Stage Control of Malayan Filariasis in Meishan

目的了解眉山市丝虫病防治后期的流行病学特征,评价消除丝虫病后的流行趋势和慢性丝虫病患者的变化。方法采取查治残存传染源、集体服药和重点人群与防治薄弱村组为主要监测对象的巩固措施,采用重点乡镇人群普服0.3%乙胺嗪药盐的净化措施;开展后期慢性丝虫病调查和复查及横向人群监测。结果 1983年眉山市基本消除丝虫病后,1983-1985年在重点人群监测的原微丝蚴血症者114人和疫点人群3 605人中,分别检出微丝蚴血症者4例,微丝蚴密度1～252条/120μl,平均38.75条/120μl;1984年和1988年横向人群监测3 104、5 551人,分别新检出微丝蚴血症者5、1人,平均微丝蚴密度6.20条、11条/120μl。随着巩固和净化措施实施,1989-2012年连续监测24年未检出微丝蚴血症者。原慢性丝虫病患者由基本消除丝虫病前的393例,减少至2011年的29例,1989年以来无新发慢性丝虫病发生。现遗留的慢性丝虫病患者表现为高龄化、病程长的特点。结论眉山市消除丝虫病后监测,未发现内源性传染源,显示实施巩固与净化措施后远期效果显著,原流行区现39岁以下人群得到了有效保护。后期工作重点应放在对输入性传染源的监测和原慢性丝虫病患者给予关怀与照料。

Objective To understand the epidemiological characteristics of the later stage of filariasis control program in Meishan,and to evaluate the epidemic trends after elimination of filariasis,as well as the changes of chronic filariasis cases.Methods Consolidation measures were comprehensively carried out,such as detecting and treating the residual infection sources,collective medication,targeted population and village in weak control program as the main surveillance objects.The targeted rural population generally took 0.3% diethylcarbamazine medicated salt.Investigation and re-examination of the later chronic filariasis,combined with the cross-sectional crowd surveillance were launched.Results After filariasis was basically eliminated in Meishan in 1983,respectively 4 and 4 microfilaria cases were detected in 114 original cases and 3605 persons living in foci during 1983-1985.Microfilaria density was 1-252/120μl.The average of that was 38.75/120μl;5 and 1 microfilaria cases were newly detected in 3140 persons and 5551 persons in 1984 and 1988 respectively in cross-sectional crowd surveillance.The average microfilaria density was 6.20/120μl and 11/120μl orderly.In 24 continuous years surveillance during 1989-2012,with the consolidation and purification measures being taken,microfilaria cases have not been detected out.Original chronic filariasis cases reduced from 393 cases before filariasis being basically eliminated to 29 cases in 2011.Chronic filariasis have not been detected since 1989.The characteristics of the residual chronic filariasis cases were aging and long duration.Conclusion There has no endogenous infection source detected in surveillance after filariasis was eliminated.With consolidation and purification measures,long-term effect has been significant in Meishan.To date,people under age of 39 in the original epidemic areas have been effectively protected.Later work should be focused on surveillance of the input sources of infection and the care of chronic filariasis patients.