Ross A G, Li Y S, Williams G M, Li Y, Sleigh A S, Zhang X, Zhou D, McManus D P
Australian Centre for International and Tropical Health and Nutrition, Queensland Institute of Medical Research, Brisbane, Australia.
Acta Trop. 1997 Oct 14;68(1):93-104. doi: 10.1016/s0001-706x(97)00076-4.
In 1995-1996 we conducted an epidemiological survey in two communities (1656 individuals) on Qingshan island, Hunan province P.R. China, in order to determine the efficacy of current control strategies since their upgrading in 1991. In 1996, the overall prevalence for Schistosoma japonicum, Ascaris lumbricoides, Ancylostoma duodenale, and Trichuris trichiura had decreased moderately since 1991. The age-specific prevalence for S. japonicum for each of the representative age groups decreased slightly, but there was a significant reduction in these prevalences for the 5-9 (P < 0.01), 55-59 (P < 0.05) and the over 60 (P < 0.01) age groups. The 1996 intensities of infection for schistosomiasis were higher for all the age categories except for those aged 0-4 and 25-29 years of age. When the study population was further classified according to the percent uninfected, lightly infected (8-100 eggs/g (epg)), moderately infected (101-400 epg) and heavily infected (> 400 epg) for S. japonicum, there were fewer (5.6%) people infected in 1996 but the proportions of moderately (21.3 vs. 15.5%) and heavily (7.6 vs. 2.3%) infected individuals were higher than those observed in 1991. The reported cases of weakness and hepatomegaly (MSL > or = 3) were significantly lower (P < 0.01) in 1996 for both uninfected and infected (all intensities) individuals. General episodes of diarrhoea were also significantly lower in 1996 for those lightly (P < 0.05) and heavily (P < 0.01) infected. Likewise, the occurrence of splenomegaly (Hackett's > or = 2) was significantly lower among uninfected (P < 0.01) and heavily infected (P < 0.05) patients. In summary, although significant progress has been made in controlling schistosomiasis and other helminth infections in this highly endemic focus for schistosomiasis, there is still room for improvement. Chemotherapy for bovines and humans, mollusciding for Oncomelania control and health education should be initiated and upgraded if the health and well being of these island communities is to further improve.
1995 - 1996年，我们在中国湖南省青山岛的两个社区（共1656人）进行了一项流行病学调查，以确定自1991年控制策略升级以来当前控制策略的效果。1996年，日本血吸虫、蛔虫、十二指肠钩虫和鞭虫的总体患病率自1991年以来有适度下降。各代表性年龄组的日本血吸虫年龄别患病率略有下降，但5 - 9岁（P < 0.01）、55 - 59岁（P < 0.05）和60岁以上（P < 0.01）年龄组的这些患病率有显著下降。1996年除0 - 4岁和25 - 29岁年龄组外，所有年龄组的血吸虫病感染强度均较高。当研究人群根据日本血吸虫未感染、轻度感染（8 - 100个虫卵/克（epg））、中度感染（101 - 400 epg）和重度感染（> 400 epg）的百分比进一步分类时，1996年感染人数较少（5.6%），但中度（21.3%对15.5%）和重度（7.6%对2.3%）感染个体的比例高于1991年观察到的比例。1996年，未感染和感染（所有感染强度）个体报告的虚弱和肝肿大（MSL≥3）病例显著减少（P < 0.01）。1996年，轻度（P < 0.05）和重度（P < 0.01）感染人群的腹泻总发作次数也显著减少。同样，未感染（P < 0.01）和重度感染（P < 0.05）患者的脾肿大（哈克特分级≥2）发生率显著降低。总之，尽管在这个血吸虫病高度流行区控制血吸虫病和其他蠕虫感染方面已取得显著进展，但仍有改进空间。如果要进一步改善这些岛屿社区的健康和福祉，应启动并升级针对牛和人的化疗、灭螺以控制钉螺以及健康教育。
