武汉市汉口江滩血吸虫病疫源地监测与风险评估体系研究

Surveillance and risk assessment system of schistosomiasis epidemic focus in Hankou marshland of Wuhan City

目的构建武汉市汉口江滩血吸虫病疫源地监测和风险评估体系,为及时掌握血吸虫病传播风险并采取有针对性的防控措施提供技术支持。方法 2013年对武汉市汉口江滩进行人群社会行为学和风险源监测,调查血吸虫感染风险因素,采用三维风险矩阵和三维可视化方法对其进行风险等级评价。结果 2013年武汉市汉口江滩节假日和工作日人流总量分别为59 582(人·次)/d和36 382(人·次)/d;垂钓和游泳为最常见接触江水方式;接触江水人群性别以男性为主(73.9%),职业以离退休为主(36.1%),居住地以本地为主(69.7%),人群收入以1 000~3 000元/月为主(52.1%),并且防护意识偏低。春季活螺平均密度为0.993只/0.1 m2,鼠密度为7.72%,野粪密度为0.78份/hm2;秋季活螺平均密度为0.596只/0.1 m2,鼠密度为5.22%,野粪密度为0.32份/hm2;秋季活螺平均密度、鼠密度和野粪密度较春季分别降低39.9%、32.4%和59.0%。三维风险矩阵评估结果显示,江滩一期和二期血吸虫感染风险为中等,三期为高等风险,四期为极高风险。三维可视化风险评估结果显示,江滩血吸虫感染风险等级从一期到四期依次增大,与风险矩阵评估结果基本一致。结论 2013年武汉市汉口江滩存在较大血吸虫感染风险,构建的血吸虫病疫源地监测和风险评估体系科学可行。

Objective To construct a monitoring and risk assessment system of schistosomiasis epidemic focus in marsh.land,so as to grasp the risk of schistosomiasis transmission,and to provide the technical support for targeted prevention and con.trol measures. Methods The crowd and the risk source of schistosomiasis in Hankou marshland in Wuhan City were monitored to grasp the risk factors of schistosomiasis. The risk level was evaluated by the three.dimensional risk matrix and three.dimen.sional visualization method. Results The total numbers of people on holidays and working days were 59 582 and 36 382 person.times a day respectively in Hankou marshland. Fishing and swimming were the most common ways to contact the river water. The most majority of the people exposed to river water were male（73.9%）,retirees（36.1%）,local residents（69.7%）and people whose income was 1000-3000 yuan per month（52.1%）,and the awareness of protection of them was low. In spring,the aver.age density of living Oncomelania hupensis snails was 0.993/0.1 m2,the rat density was 7.72%,and the density of wild feces was0.78/hm2. In autumn,the average density of living snails was 0.596/0.1 m2,the rat density was 5.22%,and the density of wild feces was 0.32/hm2. The average density of living snails,the rat density and the density of wild feces were reduced by 39.9%,32.4% and 59.0% respectively in autumn compared with those in spring. The risk assessment results of three.dimensional matrix showed that part 1 and part 2 were medium risk,part 3 was high risk and part 4 was maximum risk. The risk assessment results of the visualization method showed that the risk level increased from part 1 to part 4,which were basically consistent with the re.sults of the risk matrix. Conclusions There is a relatively large risk of schistosome infection in Hankou marshland in 2013. The surveillance and risk assessment system of epidemic focus is feasible and scientific.