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目的 在以感染性羊为主要传染源流行区,探索采用以消除感染性羊为主的综合性防治措施,实现阻断血吸虫病传播的可能性,为完成防治目标提供实证依据.方法 以江苏省镇江市丹徒区江心洲五墩村为观察现场,在2004-2010年间每年按常规实施孳生地查螺灭螺、村民和家畜同步查病治病、健康教育及感染性水域灭蚴等防治措施;2011年在常规防治措施的基础上增加淘汰全村家庭养殖羊,比较2004-2016年该村疫情变化,评价消除感染性羊措施在推进该村血吸虫病传播阻断中的作用.结果 2004-2011年五墩村人群粪检阳性率为0.4％～1.4％、感染性螺面积为(18～25)万m2、重点水域哨鼠感染率为3.3％ ～ 18.0％;2004-2008年羊血吸虫感染率为0.0％～7.3％,2009-2011年升至为32.0％～54.3％,村庄周围江滩野粪调查239份,羊粪占96.3％(230/239),羊粪粪检阳性率为15.5％～22.9％.在消除感染性羊的次年,该村的人群和家畜的感染率降到0.0％,并连续5年(2012-2016年)未查到当地新感染的血吸虫病人和病畜、感染性哨鼠及感染性钉螺,人畜病情、螺情达到国家血吸虫病传播阻断的标准.结论 江滩型血吸虫病传播控制地区,在区域性残存传染源依然存在的情况下,查清确认当地主要传染源,采取“消除主要传染源+综合性常规防控措施”,实行精准防控,是如期实现血吸虫病传播阻断和消除目标的重要策略.“,”Objective To explore the feasibility of interrupting schistosomiasis transmission with an integrated control strategy based on the elimination of Schistosomajaponicum-infected goats in schistosomiasis-endemic regions with the infected goats as a major source of infection.Methods A field study was conducted in Wudun Village,Jiangxin Township,Dantu District of Zhenjiang City,Jiangsu Province.From 2004 to 2010,the control measures were carried out,including the Oncomelania hupensissnail survey and control,schistosomiasis examination and treatment,health education and elimination of water infectivity.Since 2011,all the goats were eliminated in addition to the conventional interventions.The changes of endemic situation of schistosomiasis were compared from 2004 to 2016,so as to evaluate the effect of eliminating the infected goats on the interruption of schistosomiasis transmission.Results From 2004 to 2011,the positive rate of stool examinations was 0.4％ to 1.4％ in humans,the area with schistosome-infected snails was 180 000 m2 to 250 000 m2,and the infection rate of sentinel mice was 3.3％ to 18.0％ in key water regions.From 2004 to 2008,the schistosome-infection rate of goats was 0 to 7.3％,and the rate increased to 32.0％ to 54.3％ between 2009 and 2011.A total of 239 wild feces were examined,in which the goat feces consisted of 96.3％ (230/239),with 15.5％ to 22.9％ of positive rate.Since 2012,the infection rate was reduced to 0 in both human and domestic animals,and no infected humans,domestic animals,sentinel mice or snails were detected for 5 successive years (2012 to 2016),achieving the criteria of schistosomiasis transmission interruption.Conclusion In transmission-controlled marshland endemic regions,the understanding of the predominant sources of infection and the implementation of eliminating the major source of infection in combination with conventional integrated interventions is an important strategy to achieve the goals of schistosomiasis transmission interruption and elimination on schedule.