江西省山丘型血吸虫病流行区达标前后疫情回顾性调查分析

目的 目的 分析江西省山丘型血吸虫病流行区达到血吸虫病传播控制 （传控） 或传播阻断 （传阻） 标准前后疫情消长规律， 为修订 《血吸虫病控制与消灭标准》 提供科学依据。方法 方法 选择江西省山丘型血吸虫病流行区传阻县2个和传控县1个， 采取回顾性调查方法， 收集、 整理各县达到传控前10年和以后各年 （截止2008年或2009年） 疫情资料并建立数据库； 分析达标前后血吸虫病疫情变化规律。结果 结果 广丰、 上饶和德安等3县达到传控后， 有螺面积分别压缩了96.79%、 98.99％和99.77%， 钉螺密度维持在较低水平， 治愈了95%的病人和病牛。达传控标准后， 广丰和德安2县分别历经了17年和26年达到传阻标准； 上饶县则由于残存钉螺复现与扩散而导致螺情反复， 但人、 畜病情稳定， 尚未达到传阻标准。结论 结论 螺情反复是山丘型血吸虫流行区传控或传阻达标进程中的主要制约因素之一。在一个较孤立单元的流行区域内， 如有螺面积或钉螺密度持续控制在较低水平， 即使存在少量传染源， 血吸虫病也不易传播与蔓延。

Retrospective investigation on changes of endemic situation before and after reaching criteria of schistosomiasis transmission controlled or interrupted in hilly endemic areas of Jiangxi Province

Objective To investigate the changing rules of schistosomiasis endemic situation before and after reaching the cri- teria of schistosomiasis transmission controlled or interrupted in hilly endemic areas of Jiangxi Province, so as to provide the evi- dence for reformulating the criteria of schistosomiasis control and eradication in the future. Methods In the hilly areas of schisto- somiasis endemic in Jiangxi Province, 2 counties where th~ transmission has been interrupted and 1 county where the transmission has been controlled were selected and investigated with the retrospective research method. The endemic detailed data were collect- ed and recorded 10 years before reaching the criteria of transmission interrupted/controlled, and several years after reaching the criteria （ending in 2008）, and then a database was established. The changing rules of endemic situation before and after reaching the criteria of transmission interrupted/controlled were analyzed and compared. Results After reaching the criteria of transmis- sion controlled, in the 3 counties, Guangfen, Shangrao and Dean, the declined rates of areas with Oncomelania h~pensis snails were 96.79%, 98.99%, and 99.77% respectively. The snail density maintained a lower level, and 95% of infected persons and cattle were cured. The average time from transmission controlled to the transmission interrupted was 17 years in Guangfen County and 26 years in Dean County. However, in Shangrao County, the snail situation rebounded due to the snail re-found and spread al- though the schistosomiasis morbidity of population/animals maintained stably. Conclusions After reaching the criteria of trans- mission interrupted/controlled, the remained snails were easy to re-find and spread under some certain condition, which is one of main obstacles for reaching the criteria of transmission interrupted. In an isolated snail unit, if the snail area and snail density are controlled in a very low level, it is still difficult to transmit and spread schistosomiasis even if there exist infectious sources.