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目的评价以传染源控制为主的血吸虫病综合防治策略的实施效果,探索不同自然与人文环境下各种核心防治技术的优化组合模式。方法以湖区4省、山区2省已开展传染源控制策略的36个血吸虫病流行村为试点进行前瞻性调查研究。比较不同组合传染源控制措施试点村人畜血吸虫感染率、感染性钉螺分布等指标的变化趋势。结果 2004-2008年,36个试点村共新建厕所13084座、沼气池2091座、封洲禁牧395478.8hm2、圈养牛5222头、淘汰牛1624头、淘汰羊745只、购农机1393台、以禽代畜70370羽、安全饮用水实现人数75020人。湖南、湖北、江西省和安徽省试点村钉螺感染率分别为1.33%、0.25%、0.53%和0.04%,云南省和四川省试点村未发现感染性钉螺。共对36239人进行了查病,查出粪检阳性者452人,推算人群平均感染率为1.08%,以云南省最低(0.12%)、湖北最高(2.41%)。共对3648头牛进行查病,查出阳性牛72头,平均感染率为1.97%,其中湖南、湖北、江西、云南省和四川省试点村牛感染率分别为2.84%、3.36%、3.34%、0.77%和0。湖北、江西、湖南省和安徽省试点村哨鼠平均感染率分别为38.33%、25.45%、20.00%和1.32%。结论以传染源控制为主的综合治理是防治血吸虫病有效和可持续发展的策略,但在实施过程中要因地制宜,并注重与常规措施的有机结合。
Objective To evaluate the implementation effect of the integrated control strategy of schistosomiasis controlled by infection source and explore the optimal combination mode of various core prevention and control technologies under different natural and humanistic environments. Methods A total of 36 schistosomiasis-endemic villages with infection source control strategies in 4 provinces and 2 provinces in the lake area were selected as the pilot to carry out a prospective investigation. The infection rates of schistosomiasis and the distribution of infectious snails in the pilot villages with different combinations of source control measures were compared. Results In 2004-2008, a total of 13084 new toilets, 2091 digesters, 395478.8hm2 banned grazing in Fengzhou, 5222 captive cattle, 1624 cattle were eliminated, 745 sheep were eliminated, 1,393 agricultural machinery were purchased, 70,370 poultry birds and 7520 safe drinking water population. Infectious rates of snails were 1.33%, 0.25%, 0.53% and 0.04% in pilot villages of Hunan, Hubei, Jiangxi and Anhui respectively. Infectious snails were not found in pilot villages in Yunnan and Sichuan provinces. A total of 36,239 people were checked, found 452 were positive stool tests, the estimated population average infection rate was 1.08%, the lowest in Yunnan (0.12%), Hubei highest (2.41%). A total of 3648 cattle were investigated, 72 positive cattle were found, with an average infection rate of 1.97%. The prevalence of bovine infection in pilot villages in Hunan, Hubei, Jiangxi, Yunnan and Sichuan Provinces was 2.84%, 3.36% and 3.34% , 0.77% and 0. The average infection rates of the sentinel mice in Hubei, Jiangxi, Hunan and Anhui pilot villages were 38.33%, 25.45%, 20.00% and 1.32% respectively. Conclusion The comprehensive treatment based on infection source control is an effective and sustainable strategy for prevention and control of schistosomiasis. However, it should be adapted to local conditions in the implementation process and should be organically integrated with routine measures.