山丘型血吸虫病流行区依托城乡统筹体系建设巩固防治成果的研究

目的探讨山丘型血吸虫病流行区依托城乡统筹体系建设开展血吸虫病防治的效果,为新形势下巩固血防成果提供新模式。方法选择四川省蒲江县山丘型血吸虫病流行区的寿安镇和长秋乡为示范区,将城乡统筹体系建设和血吸虫病防治工作相结合,通过实施土地整理和集中居住等综合措施,观察分析示范区综合防治措施实施后的人群血吸虫病检查血清学阳性率、病原学阳性率、有螺面积等指标为变化。结果示范区寿安镇和长秋乡2个乡镇完成了集中居住区建设,分别改造、减少钉螺孳生环境1 330.61 hm2和1 456.84 hm2;实有钉螺分布面积分别由2000年的94.31 hm2和83.00 hm2减少到2015年的0;人群血吸虫血清学阳性率由11.8%和7.53%下降到1.01%和1.86%,感染率从0.18%和0.15%下降至0;耕牛存栏数分别由358头和368头减少为4头和6头,2000年耕牛血吸虫感染率分别为3.63%和6.51%,2004年以后未再发现血吸虫感染性耕牛。结论依托城乡统筹体系建设的血吸虫病综合防治策略可以有效降低人群感染率、减少有螺面积,为巩固防治成果、最终达到消除血吸虫的目标提供了新思路。

Study on interventions based on urban-rural integration system construction to consolidate achievements of schistosomiasis control in hilly schistosomiasis endemic areas

Objective To explore the effectiveness of comprehensive schistosomiasis control interventions based on urban?rural integration system construction to carry out the schistosomiasis control in hilly schistosomiasis endemic areas， so as to offer a new mode to consolidate the achievements of schistosomiasis control in the new situation. Methods Shouan Town and Changqiu Township in Pujiang County in hilly schistosomiasis endemic regions were selected as demonstration areas. The comprehensive schistosomiasis control interventions based on urban?rural integration system construction were implemented， including the land consolidation， centralized residence and so on. The effectiveness the interventions was evaluated. Results In Shouan Town and Changqiu Township， the transformed environments with Oncomelania hupensis snail habitats were 1 330.61 hm2 and 1 456.84 hm2， the areas with snails decreased from 94.31 hm2 and 83.00 hm2 in 2000 to both 0 in 2015， the positive rates of serological tests for schistosomiasis decreased from 11.8% and 7.53% in 2000 to 1.01% and 1.86% in 2015， and the positive rates of parasitological tests decreased from 0.18% and 0.15% in 2000 to both 0 in 2015 respectively. The numbers of cattle decreased from 358 and 368 in 2000 to 4 and 6 in 2015 respectively. In 2000， the schistosome infection rates of cattle were 3.63% and 6.51% in Shouan Town and Changqiu Township respectively， and from 2004， no infected cattle were found. Conclusion The comprehensive schistosomiasis control interventions based on urban?rural integration system construction can decrease the schistosome infection rate and area with snails effectively， providing a new mode for schistosomiasis elimination.