2016—2020年金湖县血吸虫病疫情监测及防治效果评价

Epidemic surveillance and control effect of schistosomiasis in Jinhu County, 2016-2020

目的了解2016—2020年金湖县血吸虫病疫情状况及防治效果,探讨今后防治对策。方法每年3~4月份采取系统抽样结合环境抽查落框法开展钉螺调查,框距内陆5~10 m、湖滩10~20 m。采用压碎法解剖钉螺检查感染血吸虫情况。每年6~9月份,采用网捞法和稻草帘诱螺法进行钉螺扩散监测;对过往船只进行携螺情况调查。每年采用胶体染料试纸条法对血吸虫病历史流行村居民、流动人口、血吸虫病监测门诊病人开展血吸虫病筛查,阳性者采用Kato-katz法(1粪3检)进行病原学检查。结果2016—2020年金湖县累计查螺面积15373.85 hm^(2),打捞漂浮物3010 kg,投放稻草帘800只,调查船只215条,均未发现钉螺。累计血清学查病19910人次,阳性286人,阳性率1.44%。门诊病人血清学阳性率高于疫区居民和流动人口,差异有统计学意义(χ^(2)=50.869、91.591,P均<0.01);流动人口血清学阳性率高于疫区居民,差异有统计学意义(χ^(2)=4.477,P<0.05)。男性血检阳性率1.53%,女性1.35%,差异无统计学意义(χ^(2)=1.034,P>0.05)。血检阳性者主要集中在40~岁以上年龄组,各年龄组间差异无统计学意义(χ^(2)=13.692,P>0.05)。粪便检查279人,未发现血吸虫病人。累计药物巩固性灭螺153.46 hm^(2),环境改造灭螺9.67 hm^(2);扩大化疗281例。小学生和居民健康知识知晓率均达95%以上,无害化厕所和自来水普及率均达96%以上。2017年达到血吸虫病消除标准。结论金湖县实现消除血吸虫病目标,但血吸虫病潜在传播流行因素仍然存在,需建立长期监测预警机制。

Objective To understand the epidemic situation and control effect of schistosomiasis in Jinhu County from 2016 to 2020, and to explore the future control countermeasures. Methods From March to April every year, the snail survey was carried out by the method of systematic sampling combined with environmental sampling. The distance between the frame and the inland was 5-10 m, and the lake beach was 10-20 m. The snails were dissected by crushing method to check the infection of Schistosoma japonicum. From June to September every year, net fishing method and straw curtain method were used to monitor the snail diffusion. The snail carrying status of passing ships was investigated. Dipstick dye immunoassay(DDIA) was used to screen schistosomiasis among residents of historical endemic villages, floating population and outpatients of schistosomiasis surveillance every year. Kato Katz method was used to detect the pathogens of DDIA positive patients. Results A total of 15,373.85 hm^(2)of snails were inspected in Jinhu County from 2016 to 2020, and 3,010 kg of floating objects were salvaged. 800 straw curtains were put in, 215 ships were investigated, and no snails were found. The total number of serological examination was 19,910, and 286 were positive, with the positive rate of 1.44%. The serological positive rate of outpatients was higher than those of residents and floating population in epidemic areas, and the difference was statistically significant(χ^(2)=50.869, χ^(2)=91.591, both P<0.01). The serological positive rate was higher in floating population than in residents in epidemic areas, with a statistically significant difference(χ^(2)=4.477, P<0.05). The positive rate of blood test in males and females were 1.53% and 1.35%, respectively, showing a statistically significant difference(χ^(2)=1.034, P>0.05). Patients with a positive blood test were mainly distributed in the age group of 40 years and above, but no statistically significant differences were found among the age groups(χ^(2)=13.692, P>0. 05). No schistosomiasis was found in 279 stool samples detected. The total amount of molluscicidal effect was 153.46 hm2bydrug consolidation, and 9. 67 hm2by environmental modification. 281 cases were treated with extended chemotherapy. Theawareness rates of health knowledge in primary school students and residents were both more than 95%, and the popularizationrates of harmless toilet and tap water were both more than 96%. Jinhu County reached the standard of schistosomiasis elimination in2017. Conclusion Jinhu County had achieved the goal of eliminating schistosomiasis, but the potential epidemic factors stillexisted. It is necessary to formulate long-term monitoring and early warning mechanism.