安徽省预防控制血吸虫病中长期规划纲要(2004-2015年)终期评估报告

Evaluation of long-term effectiveness of medium-and long-term programme for prevention and control of schistosomiasis in Anhui Province

目的评价安徽省预防控制血吸虫病中长期规划任务完成情况和终期效果。方法按照《安徽省预防控制血吸虫病中长期规划纲要(2004-2015年)终期评估实施方案》,对全省9个市51个血吸虫病流行县(市、区)的中长期规划目标实现情况、任务完成情况及实施效果进行评估,所有资料用Excel 2010建立数据库,进行相关统计分析和纵向比较以评价效果。结果 2004~2015年,全省各血防相关部门均完成或超额完成血吸虫病中长期规划项目任务:农业血防完成水改旱34.6万亩,养鱼灭螺7 261.9 hm^2,家畜圈养1 868 018头,封洲禁牧93 937.5 hm^2,淘汰耕牛34 930头,以机代牛83 200台,家畜查病591 557头,家畜治疗与预防服药334 569头;水利血防共完成河流治理工程317处,完成灌区改造工程6 499处,河流硬化护坡1 170.56 km,灌区硬化护坡1 585.67 km,兴建河流治理沉螺阻螺设施119座,兴建灌区改造沉螺阻螺设施1 552座,累计完成流行区安全饮水供给人口数535.93万人,流行村饮水供给累计人口数480.18万人;林业血防共建造抑螺防病林109.55万亩,种植长江防护林138.61万亩,退耕还林49.27万亩;国土血防共实施土地整治258.93万亩,修建田间道路6 561.84 km,修建沉螺池23个,修建排灌(渠)、管道5 981.14 km,土地平整面积397.96万亩;卫生血防共完成钉螺调查692 932.60 hm^2,药物灭螺93 564.19 hm^2,人群血检19 414 690人次,人群粪检2 321 886人次,人群化疗2 898 456人次,晚血救治5 7902人次,建造无害化厕所552 954户,建造无害化公厕6 082座,在水上人员集散地和渡口码头建造无害化厕所290座,全省共发放健教材料7 585 307份,开展媒体宣传17 098次,举办村干部培训班1 963班次,举办中小学师资培训班2 145班次,发放防护品412 967人份,竖立警示标志牌33 509个,刷写宣传标语26 250条;省财政血防专项资金保持平均每年10%~20%的稳步增加,累计投入近2亿元保障血防工作需求,各级财政累计投入传染源控制和血防机构能力建设10 580万元。至2015年底,全省达到了传播控制标准,另有6个县(市、区)达到了传播阻断标准;自2013年起已连续3年未发现急性血吸虫病人和感染性钉螺;到2015年全省居民血吸虫平均感染率、耕牛感染率分别降至0.13%、0.07%,较2004年分别下降了83.95%、98.12%,尚有钉螺面积为27 143.60 hm^2,较2004年小幅下降了7.94%;2015年全省居民血防知识知晓率达97.2%,正确行为形成率达93.6%。结论安徽省通过实施以传染源控制为主的综合防治策略及措施,多部门协作开展综合治理,完成或超额规划任务,如期实现中长期规划中期与长期目标,全省已具备了达到传播阻断乃至消除的基础。

Objective To evaluate the long - term effectiveness of the medium - and long - term programme for prevention and control of schistosomiasis in Anhui Province. Methods Effective evaluation was performed in ac-cordance with ＂ Final Assessment Scheme of Implementation of the Medium - And - Long - Term Programme for Prevention And Control of Schistosomiasis from 2004 to 2015 in Anhui Province＂ through data collection in 51 counties （ cities, districts） under 9 municipal administration using Microsoft Excel 2010 and statistics for longitudi-nal comparison of the prevention performance. Results Schistosomiasis control sections in the aforementioned ad-ministrative areas had completed or excelled in the tasks specified in the provincial medium - and long - term pro-gramme between 2004 and 2015. Agricultural sections had achieved rise field transforming into dry farmland by 0. 346 million mu, snail killing via fish farming in water area of 72. 619 million m2,fensed raising of the domestic livestock of 1 868 018 heads, forbidding livestock depasturing on marshland with Oncomelania snails in a total area of 939. 375 million m2, eliminating of 34 930 cattle （eith er sacrificed or sold） , introduction of 83 200 farm machines to replace the cattle,schistosomiasis infection screening in 591 557 heads of domestic animals, treatment or preven-tive drug administration in 334 569 heads of domestic animals; Water conservancy sections had completed rivermodification in 317 projects, irrigation work renovation in 6 499 parts, hardening of the river beds and revetment of the river bank and irrigation works in 1170. 56 km and 1585. 67 km, respectively, newly constructed facilities of 119 and 1552 for blocking snail in river and irrigation areas, safe water supply for a population of4. 8018 million in endemic villages; Forestry sections had finished a total of 1. 0955 million mu of forest for controlling snail, plantation of 1. 3861 million mu of protection forest along the Yangtze River, returning the farmlands to forests in 492. 7 thousand mu; Land and resources administrations had attained land consolidation of2. 5893 million mu, road build-ing of 6561. 84 km across the farmland, snail blocking facilities of 23 places, irrigation channel construction of 5981. 14 km, leveling of the land of 3. 9796 million mu; Health and schistosomiasis administrations had completed snail survey in a total area of 692932. 6 hm2,mollusciciding in an area of 93564. 19 hm2,screening with IHA in 19 414 690,stool test in 2 321 886 people, preventive anti - schistosomiasis in 2 898 456 population, treatment of advanced patients of 57 902, building of sanitary family - latrines and sanitary public latrines of 552 954 and 6 082 places, respectively, construction of sanitary latrine in 290 places where fish men lived and at ferries or docks, total distribution of the health education materials of 7 585 307 copies, media education of 17 098 times, training of the village principals in 1 963, health training of the primary and middle school teachers of 2 145 , distribution of anti-septic agent of412967 botdes, installation of the warning board of 33 509 pieces, slogans on the schistosomiasis pre-vention of 26 250 articles ; Special support by provincial finance administration was increased by yearly 10% to 20%, and total investment of nearly 200 million yuan was used for schistosomiasis control across the prov-ince. Finance sections at all levels had invested a total of 105. 8 million yuan in controlling of the infectious sources and improvement of institutional capacity in schistosomiasis control. By the end of 2015, the province had reached the criteria of transmission control, and 6 counties （cities, districts） had reached the criteria of transmission interrup-tion. No acute infection and infectious snails were reported and detected since 2013. In 2015, the infection rate of population and catde as well as areas with snails were reduced to 0. 13% , 0. 07% and 271. 436 million m2, with a decline of 83. 95%, 98. 12% and 7. 94% ,respectively, compared to 2004. Knowledge rate for schistosomiasis in residents reached 97. 2% in 2015,and the rate of correct behaviors in schistosomiasis prevention arrived at 93. 6%.Conclusion Anhui province insists on comprehensive prevention and control measures by targeting infectious source control and joint efforts of multiple administrations, which leads to achievement or excelling in the goals de-fined in the provincial medium and long - term programme in schstosomiasis control as expected. Currendy, our province is on the way to transmission interruption, even elimination of the schistosomiasis prevalence.