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[中国血吸虫病防治的成就与挑战]

[Achievements and challenges in schistosomiasis control in China].

作者信息

Zheng Jiang

机构信息

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Shanghai 200025, China.

出版信息

Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2009 Oct;27(5):398-401.

Abstract

Achievements for schistosomiasis control have been gained by implementation of integrated control strategies according to local conditions since the founding of the People's Republic of China. By the end of 2008, 5 of the 12 provinces reached the criteria of transmission interruption. Among 454 endemic counties, transmission was interrupted in 265 counties while 97 counties reached the criteria of transmission control. The number of schistosomiasis cases decreased from 10 million in history to 413,000. Currently, there still left 92 counties where the disease is endemic and mainly distributed in lake and mountainous regions. Limited by the environmental and socioeconomic factors, integrated control strategies could not be carried out in these places. Although the strategies based on reducing the roles of humans and cattle as resources of infection decreased the infection rate and intensity quickly, re-infection occurred frequently due to the spread of snails and numerous animal reservoirs. Chemotherapy alone could not interrupt the transmission. By changing the traditional bio-medical control model applying integrated control strategy mainly with social measures, integrating disease control with local social and economic development programs, changing the traditional life styles and agricultural production patterns, and eliminating the risk factors for schistosomiasis transmission, schistosomiasis control can be developed sustainably and reach the criteria of transmission interruption finally.

摘要

自中华人民共和国成立以来,通过因地制宜实施综合防治策略,血吸虫病防治工作取得了成效。截至2008年底,12个省份中有5个达到传播阻断标准。在454个血吸虫病流行县中,265个县阻断了传播,97个县达到传播控制标准。血吸虫病病例数从历史上的1000万例降至41.3万例。目前,仍有92个血吸虫病流行县,主要分布在湖区和山区。受环境和社会经济因素限制,这些地方无法实施综合防治策略。虽然以减少人和牛作为传染源作用为基础的防治策略迅速降低了感染率和感染强度,但由于钉螺扩散和众多动物宿主,再感染频繁发生。单纯化疗无法阻断传播。通过改变以社会措施为主实施综合防治策略的传统生物医学防治模式,将疾病防治与当地社会经济发展项目相结合,改变传统生活方式和农业生产模式,消除血吸虫病传播的危险因素,血吸虫病防治工作才能可持续发展,并最终达到传播阻断标准。

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