达到血吸虫病传播阻断标准10年后人群病情监测和评价

目的探讨达到血吸虫病传播阻断标准(以下简称达标)10年后人群血吸虫病病情,评价其防治效果和今后防治策略。方法对达标10年地区采用ELISA法检测人群血清抗血吸虫抗体水平,并用改良Kato-Katz法粪检血吸虫卵,进行定量观察和比较。结果达标10年地区人群粪检未查到血吸虫虫卵(0/3440),血清抗血吸虫抗体阳性率为3.50%(132/3770),男性和女性分别为4.36%(78/1788)和2.72%(54/1982),人群抗血吸虫抗体OD均值为0.068±0.056,其中男性为0.072±0.058,女性为0.065±0.054,前者显著高于后者(P<0.01);6~20岁,21~35岁,36~50岁和51~65岁年龄组抗血吸虫抗体阳性率分别为0.33%(2/609)、0.55%(4/731)、3.79%(53/1399)和7.08%(73/1031),抗血吸虫抗体OD均值分别为0.048±0.030、0.052±0.032、0.071±0.060和0.087±0.068,除6~20岁与21~35岁年龄组在抗体阳性率和抗体OD均值方面无显著性差异外(P>0.05),其余各年龄组抗体水平在统计学上均有非常显著性差异(P<0.01)。结论达标10年地区人群血吸虫病情稳定,未发现粪检阳性病人,但人群抗血吸虫抗体水平消减缓慢,在一定时期仍长期存在,且不同性别及年龄人群抗体水平仍与其暴露于原危险因素的机率有关,建议在加强输入性传染源和钉螺监测的同时加强对历史病人的清查和治疗。

Surveillance and assessment on the morbidity in transmission block areas of schistosomiasis for ten years

In order to explore and evaluate the morbidity of schistosomiasis and control strategy in the transmission block areas of schistosomiasis for ten years, the residents were screened by enzyme-linked immunosorbent assay (ELISA) and Kato-Katz technique in the regions where the transmission of schistosomiasis has been blocked for 10 years. The results showed that no Schistosoma japonicum egg positive persons were found by Kato-Katz in these regions. The serum positive rate by ELISA was 3.50%(132/3 770)in these areas,4.36%(78/1 788)in male and 2.72%(54/1 982)in female respectively. The serum antibody level(OD value)to schistosoma was 0.068±0.056 in total, and 0.072±0.058 in male and 0.065±0.054 in female respectively. The level of antibody in male was significantly higher than that in female(P<0.01).The serum positive rate in age of 6-20 ,21-35,36-50 and 51-65 groups were 0.33%(2/609),0.55%(4/731),3.79%(53/1 399)and 7.08%(73/1 031)respectively while the schistosome specific serum antibody level(OD value)to schistosoma were 0.048±0.030,0.052±0.032, 0.071 ± 0.060 and 0.087±0.068 respectively. The antibody positive rates and levels were significantly different among the age groups except 6-20 and 21-35 in areas where reached to the criterion of transmission blocking for 10 years. The schistosomiasis morbidity is stable, there was no schistosoma egg positive case occurred in areas where reached to the criterion of transmission blocking for ten years. But the serum antibody level to schistosoma decreased slowly and remain detectable for along time. There was relationship between levels of serum antibody and the probability which people exposed to the risk factor. It is suggested that not only the snails and import infection sources surveillance should be carried out, but also the population who had history of infection should be detected and treated.