安徽马鞍山市辖区实现血吸虫病传播阻断目标风险评估

Risk assessment on the achivement of schistosomiasis interruption in the district of Ma'anshan City

目的分析安徽马鞍山市辖区近年来血吸虫病疫情变化趋势,评估到2015年实现血吸虫病传播阻断目标风险。方法 2009~2013年期间、通过免疫学和病原学相结合的方法开展人畜病情监测;采用系统抽样结合环境抽查法开展螺情监测;同时,通过人畜化疗和钉螺控制措施开展血吸虫病防控工作。结果 2009~2013年,人群治疗及扩大化疗2 060人次,采用IHA法共筛查20 622人次,血检阳性率平均为3.75%,处于徘徊稳定状态;kato法粪检查病1 526人次,均未查出阳性。5年间家畜扩大化疗279头次,家畜查病231头次,均未查出阳性。2009~2013年,开展药物灭螺611.3 hm^2,环境改造灭螺10.7 hm^2,开展螺情监测3 152 hm^2,均未查获感染性钉螺;活螺密度从2009年0.205只/0.11m^2下降到2013年的0.0075只/0.11m^2,呈现逐年下降趋势,有螺面积比2009年下降44.1%。结论 2009年以来,马鞍山市辖区血吸虫病疫情呈现稳中有降的趋势,5年间均未查出病人、病畜和感染性钉螺,活螺密度和有螺面积逐年下降,距离血吸虫病传播阻断目标差距逐渐缩小。目前主要障碍仍然是辖区尚有较大面积的钉螺分布环境。

Objective To analyze the situation of schistosomiasis in recent years, and assess the risk of the achievment of schistosomiasis interruption in the district of Ma＇anshan City in 2015. Methods From 2009 to 2013, the prevalence of people and livestock was monitored by the combination of the immunological and etiological methods. The snails were surveyed by systematic and environmental sampling methods. Meanwhile, schistosomiasis control measures were carried out through human and livestock chemotherapy and snail control. Results From 2009 to 2013, 2 060 people were treated and received expanded chemotherapy. 20 622 people were screened by IHA with the average positive rate of 3.75%, which wandered in the steady state. 1 526 people were examined by Kato- Katz with no positive. 279 livestock were expanded treated, 231 were tested witj no positive in the 5 years. The area of snail control by molluscicides was 611.3 hm2, and environmental modification was implemented in an area of 10.7 hm2. The snail distribution was surveyed in an area of 3 152 hm2, and no infected snail was found. The density of living snails decreased from 0.205/0.11m2 in 2009 to 0.007 5/0.11m2 in 2013, and the snail area in 2013 declined 44.1%than that in 2009. Conclusion The endemic situation of schistosomiasis in the district of Ma＇anshan city declined gradually since 2009. No patient, no infected livestock and no infected snails were found in the 5 years. The density of snails and the area of living snails decreased year by year, and the gap to achieve the goal of schistosomiasis interruption was gradually narrowing. At present, the main obstacle was the large area of snails in the district.