2004-2013年云南省血吸虫病综合治理效果评价

Evaluation of effectiveness of comprehensive schistosomiasis control project in Yunnan Province from 2004 to 2013

目的评价云南省血吸虫病综合治理重点项目实施10年的效果,为制定下一步防治策略提供依据。方法收集2004-2013年云南省血吸虫病综合治理措施和疫情等资料,对血吸虫病疫情变化进行分析,评价防治效果。结果经过10年的综合防治,全省有螺面积由2004年的4 364.79 hm2降至2013年的1 528.50 hm2,减少了64.98%,有螺框出现率、活螺密度分别由2004年的4.71%和0.26只/0.1 m2降至2013年的1.35%和0.04只/0.1 m2,降幅分别为71.34%和84.62%。2008年后仅2011年和2013年查到感染性钉螺。2013年人群感染率(0.002 1%)与牛感染率(0.020 9%)分别较2004年下降了99.84%和99.44%,2008年后未再发现急性感染病例。疫情较重的212个一、二、三类村均下降为四类和五类村,达到了传播控制或传播阻断标准。流行区村民及中小学生血防知识知晓率分别达90%和98%以上。结论云南省血吸虫病综合治理效果显著,但巩固和扩大现有防治成果的任务还十分艰巨。

Objectives To evaluate the effect of comprehensive schistosomiasis control project in Yunnan Province after its implementation for ten years, so as to provide the evidence for formulating the future prevention and control strategy. Methods The data of the schistosomiasis comprehensive control project and the endemic situation were collected and analyzed to evaluate the control effect of the project in Yunnan Province from 2004 to 2013. Results After the comprehensive control project implementation for ten years, the Oncomelania hupensis snail area in Yunnan Province decreased from 4 364.79 hm^2 in 2004 to 1 528.50 hm^2 in 2013, with a reduction rate of 64.98%, and the occurrence rate of frames with snails and the density of living snails decreased from 4.71% and 0.26 snails/0.1 m2 in 2004 to 1.35% and 0.04 snails/0.1 m2 in 2013, with the reduction rates of 71.34% and 84.62%, respectively. The schistosome infected snails were found only in 2011 and 2013 since 2008. In 2013, the infection rates of human （0.002 1%） and cattle （0.020 9%） decreased by 99.84% and 99.44%, respectively, compared to those in 2004, and no acute schistosome infection cases were found since 2008. The 212 villages with relatively serious endemic situation （Type One, Type Two and Type Three） all declined to the slight endemic villages （Type Four and Type Five）, therefore, they reached the criteria of schistosomiasis transmission controlled or interrupted. The awareness rates of schistosomiasis control among villagers and students in endemic areas were above 90% and 98%, respectively. Conclusion The effect of the compre- hensive schistosomiasis control project is significant in Yunnan Province, but the task to consolidate and enlarge the control re- sults still remains a challenge.