血吸虫病防控技术集成研究与示范 Ⅱ疫情纵向防治效果评价

目的评价血吸虫病防控技术集成研究与示范对控制血吸虫病疫情的防治效果。方法通过在示范区实施封洲轮牧、改水改厕、健康教育等控制血吸虫病流行的综合措施,并开展血吸虫病疫情调查及相关问卷调查,评价其防治效果。结果通过连续3年的血吸虫病防控技术实施,示范区居民血吸虫感染率由3.57%降至0.83%,耕牛血吸虫感染率由17.14%降至0,洲滩未发现阳性钉螺。结论封洲轮牧、改水改厕、健康教育等综合防治技术是控制鄱阳湖区血吸虫病流行的有效措施。     

洞庭湖区血吸虫病GIS平台相关疫情指标的选择

洞庭湖区是我国主要的血吸虫病湖沼型流行区之一, 是血防工作的重点区域。近年来空间流行病学在血吸虫 病研究中广泛应用, 为突破当前我国血吸虫病防治的徘徊局面带来了新的机遇。本文从一般疫情指标和洞庭湖区特异 性指标两方面综述既往血吸虫病相关地理信息系统 （GIS） 的研究, 为建立湖南省血吸虫病GIS数据库奠定基础。     

以边际效益视角审视中国消除血吸虫病的优化路径

经过70多年的有效防治,我国血吸虫病防治工作已取得举世瞩目的成绩。当前,我国血吸虫病防治进入消除阶段,主要任务是充分利用已有资源强化血吸虫病监测响应、持续巩固已取得的防治成果、防止疫情反弹。因此,如何进一步优化消除血吸虫病干预措施亟待研究。本文在分析我国血吸虫病防治不同阶段社会经济学特征的基础上,结合边际效益基本原理讨论不同阶段干预措施评价需求与优化策略间的关系,提出了如何利用边际效益原理优化防控方案,使血吸虫病防治成本发挥出最大边际效益,为我国最终消除血吸虫病提供最优战略路径。     

1996—2011年湖南省汨罗市血吸虫病疫情纵向观察

摘要：目的 观察洞庭湖区湖沼型疫区采取以传染源控制为主的综合防治措施控制血吸虫病效果。 方法 收集、整理汨罗市1996—2011年血吸虫病有关疫情资料进行回顾性分析,观察实施以传染源控制为主的综合防治措施前后螺情与病情的变化。 结果 洞庭湖区湖沼型血吸虫病疫区实施人畜同步化疗为主的措施,垸外活螺平均密度、感染性钉螺密度变化不明显,维持在0.29～0.63只/0.1 m2和0.003 4～0.037 9只/0.1m2,人群患病率维持在2.13%～3.68%,耕牛感染率维持在1.10%～4.36%之间;实施以传染源控制为主的综合防治措施后垸外活螺平均密度虽有波动,但整体呈下降趋势,从0.52只/0.1 m2下降至0.18只/0.1 m2,感染性钉螺平均密度从0.003 8只/0.1m2下降至0.000 7只/0.1m2,钉螺感染率呈下降趋势,从第一阶段的0.72%以上下降到0.38%以下,人群患病率从2.86%下降至1.25%,耕牛感染率从2006年的2.87%上升到2008年的5.92%,又下降到2010年的1.70%。急性血吸虫病感染以散发为主,1996—2009年共发生急性血吸虫病49例,血吸虫病例以7～14岁组为多,男性感染率显著高于女性,学生多见,因游泳戏水感染最多,多为垸外感染,秋季和夏季为高发期,落实以传染源控制为主的综合防治措施后的2010—2011年未发生急感病例。 结论 血吸虫病以传染源控制为主的综合防治措施在洞庭湖区湖沼型疫区取得了明显的防治效果。加强在易感地带查灭阳性钉螺,减少垸外人畜活动,重视宣教,严防儿童在夏、秋季节发生血吸虫病的急性感染,适宜开展人畜同步化疗,依然是湖区血吸虫病防治的关键。     

洞庭湖区血吸虫病疫情监测及防治对策

目的分析洞庭湖区国家血吸虫病疫情监测点连续5年疫情变化规律,为制定全国血吸虫病防治规划和决策提供依据.方法在洞庭湖区建立4个血吸虫病疫情监测点,按<全国血吸虫病疫情监测方案>进行监测.结果居民血吸虫感染率东浃点维持在4%左右,新尚点在5%左右,全兴点在12%以上,长江点第1年为8.92%,后4年维持在4%左右.20～49岁年龄组的居民感染率最高;男性高于女性;渔民、农民、学生的感染率最高.有急性血吸虫病和新发晚期血吸虫病病例发生.牛的感染率在20.0%左右.垸外洲滩均有感染螺分布,且密度高.结论洞庭湖区血吸虫病流行依然十分严重,应加大防治力度.     

普格县特兹乡2005—2007年血吸虫病疫情分析

为探索高山峡谷地区血吸虫病综合防治的模式,进一步加强以传染源控制为主的血吸虫病综合防治措施,以点带面,推动和加快少数民族地区血吸虫病防治进程,现将2005—2007年四川省普格县特兹乡试点的血吸虫病疫情分析如下。     

普格县特兹乡2005-2007年血吸虫病疫情分析

为探索高山峡谷地区血吸虫病综合防治的模式，进一步加强以传染源控制为主的血吸虫病综合防治措施，以点带面，推动和加快少数民族地区血吸虫病防治进程，现将2005—2007年四川省普格县特兹乡试点的血吸虫病疫情分析如下。     

安乡县以淘汰牛羊为重点的血吸虫病综合防治效果

目的 了解洞庭湖区安乡县以淘汰牛羊为重点的血吸虫病综合防治措施的效果。方法 收集2004-2012年安乡 县淘汰牛羊、 查治病、 查灭螺等资料, 分析血吸虫病疫情逐年变化情况。结果 安乡县人群、 家畜及钉螺血吸虫感染率均 呈逐年下降趋势 （P均﹤0.001）, 分别由2004年淘汰牛羊前的11.23%、 17.06%、 1.07%下降至2012年的0.58%、 0及0。感染 螺平均密度由2004年的0.003 4只/0.1 m2 下降为0。结论 以淘汰牛羊为重点的传染源综合控制措施效果显著, 能有效控 制湖沼型地区血吸虫病传播。     

切实织牢三级预防网络 推进血吸虫病消除进程

我国实施以传染源控制为主的血吸虫病综合防治措施取得了显著成效,但血吸虫病流行因素复杂,使得血吸虫病疫情反弹风险较高。 三级预防是以消除影响健康的危险因素为主要内容,以促进健康、保护健康、恢复健康为目的的公共卫生策略与措施。 本文从三级预防的角度逐级介绍我国实施的血吸虫病防治措施及效果,以期切实织牢血吸虫病防治三级预防网,为今后的血吸虫病消除工作提供借鉴。     

以传染源控制为主的血吸虫病综合防治措施效果评价

目的评价以传染源控制为主的综合防治措施在湖北省血吸虫病流行区的3年防治效果,为湖沼型血吸虫病流行区防治提供经验。方法在湖北省4个疫情较重的血吸虫病流行县(市、区),选择8个疫情较严重的流行村(试点村),开展改厕和建沼气池、安全用水、耕牛淘汰、兴林抑螺等以传染源控制为主的血吸虫病综合防治措施,辅以常规卫生血防措施,对血吸虫病疫情变化及居民人均收入等进行分析。结果经过3年的综合防治,与试点工作前比较,试点村钉螺面积下降17.51%,活螺平均密度下降14.22%,阳性螺密度下降77.21%,钉螺感染率下降73.47%;平均人群血吸虫感染率下降86.38%;家畜存栏头数下降,耕牛血吸虫感染率下降88.01%;人均收入较试点前增加40.78%。结论实施以传染源控制为主的综合防治措施可有效控制湖沼型血吸虫病流行,社会效益与经济效益显著。     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

Investigation of mode of action of biofeedback in treatment of fecal incontinence

A study was carried out in 25 incontinent patients to evaluate some of the factors thought to be responsible for the success of retraining for fecal incontinence. Subjects were initially allocated to one of two groups; one group was trained to perceive small rectal volumes (active retraining), the other group carried out the same maneuvers but were not given any information or instruction. Active sensory retraining reduced the sensory threshold from 32 +/- 8 to 7 +/- 2 ml (P less than 0.001), corrected any sensory delay that was present (P less than 0.004), and reduced the frequency of incontinence from 5 +/- 1 to 1 +/- 1 episodes per week (P less than 0.01). Sham retraining caused a modest reduction in the sensory threshold (from 29 +/- 9 to 20 +/- 8; P less than 0.05) but did not significantly reduce the frequency of incontinence. Subsequent strength and coordination training did not significantly improve continence, although at the end of the study, 50% of patients had no incontinent episodes at all and 76% of patients had reduced the frequency of incontinence episodes by more than 75%. This improvement in continence was not associated with any change in sphincter pressures or in the continence to rectally infused saline but was associated with significant improvements in rectal sensation. The functional improvement was sustained over a period of two years in 16 of the 22 patients available for follow-up. In conclusion, the results support the use of retraining in the management of fecal incontinence and suggest that retraining may work by enhancing rectal sensitivity and instilling confidence.