云南山区实施以传染源控制为主的血吸虫病综合防治措施效果

Effect of comprehensive schistosomiasis control measures based on infection source control in mountainous areas of Yunnan Province

目的评价以传染源控制为主的血吸虫病综合防治措施在云南山区的效果。方法 2006-2014年在鹤庆县金墩乡高原峡谷和高原平坝2类流行区各选择2个行政村作为观察区,实施查治病、查灭螺、健康教育、改水改厕、禁牧、建卫生畜厩、以机代牛等防治措施。以2006年螺情和病情作为基线资料,评价该综合防治措施的效果。结果高原峡谷地区人群血吸虫感染率由2006年的4.94%下降到2014年的0.06%,家畜感染率则由1.11%降至0。高原平坝地区2007年在孝廉村查出1例血吸虫病病例,其余各年均未发现病例;家畜血吸虫感染率由7.38%降至0。2014年高原峡谷和高原平坝地区钉螺面积分别较2006年下降了74.89%和75.30%;两类地区钉螺面积百分比、有螺框出现率、活螺平均密度均下降,2008年以来未再发现感染性钉螺。高原峡谷地区西甸和新庄村于2009年达到血吸虫病传播控制标准,高原平坝地区的孝廉和康福村于2014年达到血吸虫病传播阻断标准。结论以传染源控制为主的血吸虫病综合防治措施能有效控制云南高原山区血吸虫病疫情,今后应将控制传染源与消灭钉螺并重,以巩固和扩大血防成果。

Objective To evaluate the effect of comprehensive schistosomiasis control measures based on infection source control in plateau mountain areas of Yunnan Province. Methods From 2006 to 2004, four administrative villages were selected as test areas from plateau canyon and plateau basin endemic areas in Jindun Town, Heqing County, two villages each type, and the comprehensive control measures were implemented, including the examination and treatment of schistosomiasis, Oncomela- nia hupensis snail survey and control, health education, improving drinking water and lavatories, banning grazing, constructing sanitary pen of livestock, replacing cattle with machine, etc. The schistosome infection state and snail status in 2006 were treat- ed as the baseline information, and the effect of the comprehensive measures were evaluated. Results The infection rate of hu- man in plateau canyon areas decreased from 4.94% in 2006 to 0.06% in 2014, and that of livestock decreased from 1.11% to 0. In plateau basin areas, there was only 1 case of schistosomiasis found in Xiaolian Village in 2007, and no any other cases found in the other years, the infection rates of livestock dropped from 7.38% to 0. Compared with 2006, the snail areas in the two type areas decreased by 74.89% and 75.30%, respectively, meanwhile, the percentage of snail area, the occurrence rate of frames with snails, as well as the average density of living snails also decreased, and no infected snails were found since 2008. Xidian and Xinzhuang villages in plateau canyon area reached the criteria of schistosomiasis transmission controlled in 2009, and Xiao- lian and Kangfu villages in plateau basin reached the criteria of transmission interrupted in 2014. Conclusions The comprehen- sive schistosomiasis control measures based on infection source control can effectively control the endemic situation of sehistoso-miasis in plateau areas of Yunnan Province. In the future, we should pay an equal attention to the infection sources control and snail control to consolidate and amplify the achievement of schistosomiasis control.