Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba,Kwale

Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Prevalence,intensity of infection and risk factors of urinary schistosomiasis in preschool and school aged children in Guma Local Government Area,Nigeria

Objective:To determine the prevalence and intensity of infection and the risk factors associated with urinary schistosomiasis in pre—school and school aged children in Cuma Local Government Area of Benue State,Nigeria.Methods:Urine filtration technique using polycarbonate membrane filters was employed to process urine specimens and to determine presence of Schistosoma haematobium eggs in urine.Questionnaires were also administered to children to collect information on socio-demographic data and water-contact activities.Results:An overall prevalence of 55.0%(165/300)was recorded out of the 300 urine samples examined.Prevalence of infection varied between 36.0%-64.0%with a significant difference(X^2=11.59,P=0.041)between the different communities visited.Males were more infected(60.6%,103/170)than females(47.7%,62/130)with a significant difference(X^2=4.95,P=0.026).The age-related prevalence showed higher prevalence(70.5%,36/52)in the 11-15 year old children than that in the 1-5 year old ones(44.9%,53/118).A significant difference was observed in the prevalence between the age groups(X^2=10.56,P=0.014).The prevalence of light intensity of infection(1-49 eggs/10 mL of urine)(86.6%)was significantly higher than that of heavy intensity of infection(5=50 eggs/10 mL of urine)(13.3%)in the area(t=16.48,P=0.000).Water contact activities of the children revealed that children that were involved in irrigation and those that went swimming in water bodies were observed to be at higher risk of becoming infected with urinary schistosomiasis in the area with odd ratios(risk factors)of 2.756(1.334-5.693)and 2.366(1.131-4.948)respectively at P<0.05 level.Conclusions:The study revealed the hyperendemicily of urinary schistosomiasis in the preschool and school aged children in Guma Local Government Area.It is therefore recommended that praziquantel should be administered to children in the area and systematic epidemiological studies should be undertaken in the whole Local Government Area and the State at large to discover new foci of infection.

Prevalence of schistosomiasis and associated factors among students attending at elementary schools in Amibera District, Ethiopia

Introduction: Schistosomiasis is one of the most prevalent parasitic diseases and an important public health problem in many developing countries including Ethiopia. The study was aimed at assessing prevalence of schistosomiasis and associated factors among students attending at elementary schools in Amibera District, Ethiopia. Methods: A cross sectional school based study was carried out on sample of 840 students. First, all elementary schools around Amibera District were grouped in to strata based on their distance from the irrigation site as “Near” or “Far”. Then two schools were selected by simple random sampling method from each stratum. Finally, proportional allocation of the sample size was done according to the number of students in each stratum. From each grade level students were selected by simple random sampling techniques. A pre-tested structured questionnaire was used to collect data on socio demographic characteristics, water contact habit and toilet utilization. Stool and urine examination were done to determine prevalence. The analysis was carried out using SPSS version 16.0. Result and Conclusions: The overall prevalence of schis- tosomiasis in this study was 8.2%;among this Schisosoma haematobium was 7.4% and Schisosoma mansoni was 0.8%. Education level (p-value = 0.047, OR = 1.834), swimming habit (p-value = 0.0001, OR = 4.979) and source of water for domestic consumption (p-value = 0.0001, OR = 0.334) had shown significant association with the occurrence of S. haematobium infection. Conclusion and recommendations: The prevalence of schistosomiasis was not what to be neglected. It was significantly associated with educational level, swimming habit of children and source of water for domestic consumption. Therefore, provision of safe water supply and health education at school level was recommended.

Efficacy and side effects of praziquantel in the treatment of Schistosomiasis mansoni in schoolchildren in Shesha Kekele Elementary School,Wondo Genet,Southern Ethiopia

Objective:To evaluate the efficacy and side effects of praziquantel(PZQ) in the treatment of schistosomiasis in Ethiopia.Methods:In a cross-sectional study,stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School,Wondo Genet, Southern Ethiopia,in April 2010.Stool specimens were examined using a single Kato-Katz thick smear for Schistosoma mansoni(5.mansoni) ova.Children who were found positive for S.mansoni were treated with a single oral dose of PZQ at 40 mg/kg bw and interviewed for treatment-related symptoms 24 hours after drug administration.Four weeks post-treatment,stool specimens were collected from the same children and examined following the same procedure as in the pretreatment.Drug efficacy was determined based on cure and egg reduction rates.Results:Pretreatment prevalence of S.mansoni infection was 74.9%with geometric mean egg count of 268. The evaluated generic PZQ produced an overall cure rate of 73.6%(P<0.000 1,OR:8.33,CI:5.3-13.1) and egg reduction rate of 68.2%(P=0.03,F=0.64).The cure rate showed significant association with age(x^2=H,P=0.004),the highest rate being observed in the 15-22 age group.83%of S. mansoni infected children showed various treatment-related symptoms,the most frerjiient being headache,nausea,and abdominal pain.These symptoms were associated with age(P<0.001) and pre-treatment intensity of infection(P<0.05).Conclusions:The present observations revealed relatively lower cure and egg reduction rates of the PZQ evaluated as compared to previous reports for other PZQ brands in Ethiopia.Hence,in depth studies are recommended to clarify whether the present relatively lower cure rate is the actual cure rate of the praziquantel evaluated,treatment failure,or reduced susceptibility of the parasite.Treatment-related side effects observed were transient and tolerable.

Evidence of increasing risk of schistosomiasis among school-age children in municipality of Calatrava,Province of Negros Occidental,Philippines

Objective:To explore risk of school-age children being infected with schistosomiasis in selected villages in the municipality of Calatrava,province of Negros Occidental,Philippines.Methods:As part of the monitoring and evaluation of the helminth control program in the province of Negros Occidental,parasitological monitoring,through the use microscopy of stool samples processed using Kato-Katz technique,was conducted to describe the baseline and follow-up parasitological status of school-age children in 2010 and 2012.respectively.Seven villages from the municipality of Calatrava were selected as study sites.Results:During baseline assessment,only one case of schistosomiasis was reported from the village of Marcelo.During follow-up assessment,32 cases(6.9%) of schistosomiasis were reported and the prevalence of moderate-heavy intensity infection was 13% in six villages.Among the seven villages included in the follow-up,Minapasuk had the highest prevalence at 14.6%.while San Isidro reported no case of schistosomiasis.Conclusions:Non-endemic villages,which have reported positive cases in school-age children,may need to be assessed for possible cndemicity for schistosomiasis.Transmission of the disease may need to be determined in these villages through active parasitological and malacological surveillance.Other nonendemic villages adjacent to or share river networks with endemic villages in Calatrava may need to be explored for possible introduction of the disease,especially after typhoons and Hooding.Establishing endemicity for schistosomiasis in these villages will help infected and at risk individuals to receive yearly treatment to reduce morbidities caused by this disease.

Influence of the Three Gorges Dam on schistosomiasis control in the middle and lower reaches of the Yangtze River

This paper summarizes the factors affecting schistosomiasis transmission in the middle and lower reaches of the Yangtze River before and after the completion of the Three Gorges Dam and analyzes schistosomiasis prevalence trends to provide a basis for the application of the Three Gorges project methodologies in other areas.The Three Gorges Dam has demonstrated a positive effect on schistosomiasis control.Hubei,Hunan,Jiangxi,Anhui,and Jiangsu in the middle and lower reaches of the Yangtze River are currently regions with a high prevalence of schistosomiasis.These five provinces contained 97.62% of known snail areas and 93.66% of calculated schistosomiasis cases with 90.07% of counties (cities,districts) not yet meeting the criteria for schistosomiasis transmission interruption by the end of 2016.After the Three Gorges Dam was built,the prevalence of schistosomiasis in the middle and lower reaches of the Yangtze River decreased.By the end of 2016,the estimated number of cases decreased by 92.75% and the snail habitat areas decreased by 6.56% compared to 2004.No acute schistosomiasis cases have occurred for two consecutive years since 2015.

Comparative analysis of urinary schistosomiasis among primary school children and rural farmers in Obollo-Eke,Enugu State,Nigeria:Implications for control

Objective:To determine the prevalence,sex-age related intensity of urinary schistosomiasis and to compare such parameters among rural school children and rural fanners in selected communities in Obollo-Eke located in Southeast,Nigeria.Methods:A cross-sectional survey involving 1 337 school children and farmers was conducted in Obollo-Eke community between September 2006 and July 2007.Demographic data of subjects was collected using a questionnaire prepared for this purpose.Urine samples were collected and examined for haematuria and ova of Schistosoma haematobium(S.haematobium) using Medi-test Combi 9 and sedimentation technique respectively.Results:The prevalence of urinary schistosomiasis based on microscopic examination of the urine sediment for the ova of 5.haematobium was 17.5%while the prevalence of haematuria was 15.6%.Infection intensity varied from light to heavy.In general,the prevalence was higher among males(20.8%) than females(14.6%;P】0.05) and was slightly higher among primary school children(18.0%;n=762) than farmers(16.9%;n=575;P】0.05).The age-specific prevalence of schistosomiasis among the study subjects ranged from 8.3%to 21.2%in 0-5 years and 11-15 years age groups respectively.Conclusions:Haematuria and mean egg/10 mL urine (r = 0.95;P【0.01) showed that both procedures are reliable for the diagnosis of the disease and can be used to ascertain the prevalence of the disease in any community.The comparative analysis of urinary bilharziasis among primary school children and rural farmers demonstrated that the infection is moderately high in these two risk population groups at Obollo-Eke.A robust intervention strategy is clearly needed.

High prevalence of urinary schistosomiasis in a desert population: results from an exploratory study around the Ounianga lakes in Chad

Background Researching a water-borne disease in the middle of the Sahara desert might not seem the most relevant concern.However,nomadic Sahelian pastoralists health concerns regarding their livestock and anecdotal reports about trematode infections of Fasciola spp.and Schistosoma spp.in desert-raised animals justified an exploratory study focusing on the lakes of Ounianga in Northern Chad.The aim was to test whether trematode parasites such as Schistosoma spp.occur in human populations living around the Sahara desert lakes of Ounianga Kebir and Ounianga Serir in northern Chad.Methods The study was carried out in January 2019 and comprised of three components.First,a cross sectional survey based on a random sample drawn from the population to detect infections with S.haematobium and S.mansoni;second,focus group discussions exploring disease priorities,access to health and health seeking behaviour;and third,surveying water contact sites for intermediate host snails.Samples of trematode parasites and snails were confirmed on species level by molecular genetic methods.For parasitological and malacological surveys descriptive statistics were performed.Qualitative data analysis included the full review of all transcripts,followed by a descriptive and explorative thematic analysis.Results Among 258 participants,the overall S.haematobium prevalence using urine filtration was 39.2%[95%confidence interval(CI):33.5–45.1%],with 51.5%of the infected suffering from heavy infection.The intermediate host snail of S.haematobium(Bulinus truncatus)occurred at water contact sites near both study villages,revealing the potential for local transmission.Although a positive S.mansoni point-of-care circulating cathodic antigen(POC-CCA)test result was obtained from 8.6%(95%CI 5.7–12.8%)of the samples,no intermediate host snails of S.mansoni were found,and the relevance of S.mansoni remains uncertain.Qualitative findings underline the importance of morbidity caused by urinary schistosomiasis,and the lack of access to diagnostics and treatment as a major health concern.Conclusions This research revealed a high prevalence of urinary schistosomiasis in the population living around the lakes of Ounianga in the Sahara,a United Nations Educational,Scientific and Cultural Organization(UNESCO)world heritage site in Chad.Despite the high public health importance of the associated morbidity expressed by the population,there is no access to diagnostics and treatment.Further work is needed to develop and test a context-adapted intervention.

Prevalence and risk factors of schistosomiasis and soil-transmitted helminthiases among preschool aged children (1-5 years) in rural KwaZulu-Natal, South Africa: a cross-sectional study

Background:Despite efforts to control neglected tropical diseases(NTDs),schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa.Recent data suggest that these infections are prevalent among preschool aged children(PSAC)in poor communities.Evidence of schistosomiasis and soil-transmitted helminths(STH)infection patterns and prevalence among PSAC is essential for effective treatment and control programmes.The aim of the study was to determine the prevalence,intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District,South Africa.Methods:A cross-seaional study was conducted among 1143 PSAC aged 1-5 years in 34 preschools and early childhood development(ECD)centres.Data on risk factors was collected using a semi-struaured questionnaire.A Kruskal-Wallis test was used to compare the differences in infection intensity with age.Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status,sociodemographic,household,water and sanitation variables and hygiene practices of PSAC and their caregivers.Results:We observed a low prevalence o f Schistosom a haem atobium(1.0%)and 5.m ansoni(0.9%).The prevalence of Ascaris lum bricoides(18.3%)was high compared to Trichuris trichiuro(1.2%),hookworms(1.6%)and Taenio(6.4%).The odds of schistosome infection were lowest among PSAC under younger(15-24 years)caregivers(0.1,95%CI:0.02-0.54)and those who used tap water(0.3,95%Cl:0.09-0.78)for domestic purposes.Schistosome infection was however higher among PSAC who bathed in river water(17.4,95%CI:5.96-51.04).STH infection on the other hand was lowest among PSAC who did not play in soil(0.1,95%CI:0.51-0.28),were from households that used tap water for domestic purposes(0.5,95%CI:0.27-0.80)and PSAC under the care of younger(25-35 years)caregivers(0.3,95%Cl:0.10-0.75).The risk of STH infeaion was highest among PSAC who did not wash their hands with soap(3.5,95%CI:1.04-11.67)and PSAC whose nails were not trimmed(3.6,95%CI:1.75-7.26).Conclusions:The findings show low prevalence and infection intensity of schistosomiasis and STH infection except A lum bricoides among PSAC.Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers'age,educational status,water and hygiene practices.STH infection was exclusively associated with PSAC playing and handwashing habits.These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes.

Epidemiology of pediatric schistosomiasis in hard-to-reach areas and populations:a scoping review

Background Schistosomiasis affects over 250 million people worldwide.Despite children and the poor being key risk groups,limited research and control activities target pre-school aged children(PSAC)and hard-to-reach populations.As endemic countries shift the goals of their schistosomiasis programs from morbidity control to disease elimination,there is a need for inclusive planning to cover all affected age groups from all geographical areas and populations to achieve sustainable impact and health equity.Methods We conducted searches in MEDLINE,Web of Science,Embase(Ovid),and LILACS per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews(PRISMA-ScR)guidelines.Quality assessment of identified articles was done using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.Relevant study data were extracted from the articles and entered into Microsoft Excel 2016 for descriptive analysis.Results From the 17,179 screened articles,we identified 13 eligible studies on schistosomiasis in PSAC living in hard-to-reach areas and populations.All identified studies were from sub-Saharan Africa.The mean sample size of the retained studies was 572,with a balanced sex distribution among the young children sampled in each study.Ten studies investigated Schistosoma mansoni,one investigated Schistosoma haematobium,while two covered both S.mansoni and S.haematobium in the target population.The prevalence of S.mansoni among PSAC in the included studies was estimated at 12.9%in Ghana,80.3–90.5%in Kenya,35.0%in Madagascar,9.6–78.0%in Senegal,11.2–35.4%in Sierra Leone,44.4–54.9%in Tanzania and 39.3–74.9%in Uganda.Out of the three studies that investigated S.haematobium,the presence of the infection was reported in only one study carried out in Nigeria.Schistosome infections reported in nearly all studies included in this review were of light intensity.Only one study conducted in Nigeria documented visible hematuria in 17.7%of the PSAC studied.Conclusions The findings document the high prevalence of schistosomiasis among PSAC in hard-to-reach populations and underscore the need to consider this population subgroup when designing the expansion of preventive chemotherapy and schistosomiasis control activities.

Urogenital schistosomiasis and associated determinant factors among senior high school students in the Dutsin-Ma and Safana Local Government Areas of Katsina State, Nigeria

Background:Human schistosomiasis is a chronic parasitic disease of poverty caused by the cercariae of digenetic trematodes of the genus Schistosoma.The disease is a major source of morbidity and mortality in 77 low-and middle-income countries in the tropics where 700 million people are at risk.In a bid to provide relevant epidemiological information to boost control of urogenital schistosomiasis at the state level in Nigeria,we conducted this study with the aim of investigating the disease’s prevalence and intensity,and the determinant factors responsible for its endemicity.Methods:Data on risk factors were obtained from a total of 645 students aged 12─25 years using well-designed questionnaires.Samples were collected between 09:45 and 14:00 in universal bottles.Each10μl centrifuged sample was examined for the eggs of S.haematobium using Motic®(Binocular)Light Microscope(model S-10-P)with a x10 objective.Average infection intensity was recorded as number of eggs per 10 ml of urine sample.Survey data were entered into Microsoft Excel 2010 and analyzed using Epi Info™7.Associations among variables were determined using the chi square test and bivariate and multivariate logistic regressions.Results:Prevalence of urogenital schistosomiasis was 30.54%among the study population,with a mean infection intensity of 30.27 eggs/10 ml of urine.Prevalence and average intensity were higher in males(28.37%and 32.21 eggs/10 ml of urine respectively)than in females(2.17%and 5 eggs/10 ml of urine respectively).Water contact activities(χ^(2)=29.031,P=0.0000),sex(male)[χ^(2)=109.82;P<0.0001],location(Dutsin─Ma)[χ^(2)=7.19;P=0.0073],age group 18-20(χ^(2)=4.819,P=0.0281),altitude(531─560 m)[χ^(2)=6.84,p=0.0089],fathers doing other brown─collar jobs(χ^(2)=8.449,P=0.0037)and mothers’occupation(χ^(2)=9.470,P=0.0021)were found to be significantly associated with urogenital schistosomiasis.Boys were six times more likely to be infected with the cercariae of S.haematobium compared to girls[AOR(95%CI):6.34(4.89─8.22)].Conclusions:Dutsin-Ma and Safana were classified as moderate-risk Local Government Areas for urogenital schistosomiasis.The strong association between the disease and mother’s occupation is of utmost importance and suggests a promising control measure:that is,directing health education as well as grassroots mass chemotherapeutic intervention with praziquantel at mothers.A good network including treated pipe-borne water,drainage system,and sewage disposal facilities available should be improved upon.Molluscicides should be provided at highly subsidized rate to help control the disease.

Reinfection of urogenital schistosomiasis in pre-school children in a highly endemic district in Northern Zimbabwe:a 12 months compliance study

Background:In light of the shift to aiming for schistosomiasis elimination,the following are needed:data on reinfection patterns,participation,and sample submission adherence of all high-risk age groups to intervention strategies.This study was conducted to assess prevalence,reinfections along with consecutive participation,sample submission adherence,and effect of treatment on schistosomiasis prevalence in children aged five years and below in an endemic district in Zimbabwe,over one year.Methods:The study was conducted from February 2016-February 2017 in Madziwa area,Shamva district.Following community mobilisation,mothers brought their children aged 5 years and below for recruitment at baseline and also urine sample collection at baseline,3,6,9 and 12 months follow up surveys.At each time point,urine was tested for urogenital schistosomiasis by urine filtration and children found positive received treatment.Schistosoma haematobium prevalence,reinfections as well as children participation,and urine sample submission at each visit were assessed at each time point for one year.Results:Of the 535 children recruited from the five communities,169(31.6%)participated consecutively at all survey points.The highest mean number of samples submitted was 2.9 among communities and survey points.S.haematobium prevalence significantly reduced from 13.3%at baseline to 2.8%at 12 months for all participants and from 24.9%at baseline to 1.8%at 12 months(P<0.001)for participants coming at all-time points.Among the communities,the highest baseline prevalence was found in Chihuri for both the participants coming consecutively(38.5%,10/26)and all participants(20.4%,21/103).Reinfections were significantly high at 9 months follow up survey(P=0.021)and in Mupfure(P=0.003).New infections significantly decreased over time(P<0.001).Logistic regression analysis showed that the risk of acquiring schistosomiasis was high in some communities(P<0.05).Conclusions:S.haematobium infections and reinfections are seasonal and depend on micro-geographical settings.The risk of being infected with schistosomes in pre-school aged children increases with increasing age.Sustained treatment of infected individuals in a community reduces prevalence overtime.Participation compliance at consecutive visits and sample submission adherence are important for effective operational control interventions.

Distribution and factors associated with urogenital schistosomiasis in theTiko Health District,a semi-urban setting,South West Region,Cameroon

Background:Increased risk of schistosomiasis in peri-urban and urban towns is not uncommon.An epidemiological survey was carried out in theTiko Health District(THD),an unmapped transmission focus for urogenital schistosomiasis(UGS),to assess the distribution,intensity,and risk factors associated with the occurrence of UGS.

Assessing the prevalence of urogenital schistosomaisis and transmission risk factors amongst school-aged children around Mapedam ecological suburbs in Malantouen district,Cameroon

Background:Urogenital schistosomiasis is a parasitic infection of public health importance that affects over 112 million people worldwide.The study aimed at assessing the urogenital schistosomiasis prevalence and risk factors of transmission around Mape dam suburds in Malantouen district,West,Cameroon.Methods:The study was conducted using semi-structured pretested questionnaires to collect socio-demographic and ecological data.Urine samples were also collected and used to confirm the prevalence of schistosomiasis in consented school-aged children in four primary schools between March-July 2014.Snails’samples around the dam surburbs were also collected for taxonomy characterization and species identification.Data were compiled and quality control assessed and analysed using SPSS version 17 and Epiinfo data 3.1.P<0.05 was considered statistical significance.Results:Questionnaires were administered to 229 pupils,with gender ratio of 1.04(m/f).The prevalence of schistosomiasis haematobium was 16.6%.Mambonko school site,which is the closest to the dam suburbs,registered the greatest prevalence rate of 40%.The age group beween 10-13 years was the most infected(18.3%)and boys were more infested than girls(21.0%vs.15.5%).Haematuria,urination pain,school absentiesm and poor performance were the major recorded complications in 39.5 and 26.3%males to female respectively.Infection rate gender disparity documented is still poorly understood and Bulinus truncatus collected from Mambonko suburb as potential snail intermediate host requires further studies.Conclusions:Authors advocated that schools and dam suburds sustained and innovative community-based surveillance and response targeted interventions implementation are needed to inform and support decisionmaking policy,but also in improving effective contextual behavioural communication changes and MDA improved uptake measures on national schistosomiasis control and elimination in Cameroon.

选择性化疗后居民血吸虫感染率感染度和病情变化研究

江西省泗山试区在经吡喹酮选择性化疗1年后,进行了居民血吸虫粪检和有关病情的调查.结果显示:居民血吸虫感染率从43.7%下降到10.2%;感染度(人群几何均数)从6.33下降到0.55;与血吸虫感染相关的肠道症状和肝脾肿大情况也得到明显的改善.提示化疗能有效地控制感染、减轻病情.

洞庭湖渔民血吸虫感染情况及化疗效果分析

目的 调查洞庭湖渔民感染血吸虫的严重程度 ,评估其化疗防治效果。 方法 2 0 0 1年 11月选择湖南省岳阳县麓角镇洞庭湖水上作业渔民 ,询问血吸虫感染与化疗史。用改良加藤法检查虫卵和毛蚴孵化法检查毛蚴 ,酶联免疫吸附测定 (ELISA)和间接血凝试验 (IHA)检测抗可溶性虫卵抗原 (SjSEA )的抗体 ,B超检查肝 /脾病变程度。人群顿服吡喹酮 40mg/kg ,一个感染季节过后复查。用SPSS软件进行分析。 结果 ①询问调查渔民 2 68人 ,“经常”或“间常”接触疫水的人数占 90 7% ;近 5年每年平均化疗人数占 2 4 0 % ,从未化疗者占 3 9 4% ;②粪检阳性率为 68 1% (111/163 ) ,克粪虫卵数 (EPG )为 48 77,男性均显著高于女性。 11～ 2 0岁阳性率最高(83 3 % ) ,“经常”或“间常”接触疫水与从未化疗的两种人群阳性率分别为 76 3 % (10 6/13 9)和 79 7% (5 1/64 ) ;③IHA检测阳性率为 88 0 % ,ELISA检测阳性率为 78 7% ,均明显高于粪检阳性率 ;④肝 /脾受损率为 77 4% (82 /10 6) ,其中 ,肝实质呈Ⅱ～Ⅲ级纤维化病变者占 3 7 7% ,肝肿率为 5 8 5 % ,脾肿率为 19 8% ;⑤多次化疗人群感染率和EPG显著低于从未化疗人群 ;⑥复查结果表明 ,化疗人群粪检阳性率 (3 5 4% )和EPG (3 6 13 )较未化疗人群(5 6 5 %和 68

荆州市人畜同步化疗控制血吸虫病疫情12年纵向观察

目的评价1992-2001年世界银行贷款中国血吸虫病控制项目期间,湖北省荆州市血吸虫病的防治效果,并观察该项目结束2年后疫情变化情况。方法采用回顾性纵向调查方法,收集整理1992-2003年荆州市8个县(市、区)人畜查病、治病、扩大化疗、查螺、灭螺和健康教育等年报资料,利用u检验进行疫情动态分析。结果2001年荆州市血吸虫病患者(77009例)比1992年(140438例)下降了45.2%,其中急性和晚期血吸虫病患者(63和1032例)分别比1992年(244和1841例)下降74.2%和43.9%;人群平均感染率由1992年的7.8%降至4.7%;防治前后人群平均感染率的差异有统计学意义(u=28.864,P<0.01)。2001年感染血吸虫的耕牛(3454头)比1992年(8035头)下降了57.0%,耕牛平均感染率亦由1992年的7.9%降至2001年的3.7%,防治前后耕牛平均感染率的差异有统计学意义(u=9.338,P<0.01)。2001年钉螺面积(19368hm2)比1992年(25395hm2)下降了23.7%。项目结束2年后,2003年急性血吸虫病例100例,比1992年下降了59.0%,但比2001年上升了58.7%。人群平均感染率上升至8.4%,比1992年和2001年分别上升了7.7%和78.7%(u=6.453、34.804,P<0.01)。耕牛平均感染率为6.5%,比1992年下降了17.7%,比2001年上升了75.6%(u=3.061、5.894,P<0.01)。钉螺面积上升至32853hm2,比1992年和2001年分别增加了29.3%和69.6%。结论人畜同步化疗可在短期内控制疫情和传播,项目结束后疫情发生反弹,甚至高于项目开始前的疫情水平。

“以机代牛”等传染源综合治理措施防治血吸虫病的效果评价

目的评价"以机代牛"等传染源综合治理措施对血吸虫病的防治效果。方法2011年在湖北省血吸虫病重度流行区选取6个已实施"以机代牛"等传染源综合治理措施的行政村(即荆州区的李埠镇杨井村和太湖管理区岳台村、监利县的新沟镇顺丰村和程集镇张马村、江陵县的马家寨乡金旗村和资市镇玉古村)为干预组,2个未实施该措施的行政村(即石首市的小河口镇老洲岭村和大垸镇中岭子村)为对照组进行效果评估。内容包括,采用整群随机抽样调查人群感染情况,采用改良加藤法检查粪便,每个村调查人数不少于300人;调查全部耕牛感染情况,采用塑料杯顶管孵化法检查粪便。采用系统抽样法调查钉螺感染情况,并在钉螺调查环境中调查野粪的感染情况(用塑料杯顶管孵化法,1粪3检)。分别对2007年(基线情况)、2009年(干预前)和2011年(干预后)干预组和对照组的防治效果进行比较分析。结果干预组,人群的血吸虫感染率由实施"以机代牛"等综合治理措施前(2007年、2009年)的3.6%(135/3 772)和2.0%(63/3 116)降至2011年的0.9%(21/2 396)(χ2=43.411,χ2=11.840,P<0.05);至2011年已无存栏耕牛;2010-2011年人群和耕牛的血吸虫感染率下降幅度分别为52.6%和100%。对照组,2007、2009和2011年的人群感染率分别为4.5%(64/1 410)、2.6%(34/1 294)和1.8%(24/1 320),2007和2011年间的差异有统计学意义(χ2=16.178,P<0.05),但2009和2011年间的差异无统计学意义(P>0.05);2007、2009和2011年耕牛感染率分别为5.1%(8/158)、1.6%(3/187)和1.6%(3/189)(χ2=3.387,P>0.05);2010-2011年人群和耕牛感染率的下降幅度分别为25.0%和5.9%。2011年的调查结果显示,干预组和对照组人群感染率的差异有统计学意义(χ2=6.309,P<0.05);两组调查点均未查到感染性钉螺;干预组未查到阳性野粪,对照组野粪阳性率为7.5%(3/40)。结论实施"以机代牛"等传染源综合治理措施可有效阻断血吸虫病的传播,人群、耕牛血吸虫感染率明显降低。

湖沼型血吸虫病重度流行区疫情现状调查

目的阐明湖沼型血吸虫病重度流行区疫情现状及特征,为进一步的疫情纵向观察提供基础资料。方法选择湖沼型湖滩亚型和洲滩亚型血吸虫病重度流行村各1个,采用Kato-Katz法和塑料杯顶管孵化法分别检查人、畜血吸虫感染情况,采用问卷法调查居民血吸虫病治疗史和患病史、疫水接触、与血吸虫病相关的症状和体征等情况。结果民生村和光辉村分别有68.24%和61.39%的居民有患血吸虫病史及治疗史,2周内有腹泻症状史者分别占3.96%和4.39%,有乏力史者分别占8.67%和5.80%。民生、光辉村居民血吸虫感染率分别为10.90%、15.18%,男性感染率高于女性。夏季接触疫水人群多于春、秋季,主要接触疫水方式为洗手、戏水、放牧、割草、捕鱼等。耕牛血吸虫感染率2岁以下幼牛较高。结论湖沼型血吸虫病流行区疫情仍较严重,常规防治措施难以使疫情大幅度下降。

日本血吸虫病人群获得性免疫与再感染研究 Ⅰ.洞庭湖区一个洲岛型疫区血吸虫病流行病学调查研究

本文报告了湖南省洞庭湖一个洲岛型血吸虫病流行区1996年居民病情调查结果。该洲岛由大（青山Qingshan）、小（严家山Yanjiashan）二岛所组成。共检查居民1909人，受检率为72．2％，Kato－Katz法阳性率大岛为14．6％；小岛为23．7％。大岛血吸虫感染有两个高峰年龄组（25岁—35岁和45岁—55岁）；小岛年龄组感染高峰略有后移。感染者人群感染度（EPG）轻、中、重分别为71．1％、21．3％和76％。肝、脾肿大率分别为21．9％和1．3％。感染率与人群感染度无直接相关；重感染度人群的肝肿大率及腹泻率高于其它组；渔民血吸虫感染率最高（22．4％）；学生的感染度最重（EPG220）。结果表明：该地目前所采用的选择性人群化疗的防治措施未能达到理想的防治效果，宜进一步加强综合防治力度。