流动渔船民血吸虫病防治措施的研究Ⅲ船员区域联动查治病机制的构建与应用

目的构建水上流动船员区域联动查治病机制与查病程序,为控制长江水域水上流动血吸虫病传染源提供有效措施。方法根据水上货运船只流动性强,但必须在船闸、码头、港口等地停靠的特点,由卫生、海事和交通部门联合协作,在船闸、码头、港口设立血吸虫病查治工作点。采用快速免疫学筛查和粪检病原学确诊的工作流程,建立区域联动工作机制,对查出的血清学阳性者利用区域联动查治病网络,追踪进行病原学检查和治疗。分析并比较不同类型查治病点、不同航行范围船员血吸虫感染情况。结果在扬州市6个区（市）12个镇设立了16个查治病点,其中固定查治点5个,流动查治点11个。6-8月开展查病40个点次,共调查967艘船只、1225名船员,查出血检阳性19例,阳性率为1.55%;追踪进行粪检14例,未发现粪检阳性病人。其中固定和流动查治点分别检查船员820人和405人,查出血检阳性4例和15例,阳性率分别为0.49%和3.70%,流动点血检阳性率显著高于固定点;检查来自长江水域和本省内陆河道船员898人和305人,查出血检阳性3例和16例,阳性率分别为0.33%和5.25%,本省内河船员血检阳性率显著高于长江水域船员。结论区域联动是开展水上流动船员血吸虫病查治的有效工作机制,其为长江水域控制水上流动传染源提供了新措施。

Study on schistosomiasis control measures in mobile boat fishermen. III. Construction and application of regional joint mechanism for schistosomiasis examination and treatment in boatmen

Objective To construct the regional joint mechanism for schistosomiasis examination and treatment and the examination protocol among mobile boatmen,so as to provide effective measures for control of mobile infectious sources of schistosomiasis in the Yangtze River basin.Methods According to the characteristics of the cargo frequent mobility of ships with fixed anchor points,the health,maritime and transport sections were jointly cooperated to set up sites for schistosomiasis examination and treatment in ship locks,wharfs and harbors.The infection of schistosomiasis was detected by means of rapid immunological screening and stool examination,and the regional joint mechanism was constructed.The sero-positives were traced for further parasitological examinations and treatment by using the regional joint network for schistosomiasis examination and treatment.The schistosome infections in boatmen were analyzed and compared between different examination and treatment sites and among different navigation coverage.Results A total of 16 sites for examination and treatment of schistosomiasis,including 5 fixed sites and 11 mobile sites,were set up in 12 townships of 6 districts（counties） of Yangzhou City.During a period between June and August,the examination of schistosomiasis was conducted in 40 sites,and of the 1 225 boatmen from 967 boats detected,19 cases were sero-positive,with a positive rate of 1.55%.Among the 14 sero-positives examined,no stool positive patients were found.Among the 1 225 boatmen detected,820 were from fixed sites and 405 from mobile sites,and 4 and 15 cases were found,respectively,with positive rates of 0.49% and 3.70%,respectively,and the sero-positive rate was higher in mobile sites and that in fixed sites.A total of 898 boatmen from the Yangtze River basin and 305 from the local inland rivers were examined,and 3 and 16 sero-positive cases were detected,respectively,with positive rates of 0.33% and 5.25%,respectively,and the sero-positive rate was significantly higher in the boatmen from the local inland rivers than that from the Yangtze River basin.Conclusion Regional joint mechanism is an effective strategy for examination and treatment of schistosomiasis among mobile boatmen,which provides a new approach to control mobile infectious sources of schistosomiasis in the Yangtze River basin.