江苏省血吸虫病疫情监测与风险评估系统的研究Ⅰ疫情监测点布局与应用效果

Surveillance and risk assessment system of schistosomiasis in Jiangsu Province Ⅰ Distribution of surveillance site and effectiveness of the system

目的构建江苏省血吸虫病疫情监测与风险评估系统,为及时掌握血吸虫病传播风险并采取针对性防控措施提供技术支撑。方法按照血吸虫病流行程度、流行类型、流域水系特点在全省设立血吸虫病疫情监测点,开展人、畜病情和螺情现场调查,并对血检查病进行质量控制,分析、比较不同监测点人畜血吸虫感染率、螺情分布及血检漏检情况。结果在江苏省10个市26个县共设立27个血吸虫病疫情监测点,其中14个位于传播阻断村,13个位于传播控制村;15个监测点属江湖洲滩型流行区,9个水网型流行区,3个属山丘型流行区。27个监测点共采用胶体染料试纸条法(DDIA)筛查16617人,检出血清学阳性326人,血检阳性率为1.96%,其中男性阳性率为2.17%,女性阳性率为1.80%;采用尼龙绢集卵孵化法查病326人,在江滩型地区查出阳性2例,监测点人群血吸虫感染率为0.01%。调查762名流动人员,查出血检阳性10人,血检阳性率为1.31%,未查出粪检阳性病例。检查479头散放家畜,未发现阳性。共调查746个环境,查出钉螺面积240.70 hm2,钉螺平均密度为0.06只/0.1 m2,未发现感染性钉螺。27个监测点共检测780份质控血清,总符合率为95.13%,其中误检率为1.28%,漏检率为19.23%。结论江苏省血吸虫病疫情监测点布局合理,全省血吸虫病疫情呈低度流行态势。

Objective To establish the surveillance and risk assessment system of schistosomiasis in Jiangsu Province,so as to provide technical support for timely understanding of the risk of schistosomiasis transmission and implementation of targeted control measures. Methods The surveillance sites of schistosomiasis were assigned according to the epidemic status and endemic type of schistosomiasis as well as the characteristics of the water system,and the prevalence of Schistosoma japonicum in humans and domestic animals,and snail status were investigated. In addition,the quality control of serum detection of S. japonicum infections was performed. The prevalence of human and animal S. japonicum infections,snail status and missing diagnosis of serum detection were analyzed and compared among regions. Results A total of 27 surveillance sites of schistosomiasis were set up in 26 counties of 10 cities,Jiangsu Province,including 14 sites in transmission-interrupted villages and 13 sites in transmission-controlled villages,and 15 sites in marshland and lake regions,9 sites in plain regions with water network and 3 sites in mountainous region. In the 27 surveillance sites,a total of 16617 residents were screened for S. japonicum infection by using dipstick dye immunoassay（DDIA）,and 326 were sero-positive,with a sero-prevalence of 1.96%（2.17% for men and 1.8% for women）. Of the 326 individuals undergoing parasitological examination,2 positive cases were detected in the marshland and lake region,with a S. japonicum human prevalence of 0.01%. Of the 762 floating population detected,10 were positive for blood test,with a sero-prevalence of 1.31%,and no egg-positive individuals were detected. No infection was found in the 476 domestic animals. Of the 746 settings surveyed,a total of 240.7 hm2 snail area was detected,with a mean snail density of 0.06snails/0.1 m2,and no infected snails were found. There were 780 quality-control sera detected in 26 surveillance sites of schistosomiasis,and the gross coincidence rate was 95.13%,with misdiagnosis rate of 1.28% and missing diagnosis rate of 19.23%.Conclusion The surveillance sites of schistosomiasis show reasonable distribution in Jiangsu Province,and the endemic situation of schistosomiasis appearsa low level in the whole province.