金湖县2006—2015年南水北调东线工程血吸虫病监测和防治

Surveillance and control of schistosomiasis in east route of South-to-North Water Diversion Project in Jinhu County,2006-2015

目的了解金湖县南水北调东线工程所涉区域血吸虫病疫情变化,做好监测预警工作。方法每年春季,采用机械抽样结合环境抽样设框法对金宝航道及其一级支流、高邮湖区和新三河的部分滩地开展钉螺调查。每年6—9月份,采用网捞法和稻草帘诱螺法在金宝航道退水闸段开展钉螺监测;采用淘洗法在金湖站对清污机打捞的漂浮物进行钉螺检测。采用胶体染料试纸条法(DDIA)对金宝航道和高邮湖区域的流行村居民、渔船民和门诊病人进行血吸虫病筛查,阳性者用Kato-katz法(1粪3检)进行检测。同时开展钉螺控制、病人治疗及阳性者化疗、健康教育、粪便管理等防控措施落实情况调查。结果 2006—2015年累计调查河道面积443.84 hm^2,结果未发现钉螺;调查湖滩面积2 568.19 hm^2,结果新发现有螺条块2个,有螺面积20.23 hm^2。在金宝航道退水闸段累计打捞漂浮物5 455 kg,投放稻草帘800块,在金湖站检测漂浮物750 kg,均未发现钉螺。完成血清学(DDIA)查病21 398人,阳性407人,阳性率1.90%;门诊人群血检阳性率高于疫区居民和渔船民,渔船民血检阳性率又高于疫区居民,差异均有统计学意义(P<0.01)。粪检8 983人,发现血吸虫病人1例。累计环境改造面积31.24 hm^2,药物喷洒灭螺36.75 hm^2、巩固性灭螺200.79 hm^2。2014年起未再发现活钉螺。治疗病人1例,扩大化疗407例。疫区居民和渔船民血吸虫病防治知识总体知晓率为98.55%、行为正确率为98.02%;中小学生血吸虫病防治知识总体知晓率为98.95%、行为正确率为98.18%。修建无害化公厕9座。结论金湖县南水北调东线工程输水河道未发现血吸虫病疫情和钉螺扩散现象,但在毗邻湖区新发现了钉螺和输入性病人,应加强风险监测。

Objective To understand the dynamics of schistosomiasis epidemic in the areas which covered in the eastroute of the South-to-North Water Diversion Project,so as to provide the evidence for effective monitoring and early warning.Methods The Oncomelania hupensis snail surveys were conducted by the mechanical sampling method combined with theenvironmental sampling method in some parts of the beach of Jinbao Channel and its first order affluent,Gaoyou Lake and theNew Xinsan River in each spring from 2006 to 2015. The snail monitoring was conducted by the net drag method and strawshade method from June to September every year in the sluice gate part of Jinbao Channel. The snails in the flotage weredetected by the elutriation method in Jinhu Station. The village residents,fishermen and out- patients were examined bydipstick dye immunoassay（DDIA）,and the positive persons were examined by Kato-Katz technique（3 examinations for 1fecal sample）. At the same time,the snail control,treatments of the patients,chemotherapy for positives,health education,andwaste management were performed. Results A total of 443.84 hm^2 river areas were investigated from 2006 to 2015 but nosnails were found. Totally 2 568.19 hm^2 lake areas were investigated and two new snail environments with area of 20.23 hm^2 were found. Totally 5 455 kg flotage was salved and 800 straw curtains were put into the sluice gate part of Jinbao Channel. Atotal of 750 kg flotage was examined in Jinhu Station but no snails were found. Totally 21 398 people were screened by DDIA,of which 407 were positive,with the positive rate of 1.90%. The positive rate of outpatients was higher than the rates of theresidents living in endemic areas and fishermen,and the positive rate of the fishermen was higher than that of the residentsliving in endemic areas（both P〈0.01）. Totally 8 983 people were examined by Kato-Katz technique,and 1 schistosomiasiscase was found. The cumulative area of environment reform was 31.24 hm^2,the area of using molluscicides was 36.75 hm^2,andthe area of snail control consolidation was 200.79 hm^2. Since 2014,no living snails have been found. One patient was cured and 407 people received the expanded chemotherapy. The total awareness rate of schistosomiasis control was 98.55% of the residents and fisherman,and it was 98.95% of the students. The rate of correct behavior was 98.02% of residents andfisherman,and it was 98.18% of the students. Nine harmless public toilets were built. Conclusion There is noschistosomiasis endemic nor snail spread in the rivers in east route of the South-to-North Water Diversion Project in JinhuCounty. However,new snail environments and an imported patient were found in the lake areas nearby. Therefore,the riskmonitoring should be enhanced.