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[江西省山丘型血吸虫病流行区达到传播控制或阻断标准前后疫情变化的回顾性调查]

[Retrospective investigation on changes of endemic situation before and after reaching criteria of schistosomiasis transmission controlled or interrupted in hilly endemic areas of Jiangxi Province].

作者信息

Lin Dan-dan, Lv Shang-biao, Gu Xiao-nan, Ying Hu, Zeng Jian-fang, Zu Zao-fen, Chen Hong-gen

机构信息

Jiangxi Provincial Institute of Parasitic Diseases, Nanchang 330046, China.

Dean Station of Schistosomiasis Control, Jiangxi Province, China.

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2013 Oct;25(5):462-6.

Abstract

OBJECTIVE

To investigate the changing rules of schistosomiasis endemic situation before and after reaching the criteria of schistosomiasis transmission controlled or interrupted in hilly endemic areas of Jiangxi Province, so as to provide the evidence for reformulating the criteria of schistosomiasis control and eradication in the future.

METHODS

In the hilly areas of schistosomiasis endemic in Jiangxi Province, 2 counties where the transmission has been interrupted and 1 county where the transmission has been controlled were selected and investigated with the retrospective research method. The endemic detailed data were collected and recorded 10 years before reaching the criteria of transmission interrupted/controlled, and several years after reaching the criteria (ending in 2008), and then a database was established. The changing rules of endemic situation before and after reaching the criteria of transmission interrupted/controlled were analyzed and compared.

RESULTS

After reaching the criteria of transmission controlled, in the 3 counties, Guangfen, Shangrao and Dean, the declined rates of areas with Oncomelania hupensis snails were 96.79%, 98.99%, and 99.77% respectively. The snail density maintained a lower level, and 95% of infected persons and cattle were cured. The average time from transmission controlled to the transmission interrupted was 17 years in Guangfen County and 26 years in Dean County. However, in Shangrao County, the snail situation rebounded due to the snail re-found and spread although the schistosomiasis morbidity of population/animals maintained stably.

CONCLUSIONS

After reaching the criteria of transmission interrupted/controlled, the remained snails were easy to re-find and spread under some certain condition, which is one of main obstacles for reaching the criteria of transmission interrupted. In an isolated snail unit, if the snail area and snail density are controlled in a very low level, it is still difficult to transmit and spread schistosomiasis even if there exist infectious sources.

摘要

目的

探讨江西省山丘型血吸虫病流行区达到血吸虫病传播控制或阻断标准前后的流行态势变化规律,为今后重新制定血吸虫病控制和消灭标准提供依据。

方法

采用回顾性研究方法,选择江西省山丘型血吸虫病流行区已阻断传播的2个县和已控制传播的1个县进行调查。收集并记录达到传播阻断/控制标准前10年及达到标准后若干年(截至2008年)的流行详细数据,建立数据库。分析比较达到传播阻断/控制标准前后的流行态势变化规律。

结果

达到传播控制标准后,广丰、上饶、德安3个县的钉螺面积下降率分别为96.79%、98.99%、99.77%。钉螺密度维持在较低水平,95%的病人和病牛得到治愈。广丰县从传播控制到传播阻断平均用时17年,德安县为26年。而上饶县虽人群/家畜血吸虫病发病率稳定,但因发现钉螺复现和扩散,钉螺情况出现反弹。

结论

达到传播阻断/控制标准后,残存钉螺在一定条件下易复现和扩散,是实现传播阻断标准的主要障碍之一。在孤立的钉螺单元中,即使存在传染源,若钉螺面积和密度控制在极低水平,血吸虫病仍难以传播扩散。

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