湖南省血吸虫病疫情回顾性调查

Retrospective investigation of schistosomiasis endemic situation in Hunan Province

目的掌握湖南省血吸虫病流行区在达到传播控制(传控)、传播阻断(传阻)前后螺情和病情的动态变化规律,为血吸虫病防治工作提供科学依据。方法选择湖南省武陵区、西湖管理区和临澧县为调查县(区)。采取回顾性调查方法,搜集、记录3个县达到传控前10年至2008年的血吸虫病疫情资料,建立调查资料数据库,分析各县螺情、病情变化趁势及规律。结果武陵区疫情逐年下降,于1974年降至查不到钉螺、病人、病畜,并保持至2008年;西湖区首次达传控后疫情出现大幅度回升,于1997年再次达传控,此后疫情保持稳定,感染性钉螺面积与人群血吸虫感染率呈正相关(r=0.584,P<0.05);临澧县在2次达到查不到钉螺、病人、病畜的疫情水平下,2次疫情回升过程中,均有螺情回升。武陵区和临澧县1960年至首次查不到钉螺期间,钉螺密度与人群、家畜血吸虫感染率呈正相关(r武陵区人群=0.965,P<0.05,r武陵区家畜=0.970,P<0.05;r临澧县人群=0.923,P<0.05,r临澧县家畜=0.908,P<0.05)。结论螺情为血吸虫病疫情回升预警的重要指标之一;钉螺控制是血吸虫病防控的重要措施之一。

Objective To understand the dynamic rules of schistosomiasis endemic situation before and after reaching the criteria of schistosomiasis transmission controlled or transmission interrupted,so as to provide the evidence for improving schistosomiasis control. Methods Wuling District,Xihu District and Linli County were selected and investigated retrospectively to collect the schistosomiasis epidemiological information 10 years before they reached the criteria of transmission controlled and the subsequent years until 2008. A database of retrospective investigation was established for analyzing the trends and rules of changes of the Oncomelania hupensis snail status and infection status of cattle and human. Results In Wuling District,the endemic situation was declining,and no schistosome infection persons,animals and snails were found after 1974. There was no rebound until 2008. In Xihu District,the endemic situation reached the criteria of transmission controlled in 1997,and the endemic situation was stable. The human infection rate was positively correlated with the area of infection snails（r=0.584,P〈0.05）. In Linli County,there were no snails,no infected persons and cattle twice,but 2 endemic rebounds,and there were positive correlations between the densities of living snails and the infection rates of human and animal during the endemic rebound period.Conclusion The snail status is an important indicator of schistosomiasis endemic rebound. Therefore,the snail control is one of the most important schistosomiasis control measures.