2004-2021年云南省血吸虫病综合治理效果分析

The effect analysis of comprehensive governance for schistosomiasis in Yunnan Province from 2004 to 2021

目的分析2004—2021年云南省血吸虫病综合治理效果,为制定下一步防治策略提供依据。方法收集2004—2021年云南省血吸虫病疫情监测报表、防治报表以及农业、水利、林业和国土等部门血吸虫病综合治理相关资料,统计分析各项综合治理措施、病情、螺情以及防治经费投入的变化,评价防治效果。结果2004—2021年,云南省累计药物灭螺100061.87 hm^(2),人群扩大化疗累计4146548人·次,牛扩大化疗累计1823871头·次,建造无害化厕所293731座;圈养牛4277980头·次,淘汰牛13371头,以机代牛96181套,水改旱64624.40 hm^(2);灌区改造925.16 km,安全饮用水覆盖人口126.65万人;种植抑螺防病林14464.14 hm^(2);土地平整56.99 hm^(2)。2004年全省人群血检阳性率为21.10%,人群校正感染率为2.51%,耕牛感染率为3.76%,钉螺感染率为0.70%,感染性螺点771个,有螺面积为4364.79 hm^(2),有螺框出现率和活螺密度分别为4.71%和0.2560只/0.1 m^(2)。2021年全省人群血检阳性率为2.21%,人群校正感染率和耕牛感染率均为0,2013年后未查到感染性钉螺,2021年有螺面积为1058.59 hm^(2),有螺框出现率和活螺密度分别为1.21%和0.0343只/0.1 m^(2)。2004—2021年,云南省血吸虫病综合治理措施累计投入经费398671.52万元,2004—2008年、2009—2015年、2016—2021年期间平均每年投入经费分别为19983.26、25300.16和20275.68万元。结论云南省以传染源控制为主的血吸虫病综合治理措施效果显著,人群和耕牛血吸虫病感染率明显下降,钉螺面积大幅压缩。但仍存在有螺面积压缩和家畜传染源防控难度大等困难,应继续保障经费投入,以进一步完善综合治理措施,巩固血吸虫病防治成果。

Objective To analyze the effect of comprehensive treatment of schistosomiasis in Yunnan Province from 2004 to 2021 for providing a basis to formulate control strategies in following stage.Methods The surveillance reports and preventive and control reports of schistosomiasis as well as the relevant data of agriculture,water conservancy,forestry and data maintained in the state land administration for comprehensive control of schistosomiasis were collected in Yunnan Province from 2004 to 2021.The control effect was evaluated based on statistical analysis of the annual control expenditure,comprehensive control measures,and the changes of population,cattle disease and snail situation.Results From 2004 to 2021,molluscide was applied to a total area of 100061.87 hm^(2) in Yunnan Province.4146548 people and 1823871 cattle underwent extended chemotherapy,and 293731 innocuous-sanitary toilets were built.4277980 cattle were raised in pens,13371 cattle were eliminated and 96181 cattle were replaced by machines.In total,64624.40 hm^(2) of water area was replaced with dry land,and 925.16 km of irrigated areas were transformed.1.2665 million people were access to safe drinking water.14464.14 hm^(2) forests were planted for snail suppression and disease prevention,and 56.99 hm^(2) of land was leveled.In 2004,the positive rate of human blood test was 21.10%,the corrected infection rate was 2.51%.The infection rate of cattle and Oncomelania hupensis was 3.76%and 0.70%,respectively.Infected snails were found in 771 sites,and the area with snails was 4364.79 hm^(2).The occurrence rate of snail in individual frame and live snail density were 4.71%and 0.2560 snails/0.1 m^(2),respectively.In 2021,the positive rate of human blood test was 2.21%,and the corrected infection rate and cattle infection rate were both zero.No infected snails were detected after 2013.In 2021,the area with snails was 1058.59 hm^(2),and the rate of snails occurred in individual frame and live snail density were 1.21%and 0.0343 snails/0.1 m^(2) respectively.3.9867152 billion yuan was used for comprehensive control of schistosomiasis in Yunnan Province from 2004 to 2021.The average annual investment was 199.8326 million yuan from 2004 to 2008;253.0016 million yuan from 2009 to 2015;and 202.7568 million yuan from 2016 to 2021,respectively.Conclusion The comprehensive control measures primarily based on control of the transmission sources of schistosomiasis in Yunnan Province have achieved remarkable results,and lead to obviously decreased infection rate of schistosomiasis in population and cattle,as well as greatly reduced areas with snails.However,some difficulties still exist,including the bottleneck in further cutting down the snail area,and prevention and control of the infection sources in livestock.Following measures should include continuously ensuring the investment of funds to further improve the comprehensive control measures and consolidate the results of schistosomiasis control.