Li-Juan Zhang, Zhi-Min Xu, Si-Min Dai, Hui Dang, Shan Lü, Jing Xu, Shi-Zhu Li, Xiao-Nong Zhou
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Center for Tropical Diseases; Key Laboratory of Parasite and Vector Biology; National Health Commission, Shanghai 200025, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2018 Oct 25;30(5):481-488. doi: 10.16250/j.32.1374.2018219.
This report presents the endemic status of schistosomiasis in the People's Republic of China at national level in 2017, and analyzes the data collected from the national schistosomiasis prevention and control system and 457 national schistosomiasis surveillance sites. Among the 12 provinces (municipality and autonomous region) being endemic of schistosomiasis japonica in P. R. China, 5 provinces (municipality and autonomous region), i.e., Shanghai, Zhejiang, Fujian, Guangdong and Guangxi, continued to consolidate the status of elimination of schistosomiasis. Sichuan Province achieved the transmission interruption and 6 provinces of Yunnan, Jiangsu, Hubei, Anhui, Jiangxi and Hunan kept the transmission control by the end of 2017. There were 450 endemic counties (cities, districts) covering 259 million people, specifically including 28 544 endemic villages of 70 324.5 thousand people at risk. Among the 450 endemic counties (cities, districts), 47.78% (215/450), 34.00% (153/450) and 18.22% (82/450) reached the criteria of elimination, transmission interruption and transmission control, respectively. By the end of 2017, a total of 8 401 113 individuals received schistosomiasis examinations and 14 individuals were parasitologically diagnosed, decreased by 97.67% compared with 600 cases in 2016. It was estimated of 37 601 cases of schistosome infection, decreased by 30.95% compared with 54 454 cases in 2016. One acute schistosomiasis case was reported in 2017. There were 29 407 advanced schistosomiasis cases documented in 2017. snail surveys were performed in 19 784 endemic villages and snails were found in 7 310 villages, accounting for 36.95% of total villages, with 19 newly detected villages with snails.The snail survey covered an area of 622454.49 hm and snails were found in an area of 172501.56 hm, including a newly detected area of 208.54 hm. No schistosome-infected snails were found in 2017. A total of 737 016 bovines were raised in the schistosomiasis endemic areas. Of them, 454 830 bovines received the examinations for schistosome infection, and 1 bovine was stool examination positive. There were 119 326 schistosomiasis cases receiving chemotherapy in 2017, with 1 973 968 individuals undergoing expanded chemotherapy; one bovine with schistosomiasis receiving chemotherapy, with 418 925 bovines undergoing expanded chemotherapy. A total of 144 605.31 hm area with snail was controlled by using molluscicides, with actual molluscicide-treated area of 73 755.37 hm; and 5 002.92 hm area with snail was treated by environmental modification. Based on the data from the 457 national schistosomiasis surveillance sites, the mean infection rate was 0.001 6% and 0 in humans and bovines, respectively. No schistosome-infected snails were found by microscopic examinations in all the surveillance sites, and 7 snail samples with schistosome nucleic acid positive were detected by loopmediated isothermal amplification (LAMP) among 6 surveillance sites. The results demonstrate a continuous decline trend on the endemic situation of schistosomiasis in P. R. China. However, the risk of epidemic rebound still exists in some regions and it is still a challenge to achieve the target set by the Thirteenth Five-Year National Plan for Schistosomiasis Control in 2020.
本报告介绍了2017年中华人民共和国全国层面的血吸虫病流行状况,并对全国血吸虫病防治系统及457个全国血吸虫病监测点收集的数据进行了分析。在中国日本血吸虫病流行的12个省(直辖市、自治区)中,上海、浙江、福建、广东和广西5个省(直辖市、自治区)继续巩固血吸虫病消除状态。四川省实现了传播阻断,截至2017年底,云南、江苏、湖北、安徽、江西和湖南6省保持传播控制状态。有450个流行县(市、区),覆盖2.59亿人口,其中包括703.245万高危人群所在的28544个流行村。在450个流行县(市、区)中,分别有47.78%(215/450)、34.00%(153/450)和18.22%(82/450)达到消除、传播阻断和传播控制标准。截至2017年底,共有8401113人接受血吸虫病检查,14人经寄生虫学诊断确诊,与2016年的600例相比下降了97.67%。估计血吸虫感染病例为37601例,与2016年的54454例相比下降了30.95%。2017年报告1例急性血吸虫病病例。2017年有晚期血吸虫病病例29407例。在19784个流行村开展了查螺,7310个村查到钉螺,占总村数的36.95%,新发现有螺村19个。查螺面积622454.49公顷,查到钉螺面积172501.56公顷,其中新发现面积208.54公顷。2017年未发现感染性钉螺。血吸虫病流行区共饲养牛737016头,其中454830头牛接受了血吸虫感染检测,1头牛粪便检查阳性。2017年有119326例血吸虫病病例接受化疗,1973968人接受扩大化疗;1头病牛接受化疗,418925头牛接受扩大化疗。使用杀螺剂灭螺面积共144605.31公顷,实际施药面积73755.37公顷;环境改造灭螺面积5002.92公顷。根据457个全国血吸虫病监测点的数据,人群和牛的平均感染率分别为0.0016%和0%。所有监测点镜检均未发现感染性钉螺,6个监测点采用环介导等温扩增技术(LAMP)检测到7份血吸虫核酸阳性钉螺样本。结果表明,中国血吸虫病流行态势呈持续下降趋势。然而,部分地区仍存在疫情反弹风险,实现《“十三五”全国血吸虫病防治规划》2020年目标仍面临挑战。