湖沼型地区血吸虫病流行影响因素调查

摘要：目的研究湖沼型地区血吸虫病流行影响因素，为制定防治策略及干预措施提供参考。方法2009～2011年，在湖南、湖北2省3个典型的湖沼型地区采用随机分层整群抽样方法选取15个乡镇21个血吸虫病流行村，调查区域内的地理环境、人畜感染状况、家畜饲养方式、垸内外钉螺分布及洲滩野粪污染、水体感染和人群疫水暴露状况，应用多因素Logistic逐步回归法分析各相关因素的关系。结果累计调查村民9297户50857人次、家牛564户4077头次、垸内外钉螺面积11599．12hm2．垸外有螺洲滩野粪污染和水体感染状况14处130．73hm-1，结果显示，人群感染率与家畜、野粪、垸外钉螺及水体阳性率、疫水暴露率均有明显相关关系（P均〈0．01），复回归方程Y人群感染率=0．424＋0．242X家畜感染率＋0．049x疣托暴露率。人群疫水暴露率、暴露程度及感染率受性别、年龄、职业及文化程度等因素的影响，35～60岁疫水接触频率较高的农民、渔牧民和樵民血吸虫病感染率高于其他年龄段职业群（P均〈n05）。结论家畜传染源和疫水接触频率较高的职业人群对湖沼型地区的血吸虫病传播流行具有重要影响，结合当地经济发展，因地制宜地采取以家畜传染源控制为主的综合防治措施，加强高危易感人群的监控，对湖沼型地区的血吸虫病传播控制具有重要意义。

Study on risk factors of schistosomiasis transmission in lake and marshland regions

Abstract：Objective To study the risk factors of schistosomiasis japonica transmission in lake and marshland regions, so as to provide evidences for control strategy and measure. Methods Twenty-one villages from 15 townships were random sampled with the stratified cluster sampling method in the 3 typical lake and marshland regions from Hunan and Hubei Province. The geographical conditions, schistosomiasis infection status of population and livestock,bovine feeding ways, snail distribution, the situation of wild stool pollution and water infectivity outside embankment and villagers exposure rate of infected water were surveyed by questionnaire and on-site inspection from 2009 to 2011 year. The Logistic stepwise regression was used to analyze the relationship among all correlative risk factors. Results Cumulative 50857 person-times from 9297 households,4077 cattle from 564 households, 11 599.12 hm2 snail habitat areas,including 130.73 hm2 with wild stool pollution and water infectivity from 14 places,had been surveyed. The results showed that there existed a significant positive correlation between the population infection rate and the positive rate of bovine, snail, wild stool and water and exposure rate of infected water（P〈0.01 ）, the multiple regression equation was Y=0.424＋0.242X1＋0.049X2（letterY ,X1 and X2 were respectively the infection rate of population and cattle and villagers exposure rate of infected water）. The villagers exposure rate and degree of infected water and infection rate been influenced by the factors of sex, age, occupation and degree of education. Among different age and occupational groups, the farmers,fishmen, herders and woodcutters aged 35 to 60 years old with higher contact frequency of infected water were found to have higher infection rate. Conclusions The livestock infection source and occupational groups with higher contact fluency of infected water have a significantimpact on schistosomiasis transmission in lake and marshland regions. To take suitable comprehensive control measure with emphasis on livestock infection source control in according to the local economic situation and to strengthen surveillance for high-risk groups will play an important role in schistosomiasis transmission control.