镇江市润州区血吸虫病传播阻断策略及实施效果

Strategy of transmission interruption of schistosomiasis and its effects in Runzhou District,Zhenjiang City,Jiangsu Province

目的评价镇江市润洲区血吸虫病传播阻断策略的实施效果。方法 2001-2016年在镇江市润洲区实施以全覆盖灭螺、血吸虫病扩大化疗和健康教育为主的血吸虫病综合防治策略,以居民血吸虫感染率、有螺面积、灭螺面积和居民血防知识知晓率、行为正确率为指标评估综合防治策略的实施效果。结果 2001-2016年镇江市润州区有螺面积总体呈下降趋势,累计灭螺面积7 091.50 hm^2,有螺面积和总灭螺覆盖强度呈显著负相关(r=-0.874,P=0)。2001-2016年镇江市润州区常住居民血吸虫病血检阳性1 703例,粪检阳性病人199例;对粪检阳性者和血检阳性者全部采用吡喹酮进行治疗和扩大化疗;2005年后居民血检阳性率下降至1%以下,自2004年后未查出粪检阳性病人。2001-2016年问卷调查居民189 639人次,居民血防知识知晓率和行为正确率逐年提升。全区于2016年达到血吸虫病传播阻断标准。结论江滩型血吸虫病流行区实施以全覆盖灭螺、吡喹酮扩大化疗和健康教育为主的综合防治策略可实现血吸虫病传播阻断目标。

Objective To evaluate the effects of the strategy of transmission interruption of schistosomiasis in Runzhou Dis- trict, Zhenjiang City, Jiangsu Province. Methods The comprehensive prevention and control strategy was carried out in Run- zhouDistrict, Zhenjiang City, Jiangsu Province. The strategy was relied mainly on the Oncomelania hupensis snail control, ex- tended chemotherapy of schistosomiasis in residents and the health education. The infection rate of schistosomiasis in residents, area with snails, area with snails controlled, and the rates of awareness and correct behavior of schistosomiasis were as evalua- tion indexes. Results The area with snails controlled was 7 091.50 hm2 in Runzhou District, Zhenjiang City from 2001 to 2016. The area with snails reduced year by year from 2001 to 2016. There was a negative correlation between the coverage intensity of snail control and the area with snails （r = -0.874, P = 0）. There were 1 703 serum positive and 199 fecal positive people of schis- tosomiasis in the permanent residents from 2001 to 2016. These serum and fecal positive people of schistosomiasis were all treat- ed with praziquantel. The serum positive rate of schistosomiasis in the permanent residents dropped to below 1.0% after 2005. The fecal positive patients were not found in 2004 and later. Totally 189 639 people received the questionnaire survey for the knowledge of schistosomiasis control from 2001 to 2016. The rates of awareness and correct behavior of schistosomiasis were raised in the residents year by year. The goal of the transmission interruption of schistosomiasis came to true in Runzhou Dis- trict, Zhenjiang City in 2016. Conclusion The comprehensive prevention and control strategy including mainly the snail con- trol, extended chemotherapy of schistosomiasis and health education could achieve the goal of transmission interruption of schis- tosomiasis in the areas of marshland along the Yangtze River.