株洲市山丘型血吸虫病疫区成因及防治对策效果分析

目的初步探明株洲市山丘型血吸虫病疫区成因及防治对策效果,为制定控制血吸虫病疫区扩散的对策提供科学依据。方法调查自然环境是否适宜钉螺孳生;常规法查螺查病评估血吸虫病疫区的防治效果;调查血吸虫病疫区流动人群、家畜及物流等。结果在疫区农贸市场活鱼虾中查获活钉螺16个;经常有病人和病畜进入疫区,流动人群中血吸虫病阳性率为15.76%;在株洲市范围内各县(市)、区自然环境均适合钉螺生长;居民血吸虫病感染率由1998年的17.97%下降到2005年的1.89%(U=26.06,P<0.001)。家畜感染率由13.45%下降到3.75%(U=20.26,P<0.05);活螺平均密度由1998年的2.19只/0.11 m2下降到2005年的0.12只/0.11 m2,钉螺阳性率下降了85.7%。结论株洲市血吸虫病经过几年来的防治取得了明显效果,但尚未达到传播阻断标准,仍有向周边扩散的可能,因株洲市血吸虫病流行区和非流行区自然环境和居民生产生活习惯相似。疫区成因,钉螺夹带输入可能性较大,传染源可能与进入本地的病人、病畜相关。     

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。     

Socio-cultural and ethical factors involved in the diagnosis of schistosomiasis mansoni in an area of low endemicity

Five annual parasitological surveys and one serological survey, respectively based on the Kato-Katz and free sedimentation methods and the Western blot technique, were conducted in Sumidouro, Rio de Janeiro, Brazil, an endemic county for schistosomiasis. Possible influences of the use of these methodologies on social, cultural, and ethical aspects of the study population were also evaluated. Having the opportunity to choose the different techniques was a conclusive issue influencing participation by the population. Prevalence rates of positive results for stool tests were: 11.6% (1995); 8.8% (1996); 12.2% (1998); 5.9% (1999); and 3.2% (2000). In the period during which the serological survey was performed, the use of laboratory testing in association with analysis of clinical data and available data on transmission and treatment generated a diagnostic procedure termed "coproseroepidemiology". This methodology contributed to significant improvements in the accuracy of measurement of local schistosomiasis prevalence, indicating that epidemiological surveillance could help prevent the recurrence of high prevalence rates. The fact that Biomphalaria glabrata was replaced by Melanoides tuberculata in the main transmission focus contributed to a significant decrease in infection rates.     

石台县地区晚期血吸虫病现状调查与分析

目的研究安徽省石台县晚期血吸虫的疾病变化情况。方法采用走访抽查方式对石台县2005年和2013年的螺情及晚血疾病状况进行调查。统计当地钉螺分布区域和患病人数并进行统计学对比。结果 2005年,粪便检测有5人呈阳性反应,感染率为0.08%,累计存活例数为102例。2013年,粪便检测有2人呈阳性反应,感染率为0.04%,累计存活例数为65例。当地钉螺存活环境为944处,覆盖范围总计为249.85万m2。两次调查的统计数据变化明显,2013年疾病控制情况显著优于2005年P〈0.05。结论石台地区晚血感染情况严重而复杂,在治理石台县的晚期血吸虫疾病时,必须双管齐下,既要采取消灭钉螺的措施,又要对疾病进行诊疗。     

Guineaworm infection in the Wa district of north-western Ghana

The Ghana-5 schistosomiasis project is situated in an exclusively rural area of north-western Ghana. Since the inhabitants rely for the most part on natural sources of drinking water the transmission of both urinary schistosomiasis and guineaworm infection must often occur at the same sites, and the epidemiology and the problems of control of these diseases might be expected to have features in common. An epidemiological survey of 8 300 people in 1967-68 showed that guineaworm had a scattered distribution, 35 of 43 villages having an annual incidence of less than 10%. Intensive study of 5 of the most seriously affected villages over a period of 3 years has shown that there is a delicate balance between the parasite and its human host in this area, largely as a result of the impermanent nature of the principal transmission sites, i.e., ponds and the smaller riverine pools. The timing, duration, and intensity of transmission have been shown to vary widely from one locality to another, as well as from year to year. These characteristics are determined by the type and extent of the local source of drinking water, the availability of alternative sources, and the monthly pattern of rainfall.     

上海市嘉定区2个镇外来流动人口血吸虫病感染率调查

[目的]了解上海市嘉定区外来流动人口的血吸虫病感染情况,评估其潜在传播危险程度。[方法]对嘉定区马陆镇、黄渡镇来自血吸虫病流行省的外来流动人员1 477人进行血吸虫病感染情况调查。[结果]1 477例外来流动人员的血清学阳性率为4.54%;病原学监测阳性1例,阳性率为1.49%。不同年龄段中30～40岁人群的血清阳性率最高(7.38%);不同教育程度人群的血清阳性率以小学学历者最高(5.48%);来沪前为农民者血清阳性率最高(7.60%);来自湖北省的流动人员血清阳性率最高(7.47%)。[结论]血吸虫病流行地区的外来流动人口大量进入,对嘉定区血吸虫病传播带来潜在威胁,应继续加强对外来流动人员特别是来自血吸虫病未控制地区人员的血吸虫病监测工作。     

广东省2005—2009年流动人口血吸虫病监测结果分析

目的了解广东省流动人口血吸虫病感染情况,为制定监测技术方案提供科学依据。方法 2005—2009年开展流动人口血吸虫病的主动监测和被动监测。常规性主动监测是在广东省原疫区12个县每年各在1个乡镇对所有外来流动人口采用整群抽样方法进行血吸虫病检查,监测县每年检查300人以上;选择性主动监测是全省按地理、经济分层整群抽样抽取26个县,每县以乡镇为单位采用整群抽样抽取来自外省疫区人群进行1次血吸虫病检查,检查500人以上。主动监测均以≥6岁的外来流动人口为监测对象。被动监测通过法定传染病疫情网络直报系统对全省输入性可疑病例进行核查。用胶体金免疫渗滤法（D IGFA）筛查,抗体阳性者再用尼龙绢集卵法或改良加藤氏法（Kato-katz）检查血吸虫卵、毛蚴。结果 2005—2009年广东省流动人口进行常规主动监测10 728人,选择性主动监测16 322人,血吸虫抗体阳性率分别为0.92%和1.84%,2种监测方法的阳性率差异有统计学意义（P〈0.01）。选择性主动监测发现慢性血吸虫病例66例,其中排虫卵者6例,5年被动监测共发现血吸虫病例235例,7例在粪便中查获虫卵或毛蚴,其中在2005年发现急性感染病例3例。301例输入病例主要分布在珠三角,占94.35%（284/301）,主要为20~54岁,占69.77%（210/301）,农民工、工人占54.49%（164/301）。结论输入性血吸虫病例是影响广东省血吸虫病疫情的主要潜在危险因素,必须加强对来自疫区流动人口的监测。现阶段要重点开展选择性主动监测,同时加强被动监测。     

嘉兴市1995-2012年血吸虫病人群监测结果分析

目的 为探索血吸虫病严重流行地区达到传播阻断标准后病情动态,制订防治措施提供依据. 方法 采用血清学间接血凝试验（IHA）、酶联免疫吸附试验（ELISA）等常规法对当地7岁以上人群开展新感染、残存传染源和外来输入传染源以及疑似血吸虫病人监测;对在册的晚期血吸虫病人随访和新增晚血鉴定. 结果 18年共监测各类人员989 783人（次）,血清学阳性22 089人,阳性率2.23％,进一步作粪检者12 791人,查到输入性病人4人,当地人群无粪检阳性病人;18年间晚期病人死亡1 104人,新增682人,临床治愈或其它原因减少311人. 结论 18年监测当地居民疫情稳定,但存在外来输人性病例.今后监测的重点是来自未达到疫情控制地区的流动人员.通过卫生行政干预,将监测任务落实到乡镇,社区卫生服务站,对在社区医疗中发现不明原因发热、嗜酸性粒细胞增高、肝脾肿大、长时间腹泻、便血等疑似病人报告或采血送当地疾病预防控制中心检测,是一种简便易行的监测分工和方法.     

2008—2011年临安市省级血吸虫病监测点监测结果分析

目的：掌握省级血吸虫病监测点疫情动态和流行现状,探索一条山丘型地区血防监测之路,为制定浙江省血吸虫病防治策略以及考核防治效果提供科学依据。方法：根据《浙江省血吸虫病监测点监测方案》的要求,临安市于2008—2011年每年对省级监测点板桥乡板桥村开展病情、螺情监测并对监测资料进行分析。结果：2008—2011年共查螺投工265工,累计查螺面积75830平方米,未发现钉螺。本地居民共查病975人,IHA阳性率为0．30％。流动人口查病400人,IHA阳性率为0．75％。结论：监测区2008—2011年虽未查出有螺面积,亦未查出血吸虫病原学阳性病人,但近几年临安市其它乡镇还有钉螺查出,外来流动人口出人频繁。因此,该地仍需采取“查灭残存钉螺和防控外来传染源为重点的综合性巩固策略”,以进一步巩固血防成果。     

四川大山区血吸虫病传播动力学及控制的研究

目的 利用数学流行病学和计算机模拟方法研究山区血吸虫病的传播因素及其控制策略.方法 基于在四川西昌20个村的血吸虫病流行病学调查,建立基于本地传播因素的血吸虫病传播模型.利用蒙特卡罗模拟对模型进行模拟,采用二分法用3个村的数据来效验模型,并用经效验的模型来分析在3种控制策略下本地血吸虫病传播的趋势.结果 现场调查显示以村为单位的人群血吸虫病感染率和感染强度分别在3%～73%和平均克粪虫卵数(epg)在0.1至100.0之间.流行因素包括居民职业、疫水接触、微环境参数(气温、降雨),被整合入模型中.经二分法效验的模型预测显示连续化疗(50%～60%的覆盖率)在6年内能将感染强度降低30%～80%,但不能降低传播潜力;所以化疗一旦停止,传播即反弹.持续的局部的环境干预,如灭螺和虫卵控制(30%～50%覆盖率),可以将传播控制在半稳定水平;只有持续的包括化疗和环境干预在内的综合控制,在5～10年间才能将传播控制到很低的水平,甚至阻断传播.结论 利用传播模型结合现场数据能够帮助分析影响血吸虫病本地传播的因素,并帮助制定相应的控制策略;血吸虫病的控制应建立在对本地因素的认识和可持续的环境干预基础上.     

Preliminary evaluation of morbidity due to S. haematobium and S. mansoni in the area of the future Adjarala Dam in Benin

The aim of this study was to provide a preliminary assessment of morbidity due to schistosomiasis in the area of the future Adjarala Dam in Benin. We included 412 schoolchildren from five villages in the study. The mean age of the children was 9.4 +/- 2.3 years and the sex ratio (F/M) was 0.94. These children underwent parasitological examination. The children provided urine samples, which were examined by eye, filtered and tested for blood and protein. Stool samples were examined using Kato's technique and an ultrasound scan of the urinary tract was performed. We carried out a survey of snails at the possible transmission sites of all the villages, with a view to identifying the intermediate hosts. We detected S. mansoni and S. haematobium in the area. Urinary schistosomiasis was mesoendemic (prevalence of 19.7%) whereas schistosomiasis due to S. mansoni was hypoendemic (prevalence of 3. 9%). Ultrasound scans showed that 28% of the children had bladder lesions and that 2.5% were carriers of hydronephrosis. We compared the diagnostic performances of the various indirect indicators of morbidity. We found that a history of hematuria was the most sensitive indicator (88%) but that the sensitivity of this indicator differed significantly according to the sex of the child. Hematuria >= 1+ was the most effective indicator. Snail surveys showed that Biomphalaria pfeifferi and Bulinus globosus were present in the area.     

流动人口血吸虫病检测结果分析

目的 研究外来流动人口血吸虫病流行状况.方法 对浙江省慈溪市外来流动人口采用间接血凝法(IHA)初筛,阳性者用斑点金免疫渗滤法(DIGFA)进行复检,复检阳性者用粪枪法进行确诊.结果 临测流动人口血清23 585份,确诊慢性血吸虫病例45例,以安徽和江西籍患者为主,占66.67%(30/45);人群分布以青壮年为主,其中20～40岁占82.22%(37/45);职业分布以农民为主.结论 疫区来源的青壮年务工人员应作为今后血吸虫病疫情临测的重点对象.     

广东省外来流动人口血吸虫感染状况的研究

目的了解广东省外来流动人口血吸虫感染情况及病人的分布状况,为制定血吸虫病监测技术方案提供科学依据。方法于2005年6月至2007年7月在广东省分粤东、粤西、粤北、粤中4个区,每区按经济发展程度高、中、低各随机抽取2个共24个县(市、区)作为调查点;采用分层整群抽样调查外来流动人口分布情况;每个调查点按整群抽样原则抽取来自疫区的流动人口1000人,并对其采用胶体金渗滤法(DIGFA)检测血清中血吸虫抗体、病原学检查(kato-katz)进行确诊;统计分析外来流动人口城乡分布、来自疫区人口比例、血吸虫病患病率、血吸虫病确诊率等。结果共调查22个县(市、区),收集统计外来流动人口数6360505人,主要集中在粤中的珠江三角洲地区,占91.18%,当中主要是分布在农村地区和城乡结合部,占82%。外来流动人口中来自疫区的占19.49%(24777/127122),主要是15～49岁的人群,占98.92%。来自疫区人群血吸虫抗体阳性率为1.74%(228/13076),以15～39岁的人群较高(P<0.01);血吸虫抗体阳性者血吸虫病患病率为21.93%(50/228),调查人群总患病率即为0.38%(50/13076);血吸虫抗体阳性者病原确诊率为2.63%(6/228),即调查人群总确诊率为0.05%(6/13076)。结论推算在广东省的外来流动人口中可能有血吸虫病患者3万例以上,大部分患者是居住在粤中水网地带的农村地区或城乡结合部,可能将对该地区血防成果的巩固造成一定的威胁。     

Impact assessment of gilgel gibe hydroelectric dam on schitosomiasis: a cross sectional study in southwest ethiopia

Background

Intestinal schistosomiasis is prevalent in East Africa including Ethiopia. Constructed five years back, Gilgel Gibe dam is suspected to harbor the intermediate host for transmission of schistosomiasis. The objective of this study was to determine the prevalence of intestinal schistosomiasis and risk factors among school children.

Methods

A comparative cross-sectional study was carried out in October 2008 in four Woredas bordering Gilgel Gibe dam, within 10 kilometers, and Bulbul, which is 30 Kms away from the dam. Children attending grades 1–8 in the schools located adjacent to the dam constituted the cases and those living in Bulbul constitute the controls. Using Epinfo version 6.0 for cross-sectional study, a sample size of 937 was determined. Sample size allocation was done 2:1 for cases and control. After interview, stool sample was collected and analyzed. Screening for the presence of intermediate host and physiochemical analyses of selected water bodies along the major water contact sites of the reservoir was also done Data were entered into computer and analyzed using SPSS for windows version 13.0.1.

Results

Out of 624 sampled cases and 312 controls, 585 and 270 participated in the study giving a response rate of 93.8% and 86.5%, respectively. Four hundred seventy four (81.0% of the cases and 203 (75.2%) controls use latrine regularly. On stool examination, 406 (47.5%) children, 295 (50.4%) cases and 111 (41.1%) controls) were positive to intestinal parasites but only two children, both from the control groups, were positive for Schistosoma mansoni. The three river water samples on which malacological survey was done had similar physicochemical characteristics in many ways except high conductivity, pH and percent of dissolved oxygen concentration (milligram per liter) at one site where uninfected Biomphilaria Pfeifferi was found

Conclusion

The study revealed that schistosomiasis is not yet a problem at Gilgel-Gibe dam. But, continuous surveying is required as the intermediate host is prevalent, the water bodies are suitable for the intermediate host and cases of schistosomiasis are identified 30 kms away the dam, in control area.     

Sporotrichosis in Himachal Pradesh (north India).

Sporotrichosis is being increasingly reported from a particular area of Himachal Pradesh, a state in north-west India. A skin-test survey was conducted using sporotrichin and peptido-rhamnomannan antigen among the population in the villages where 2 or more cases of sporotrichosis had been reported and results were compared with those for villages of the same where no case of sporotrichosis had been reported. The study was helped by local doctors, leaders and patients who were cured of sporotrichosis. The delayed-hypersensitivity positivity rates were significantly higher in case villages (range 22.9-40.0%) compared to control area (range 6.5-7.6%). Analysis by age showed that positivity rate increased with increase in age for both sexes. Analysis by occupation showed higher skin-test positivity in populations engaged in horticulture, nursery work, gardening, woodwork (43.2%) and farming (33.9%). The case villages have lower temperature and higher rainfall than the control villages. During the 1-year study period (1996-97), 25 cases of sporotrichosis were diagnosed: 16 cases were referred by doctors from the local area and 9 were from cases suspected during the skin-test survey. This study identifies Kangra district and adjoining areas in Himachal Pradesh as an endemic region for sporotrichosis and highlights the need for evaluation of geo-climatically similar areas.     

2016—2020年高邮湖区血吸虫病疫情监测及防治效果

目的了解高邮湖区4县(市)“十三五”期间血吸虫病疫情状况及防治效果,探讨今后防治对策。方法每年3—4月份,采取系统抽样结合环境抽查法对高邮湖区开展钉螺调查;每年6—9月份,采用网捞法和稻草帘诱螺法对高邮湖区重点地段开展漂浮物和水体钉螺扩散监测。每年在血吸虫病流行季节,采用酶联免疫吸附试验或胶体染料试纸条法对高邮湖区重点人群进行血吸虫病筛查,阳性者采用Kato-katz法(1粪3检)进行病原学检查。调查统计湖区4县(市)灭螺、治疗、粪便管理、健康教育、联防联控等防治措施落实情况及效果。结果2016—2020年高邮湖区4县(市)累计查螺面积38755.10 hm^(2),发现有螺面积284.45 hm^(2),其中新发现有螺面积2.83 hm^(2)。宝应县有螺面积17.37 hm^(2),高邮市有螺面积267.08 hm^(2)。累计解剖钉螺14319只,未发现感染性钉螺。累计开展人群血清学查病114890人次,血清学阳性率0.90%。粪检查病14449人次,未发现阳性者。累计开展药物灭螺及巩固性灭螺2608.08 hm^(2),有螺面积下降了53.84%。扩大化疗970例,新建无害化厕所9座。目标人群血防知识知晓率达到95%以上。结论高邮湖区4县均达到消除血吸虫病标准,仍应做好包括血吸虫病非流行区在内的长期监测工作。     

地理信息系统技术在浙江省钉螺监测中的应用

目的 探索地理信息系统(GIS)在浙江省血吸虫病中间宿主钉螺监测中的应用.方法 收集浙江省2005-2009年血吸虫病调查资料,建立GIS螺情数据库,应用ArcGIS9.2软件,导入GIS数据库各项属性并制作所需钉螺面积空间分布电子图和差值图.结果 2005-2009年共有28个县先后查出钉螺,5年累计查出有螺村1580个,有螺面积513.28 hm2.建立了"十一五"期间全省GIS螺情数据库;根据钉螺面积大小标记不同颜色,制作了电子分布图,实现全省钉螺分布信息电子化;2009年与2005年有螺面积比较,差值空间分布图显示有螺面积压缩或增加的县数分别占48.0%(12/25)和52.0%(13/25);在国家级血吸虫病监测点建立了有螺环境卫星迭加图,呈现17个螺点,每个螺点显示螺情有关信息.结论 应用GIS制作的钉螺面积分布图、差值空间分布图能直观地显示螺情变化,为掌握血吸虫病疫情以及制定防治策略提供科学依据.     

Schistosomiasis in north-western Ghana

A survey of 8 274 people in the Ghana-2101 project area showed that 12% were passing ova of Schistosoma haematobium in the urine, the infection rate rising to a peak of 34% in males 15-19 years of age. S. mansoni, despite the wide distribution of its potential intermediate host, was not encountered in 1 698 boys examined for it. Urinary schistosomiasis in northern Ghana is focal in character and is usually contracted in standing water during the dry season. A method of control was developed that depends on the identification of localities subject to relatively intense and prolonged transmission, followed by dry season mollusciciding of the water sources in each locality infested with the snail hosts. Two such control cycles were carried out in 30 localities. The results suggest that selective, dry season, focal control of schistosomiasis can be effective in reducing transmission.     

湖北省阳新县农村群众防治血吸虫病知信行情况分析

目的调查湖北省阳新县不同人群的血防知信行情况，为血防大众传播策略的制定提供依据。方法在湖北农村于2006年5月进行了问卷调查，共调查本地成人294人，流动人口126人，学生344人，对不同人群和不同地区的血防知信行情况进行了比较研究。结果流动人口的血防知信行普遍低于本地成人；成人的大部分血防知识、态度和行为在不同性别间无差异；学生年级越高，知识的知晓率越高，学生受教育程度与态度、行为无相关性；疫情越轻的地区，人们知识的知晓率和态度、行为的正确率越低。结论学生和流动人口是血防健康教育的重点人群；宣传内容要有人群针对性和地区针对性。     

2015—2020年武汉市国家血吸虫病监测点疫情分析

目的 分析2015—2020年武汉市国家血吸虫病监测点疫情动态,为血吸虫病监测工作的循证决策提供依据。方法 在武汉市设立12个国家血吸虫病监测点,对人群病情、家畜感染和钉螺控制等情况开展监测和分析。结果 2015—2020年,监测点本地人群累计开展血吸虫血清学筛查35 427人,阳性414例,血检阳性率由2.161%降至0.778%,其逐年下降趋势有统计学意义（趋势χ²= 56.722,P＜0.001）;男性,40岁以上,职业为农民、工人、民工、离退人员血检阳性率较高。2015年发现2例粪检阳性病例为农民,人群血吸虫校正感染率为0.04%。流动人群血吸虫血检阳性率由1.042%降至0.039%;2020年检出1例外省输入性粪检阳性病例。家畜累计检测414头,未发现阳性。2015—2020年查出有螺面积由535.759 hm2逐年降至111.323 hm2,2015—2019年监测点有螺框出现率由2.330%降至1.566%,活螺平均密度由0.053只/框逐年降至0.023只/框,但2020年回升至2.617%和0.063只/框,压碎镜检法未发现感染性钉螺;LAMP法累计检测钉螺混合样本475份,仅2018年检出阳性样本1份。结论 武汉市血吸虫病疫情近年呈低度流行且持续下降,但仍存在高危人群血防意识薄弱、钉螺孳生环境未彻底改变等潜在风险,未来需持续加强风险监测、健康教育、钉螺控制等措施,防止疫情反弹。