Xu Jing, Li Shi-Zhu, Huang Yi-Xin, Cao Zhi-Guo, Tu Zu-Wu, Wu Cheng-Guo, Miu Feng, Dang Hui, Zhang Li-Juan, Chen Zhao, Wang Li-Ying, Guo Jia-Gang, Zhou Xiao-Nong
National Insitute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2012 Dec 30;30(6):428-33, 437.
To analyze the impact of large hydraulic projects on schistosomiasis transmission and evaluate the transmission risk in potential endemic areas.
During 2008-2010, surveillance on risk factors related to schistosomiasis transmission and risk assessment were carried out in potential endemic sites in counties of Xuyu, Hongze, Jinhu, and Gaoyou in Jiangsu Province, Weishan County in Shangdong, Qianjiang City and Yiling District of Yichang City in Hubei, Juchao District of Chaohu City in Anhui Province, Wanzhou and Kaixian in Chongqing in Three Gorges Dam region or passed by South-to-North Water Diversion Project and Zhangjiagang City in Jiangsu Province located in lower reach of Yangtze River. At least one fixed and three temporary monitoring sites were set in each county (city or district). Local inhabitants aged 6-65 years old were screened by indirect haemagglutination assay (IHA) or ELISA, and the sero-positives were tested by Kato-Katz or miracidium hatching techniques to investigate possible infection in 2008. The endemic status of schistosomiasis in mobile population was surveyed every year during 2008-2010. Infection status in livestocks was surveyed in Juchao, Qianjiang, Gaoyou and Wanzhou Counties in 2008-2010. Oncomelania hupensis distribution was investigated in risky and suspicious areas. Snail spreading investigation was conducted through salvaging floater and snails-inducing by straw curtains in rivers connected with Yangtze River.
8 256 local inhabitants were investigated by serological tests with a positive rate of 0.7% (60/8 256). Among the 60 serologically positive subjects, 55 individuals were examined by stool examination but none of them was egg positive. The antibody prevalence rate of migrating population in 2008-2010 was 2.0%, 1.4%, and 1.7%, respectively, with no significant difference (chi2 = 3.57, P > 0.05). Among the serologically positive subjects, egg-positive cases were found in migrating population in Juchao District each year and one case was found in Jinhu County in 2010. Oncomelania snails were only found in in Jinhu and Gaoyou without infected ones. A lot of aquatic shell-fish and snails were collected in the water floater and straw curtain without Oncomelania snails.
Schistosomiasis is not endemic in the original nonendemic areas in Three Gorges Dam region and areas passed by South-to-North Water Diversion Project until now, but potential risk of transmission exists. Long term surveillance scheme on schistosomiasis should be established with varied monitoring factors in different category areas.
分析大型水利工程对血吸虫病传播的影响，并评估潜在流行区的传播风险。
2008 - 2010年期间，在江苏省盱眙、洪泽、金湖、高邮县，山东省微山县，湖北省潜江市、宜昌市夷陵区，安徽省巢湖市居巢区，重庆市三峡库区的万州、开县或南水北调工程经过的地区以及长江下游的江苏省张家港市的潜在流行地点，开展与血吸虫病传播相关的危险因素监测和风险评估。每个县（市、区）至少设置1个固定监测点和3个临时监测点。2008年，采用间接血凝试验（IHA）或酶联免疫吸附测定（ELISA）对6 - 65岁的当地居民进行筛查，血清学阳性者采用加藤 - 卡氏厚涂片法或毛蚴孵化法检测，以调查可能的感染情况。2008 - 2010年每年对流动人口中的血吸虫病流行状况进行调查。2008 - 2010年在居巢、潜江、高邮和万州等县对家畜的感染状况进行调查。在有风险和可疑的地区调查钉螺分布情况。通过打捞漂浮物和在与长江相连的河流中用草帘诱螺的方法进行螺情扩散调查。
对8256名当地居民进行血清学检测，阳性率为0.7%（60/8256）。在60名血清学阳性者中，55人进行了粪便检查，但均未发现虫卵阳性。2008 - 2010年流动人口的抗体阳性率分别为2.0%、1.4%和1.7%，差异无统计学意义（χ2 = 3.57，P > 0.05）。在血清学阳性者中，居巢区每年在流动人口中发现虫卵阳性病例，2010年在金湖县发现1例。仅在金湖和高邮发现有钉螺，未发现感染性钉螺。在漂浮物和草帘中采集到大量的淡水贝类和螺类，但未发现钉螺。
截至目前，三峡库区和南水北调工程经过地区的原非流行区尚未出现血吸虫病流行，但存在潜在传播风险。应针对不同类型地区设置多种监测因素，建立长期的血吸虫病监测方案。
