中国血吸虫病流行现状分析

目的 分析近5年来中国血吸虫病流行趋势及疫情变化的特点。方法 收集血吸虫病流行历史资料及近年流行区疫情报告资料,比较分析1998年后全国血吸虫病流行趋势和疫情回升特点。结果 2003年底报告资料显示,与建国初期相比,全国流行省、县、乡镇分别减少了42％、40％和53％;血吸虫病估计病例数较建国初期减少了92.74％;钉螺面积减少了73.56％。但全国推算慢性血吸虫病例数徘徊在80万左右,急性感染报告数以年平均25％上升;1998年以来钉螺面积净增加31321.5万m~2,全国7省20个纵向监测点内,30％、70％和35％监测点的人群、耕牛和钉螺的感染率分别出现上升趋势。湖区5省中有38个达到血吸虫病传播控制和传播阻断标准县(市、区)疫情分别出现了明显的回升,湖南省6个非疫区(株洲市3个、长沙市2个、桃源县1个)新发现钉螺,长沙市桔子洲头等I6个洲滩均有钉螺,并发生急性感染;已阻断传播地区如上海、浙江、福建等省市也发现大面积钉螺。长江中下游沿江的大中城市相继发现感染性钉螺和新发病例。结论 近年来长江中下游地区局部血吸虫病流行区疫情回升明显,回升原因有环境生态变化、社会经济变化及预防控制力度变化等因素的影响。     

湖南省血吸虫病传播阻断地区疫情监测报告

目的：监测血吸虫病传播阻断地区疫情动态。方法：采取系统抽样结合环境抽样方法查螺，用IHA血检结合粪检对居民及流动人群进行查病，对家畜用孵化法进行粪检。结果：9个达血吸虫病传播阻断标准的县(区、农场)，达标时仅一个单位残存小面积钉螺，在达标4—16年后，除2个单位仍无钉螺外，7个单位均新发现成复发现钉螺面积；两个单位发现感染螺、当地感染的新病人和急性血吸虫病人，重新成为疫区。结论：血吸虫病传播阻断地区巩固成果是艰巨的，达标后必须长期坚持不懈地、认真地进行疫情监测。     

常山县2008-2011年血吸虫病监测点监测结果分析

目的分析常山县血吸虫病监测点2008-2011年疫情状况,掌握山丘地区复杂环境血吸虫病监测方法,为制订山丘地区监测方案提供科学依据。方法根据全国和浙江省血吸虫病监测点监测方案,每年对螺情、自然因素、常住人群、流动人口和家畜疫情进行监测,纵向观察和分析山丘地区血防传播阻断下疫情变化趋势。结果 2008-2011年监测点疫情监测未发现本地急性感染和新感染病人(畜)。螺情监测每年均发现少量残存钉螺,4年累计发现有螺面积6 680m2,活螺1 021只,未查到感染性钉螺。本地居民血检IHA阳性率为3.43%,输入性病例血检IHA阳性率为6.37%,未发现输入性急性血吸虫病例。结论监测点疫情稳定,但有少量残存钉螺,仍易引起血吸虫病重新传播流行,应重点做好本地螺情和输入性传染源的监测。     

上虞市血吸虫病传播阻断后15年监测结果分析

[目的]掌握血吸虫病传播阻断后疫情动态,为血防工作提供依据。[方法]按血吸虫病传播阻断地区监测巩固方案进行监测。[结果]连续15年螺情监测,查螺面积416.5×105m2,在一个村断续7年查出残存钉螺,有螺面积1.5×105m2,查出螺点36处,解剖活钉螺6 267只,未检出血吸虫感染钉螺。病情监测,查病24 042人,粪检血清学阳性者1 052人,疫区耕牛1 292头,解剖家畜及野生动物358只,均未查到病原。[结论]本地无血吸虫病原存在,血吸虫病传播途径被阻断。今后工作重点应放在根除残存钉螺和加强外来传染源的监测上。     

常州市血吸虫病传播阻断后新发现钉螺环境调查

目的:了解血吸虫病传播阻断后疫情的变化情况,为监测巩固工作提供科学依据.方法:分析1999-2008年常州市血吸虫病螺情监测资料.结果:钉螺面积仍处在徘徊状态,并有新发现的有螺环境.结论:血吸虫病传播阻断后,仍需加强监测,尤其是螺情监测.     

流动人口血吸虫病监测方法的评价

日本血吸虫病是一种严重危害我国人民健康、影响经济发展的人畜共患传染病。我国血吸虫病流行区分布于长江流域及其以南的江苏、浙江、安徽、江西、福建、上海、湖南、湖北、广东、广西、云南和四川12个省（自治区、直辖市）。建国初期，全国估计有患者1200余万例，病牛120万头，钉螺面积148亿m^2。经过几十年的血吸虫病防治（简称血防）工作，取得了很大的成效，截止2005年底，在全国435个疫区县（市、区）中，已有264个县达到了血吸虫病传播阻断标准，66个县达到了血吸虫病传播控制标准。由于社会经济发展等诸多因素的影响，现阶段血吸虫病疫情普遍出现回升，而且也时刻威胁着血吸虫病传播阻断地区。     

南京市浦口区血吸虫病传播阻断达标考核结果

目的评价浦口区血吸虫病防治效果。方法收集2016年汤泉街道九龙村、顶山街道大新村、桥林街道周营村人畜血吸虫病疫情、螺情和相关因素的调查数据进行分析。结果 2016年3个村血吸虫病血清学阳性率以及居民感染率分别为1.08%和0,家畜感染率为0;2016年3个村共调查面积231万平方米,查获钉螺1只,钉螺感染率为0。结论浦口区人畜血吸虫病感染率处于较低水平,无钉螺感染,达到血吸虫病传播阻断标准。     

血吸虫病传播阻断后的综合干预研究

宁波市地处浙东沿海，全市辖下6区5县(市)，2003年当地总人口为530余万，流动人口数百万。虽然历史上曾有8个县(市)区流行血吸虫病，但到1992年均达到传播阻断标准。近年来，随着流动人口的逐年增多，及当地时有钉螺发现，给巩固血吸虫病防治成果增添了新的问题和难度。为了寻求传播阻断地区血吸虫病管理与监测的有效方法，从1990年起．我们在全市范围内开展了血吸虫病传播阻断后的综合干预研究。     

嘉兴市阻断血吸虫病传播7年监测结果分析

目的　分析水网型地区达到阻断血吸虫病传播后监测结果 ,寻找更有效的监测方法。　方法　选择未经环境改造的历史螺区 ,特别是 2 0年内曾有螺地段及延伸环境作螺情监测 ;病情监测的重点是外来流动人员 ,由医疗卫生单位在医疗过程中对血吸虫疑似病人进行检验和报告。　结果　在 4个县 ,10个乡 ,2 5个村和机场查到 77个有钉螺条块 ,面积 2 7.7万 m2 ,无阳性钉螺。检查 5 7.7万人 ,查到外来流动人员血吸虫病人 2例 (其中急血 1例 ) ,未查到当地病人。未查到阳性耕牛。　结论　嘉兴市血吸虫病得到有效控制。     

2012年高邮市新民村血吸虫病疫情监测工作报告

目的掌握湖滩型血吸虫病传播阻断地区血吸虫病疫情动态,评估"十二五"期间防治效果,为今后调整防治对策提供科学依据。方法根据《江苏省血吸虫病疫情监测点工作方案(2012—2015年)》,选择高邮市新民村作为观察点,开展螺情、病情等监测。结果监测表明,疫情呈"有螺无病"态势。查出钉螺面积447 557 m2,占历史有螺面积的1.76%,钉螺密度0.493只/m2;哨鼠、钉螺、畜牲以及人群均未发现感染血吸虫;不同人群之间血吸虫病血清学抗体水平差异无统计学意义(P值均>0.05)。结论监测点所采用的综合性防治措施对控制血吸虫病疫情有效,但监测巩固工作仍较为艰巨,发生疫情的隐患依然存在。应积极探索高效、低廉的疫情监测方法,构建便捷、完善的疫情监测体系,密切监测产业结构调整对血吸虫病传播的影响。     

洞庭湖区外出务工人员血吸虫病感染情况调查

目的了解血吸虫病非流行区和流行区外出务工人员(农民工)流向、工种、工作生活环境及其行为学,分析外出打工者血吸虫病感染现状及造成血吸虫病传播或再流行的潜在危险。方法分别从非流行区和流行区外出务工人员中,随机抽取500人以上进行问卷调查,然后进行血清学和病原学方法检查。结果非流行区调查外出务工人员577人,血清检查阳性率15.53%,粪检阳性率1.89%,务工期间有99.8%的人员接触过疫水;流行区调查外出务工人员529人,血清检查阳性率32.82%,粪检阳性率3.40%,务工期间98.9%的人员未接触疫水。结论非流行区外出人员在血吸虫病流行区务工期间,以务农为主接触疫水时间多,容易形成血吸虫病新感染;流行区外出人员中的血吸虫病人或传染源,在城市工厂打工,接触疫水感染血吸虫病机率少,造成当地血吸虫病传播或再流行的可能性小,但对有螺无病区、历史流行区、不知情疫源地,是造成血吸虫病再流行的潜在危险因素。     

Schistosomiasis control in China: the impact of a 10-year World Bank Loan Project (1992-2001)

China has been carrying out large-scale schistosomiasis control since the mid-1950s, but in the early 1990s, schistosomiasis was still endemic in eight provinces. A World Bank Loan Project enabled further significant progress to be made during the period 1992-2001. The control strategy was focused on the large-scale use of chemotherapy -- primarily to reinforce morbidity control -- while at the same time acting on transmission with the ultimate goal of interrupting it. Chemotherapy was complemented by health education, chemical control of snails and environmental modification where appropriate. A final evaluation in 2002 showed that infection rates in humans and livestock had decreased by 55% and 50%, respectively. The number of acute infections and of individuals with advanced disease had also significantly decreased. Although snail infection rates continued to fluctuate at a low level, the densities of infected snails had decreased by more than 75% in all endemic areas. The original objectives of the China World Bank Loan Project for schistosomiasis control had all been met. One province, Zhejiang, had already fulfilled the criteria for elimination of schistosomiasis by 1995. The project was therefore a success and has provided China with a sound basis for further control.     

浙江省2011年血吸虫病疫情监测结果分析

目的 及时掌握浙江省血吸虫病疫情动态变化,为制定防治策略提供科学依据.方法 根据《浙江省血吸虫病监测巩固方案(2007年修订版)》,在全省开展螺情和病情监测.螺情监测用系统抽样结合环境抽查法,查到的钉螺用压碎法检查血吸虫感染情况,用土埋结合药物方法灭螺;病情监测用血清学筛查阳性者粪检,对有螺村和来自尚未控制血吸虫病县人(畜)采用血清学筛查监测病情,血清阳性者进一步粪检.结果 在17个流行县(市、区)中查出有螺面积59.62 hm2,其中新查出有螺面积0.53 hm2;解剖钉螺71 450只,未发现感染性钉螺.血清学查病139 896人,阳性1279人,阳性率为0.91％;发现输入性血吸虫病病例9例,其中2例急性病例,未发现本地粪检阳性患者(畜).结论 今后要继续加强监测,查清螺情,压缩残存钉螺,防控外来传染源.     

湖南省1979～2003年血吸虫病新流行区疫情现状

目的 分析掌握血吸虫病新流行区形成的主要因素及流行特点。方法 收集湖南省1979～2003年血吸虫病新流行区的螺情、病情以及传染源等有关疫情调查资料。结果 所有新发现血吸虫病疫区,都是先发现患者,甚至是出现了急性病例。且一旦发现新的流行区,居民感染都很高(最高村民组达87.1％)。特别是新流行区多集中在城郊、城镇附近的沟港、滩地。结论 以上新流行地区成因大多是通过打湖草、捞鱼虾(鱼卵草)以及渔船民作业、运输工具将钉螺带入扩散所致,传染源为当地人群到疫区下湖作业感染,以及从疫区迁入病例和购进的家畜。     

Knowledge, attitudes and practices among rural communities in Zimbabwe in relation to Phytolacca dodecandra—a plant molluscicide

Questionnaires about schistosomiasis and Phytolacca dodecandra, a plant molluscicide with potential to control schistosomiasis transmitting snails, were administered to 271 women and 168 men in two communal areas where the plant grows naturally, and in a further two areas where no records of the plant exist. 78.9% of the respondents thought that schistosomiasis was a dangerous disease with blood in urine being the most recognised symptom. 11.8% said that snails were involved in the transmission of the disease, although their role in sustaining the life cycle of the schistosome parasite was not understood. Knowledge about P. dodecandra was restricted to people resident in areas where the plant grows naturally and to immigrants from areas where it is known to grow. The most common use of the plant was as a floor polish. Knowledge of uses of the plant were found to be related to the sex of the respondents. Seventy-seven percent of the people interviewed were prepared to cultivate the plant for self-help schistosomiasis control programmes. Of the 23% that were not willing to cultivate P. dodecandra, 47.7% cited scarcity of land as the main obstacle. Other reasons were lack of knowledge about the plant (21%), lack of confidence in the success of such self-help programmes (11.2%) and indifference due to old age (20%).     

Eradication of schistosomiasis in Guangxi, China. Part 3. Community diagnosis of the worst-affected areas and maintenance strategies for the future

Reported are the results of a community-based assessment of maintenance of schistosomiasis eradication in Guangxi, a large autonomous region of China with a population of 44 million. Eradication of the disease was achieved in 1989 in Guangxi but maintenance costs are rising. We focused on three counties that had the most intense transmission in the past: Binyang, Jingxi, and Yishan. Four instruments were used: in-depth interviews, focus group discussions, a knowledge, attitudes and practices survey, and subsequent community feedback. In the past, schistosomiasis had serious consequences in Guangxi, decreasing work capacity and restricting marriage and occupational mobility. Since its eradication there have been clear benefits in terms of increased agricultural output and improved farming conditions. Personal habits and traditional manual farming activities in Guangxi would continue to expose a large proportion of the population to environmental risk if the disease were to return. Ignorance about control programme achievements is increasing and is related to youth and inexperience. There was a universal desire in the study counties for more local education about the history of the programme and about the risk of schistosomiasis returning. Snail surveillance is considered important, but people are not willing to volunteer for such work. Our study methods were novel for Guangxi and community feedback was helpful. Snail checking procedures have been modified to make them more efficient and no snails have been found since 1992. The animal and human stool examinations have ceased and vigilance now concentrates on snails and children (skin tests). The long-term strategy is to make the population invulnerable to future schistosomiasis transmission if the snail vectors return. This means continuing education and making the former endemic counties a high priority for water and sanitation improvements.     

2007年浙江省血吸虫病疫情监测结果分析

目的 掌握血吸虫病疫情,为制定防治策略提供科学依据.方法 螺情调查与疫区人群的检查相结合.螺情监测用系统抽样结合环境抽查法,查到的钉螺用压碎法检查血吸虫感染,用土埋结合药物方法灭螺;病情监测用血清学筛选阳性者后粪检,检查有螺村和来自尚未控制血吸虫病县人(畜).结果 对浙江省53个县的427个乡(镇)4193个村开展查螺,在22个县的84个乡349个村查到钉螺,面积122.02hm2,捕获并解剖钉螺107 613只,结果均阴性.查病210 989人,未发现本地患者,但查到输入性病例24例.全省共确认晚期血吸虫病患者1060例,并已展开救助.结论 浙江省血吸虫病疫情稳定,但残存钉螺面积居高不下,输入性病例时有发生,今后血防重点是查灭钉螺和防控外来传染源.     

Re-emerging schistosomiasis in hilly and mountainous areas of Sichuan, China

Despite great strides in schistosomiasis control over the past several decades in Sichuan Province, China the disease has re-emerged in areas where it was previously controlled. We reviewed historical records and found that schistosomiasis had re-emerged in eight counties by the end of 2004 - seven of 21 counties with transmission control and one of 25 with transmission interruption as reported in 2001 were confirmed to have local disease transmission. The average "return time" (from control to re-emergence) was about eight years. The onset of re-emergence was commonly signalled by the occurrence of acute infections. Our survey results suggest that environmental and sociopolitical factors play an important role in re-emergence. The main challenge would be to consolidate and maintain effective control in the longer term until "real" eradication is achieved. This would be possible only by the formulation of a sustainable surveillance and control system.     

三峡库区可能传播血吸虫病的危险因素及其防制对策

目的 掌握三峡库区可能传播血吸虫病的危险因素并提出相应的防制对策。方法 采用流行病学、免疫学和现场调查相结合的方法,调查三峡库区流动人口、库区移民和家畜血吸虫病传染源可能输入库区的潜在危险因素。运用钉螺生态学的方法,观察钉螺在模拟环境中的生存繁殖状况,并提出防止血吸虫病传染源和钉螺可能输入库区的对策和措施。结果 从库区流动人口来自血吸虫病疫区的175人中,查出1例间接血凝试验(IHA)和环卵沉淀试验(COPT)均阳性者。通过2个年度的观察,肋壳钉螺和光壳钉螺都能在模拟环境中生存、繁殖。结论 血吸虫病传染源已扩散到库区,一旦钉螺输入到库区,将会构成血吸虫病在库区流行。为及早杜绝隐患,提出了相应的防范措施和对策。