江西省传染源控制策略示范区和推广区建设项目血防效果评估与分析

doi:10.12140/j.issn.1000-7423.2019.06.001

中国寄生虫学与寄生虫病杂志 ›› 2019, Vol. 37 ›› Issue (6): 625-631.doi: 10.12140/j.issn.1000-7423.2019.06.001

江西省传染源控制策略示范区和推广区建设项目血防效果评估与分析

葛军¹(), 胡飞¹, 张利娟², 杭春琴¹, 刘克星¹, 李石柱², 林丹丹¹, 刘亦文^1,^*()

1 江西省寄生虫病防治研究所,南昌 330096
2 中国疾病预防控制中心寄生虫病预防控制所,国家热带病研究中心,世界卫生组织热带病合作中心,科技部国家级热带病国际联合研究中心,卫生部寄生虫病原与媒介生物学重点实验室,上海 200025

收稿日期:2019-09-20 出版日期:2019-12-30 发布日期:2019-12-31
通讯作者: 刘亦文
作者简介:
作者简介：葛军（1976-）,男,硕士,副主任医师,从事寄生虫病防治工作。E-mial：561734255@qq.com
基金资助:
国家自然科学基金（No. 71764011）;江西省重点研发计划（No. 20181BBG70033）;江西省重点实验室计划项目（No. 20192BCD40006）;江西省卫生计生委科技计划项目（No. 20156036）

Evaluation and analysis of schistosomiasis control in model demonstration and expansion areas with infection sources control strategy implemented in Jiangxi Province

Jun GE¹(), Fei HU¹, Li-juan ZHANG², Chun-qin HANG¹, Ke-xing LIU¹, Shi-zhu LI², Dan-dan LIN¹, Yi-wen LIU^1,^*()

1 Jiangxi Provincial Institute of Parasitic Diseases, Nanchang 330096, China
2 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China

Received:2019-09-20 Online:2019-12-30 Published:2019-12-31
Contact: Yi-wen LIU
Supported by:
Supported by National Natural Science Foundation of China (No. 71764011), Jiangxi Province Key Research and Development Project (No. 2018BBG70033), Jiangxi Province Key Lab Project (No. 20192BCD40006), Science and Technology Planning Project of Jiangxi Health Department (No. 20156036)

摘要/Abstract

摘要：

目的评估与分析江西省传染源控制策略示范区和推广区建设项目血吸虫病的防治效果。方法示范区和推广区建设项目于2011-2015年分期启动实施,开展耕牛（肉牛）淘汰、以机代牛、封洲禁牧、钉螺查灭、人畜查治、健康教育等传染源控制综合防治措施。以乡为单位,收集2010-2018年示范区和推广区疫情数据资料,用Microsoft Excel 2016建立数据库,以钉螺、人群、牛感染率为评价指标,比较示范区和推广区项目实施前后的人、牛感染及螺情变化情况,分析流行态势,评估防治效果。结果项目区共覆盖13县（市、区）69个乡（镇）672个村。示范区项目实施3年后,钉螺感染率从实施前2010年的0.22%（35/16 234）降为2014年的0（0/25 786）,2015-2018年连续4年未查获感染性钉螺。示范区人群粪检阳性率和牛感染率在项目实施前（2010年）为1.12%（175/15 585）和2.95%（166/5 629）,分别在项目实施4年后(2015年)和2年后（2013年）降为0。4期推广区均在项目实施1年后,钉螺感染率降为0,此后均未查获感染性钉螺;牛感染率在项目实施1~3年后降为0;2015-2018年,推广区仅发现粪检阳性者7例。结论实施传染源控制示范区和推广区建设项目后,人群、牛和钉螺的血吸虫感染率均进一步下降,防治效果明显。

关键词: 血吸虫病, 传染源控制策略, 防治, 示范区, 推广区

Abstract:

Objective To evaluate and analysis the schistosomiasis control in model demonstration and expansion areas with infection sources control strategy implemented in Jiangxi Province. Methods The programs of model demonstration and expansion areas for schistosomiasis control were initiated during 2011-2015, where the measures to control infection source of schistosomiasis were implemented. These measures included eliminating farming cattle, replacing the farming cattle with agricultural machine, forbidding grazing on snail-inhabited marshlands, snail control, examination and treatment for resident people and livestock and performing health education. The epidemiological data were collected from these areas from 2010-2018 and analyzed. The infection of resident, livestock and snail in these areas after the implementation of the control measures was compared with that before implementation. The epidemic and control effects were analyzed and evaluated. Results The program covered total 672 villages within 69 townships in 13 counties. In the model demonstration areas, after the implementation of control measures, the infection rate of snail decreased from 0.22% in 2010 to 0 in 2014, and there is no infectious snails found for 4 consecutive years from 2015 to 2018. The positive rate of fecal examination in residents dropped from 1.12% (175/15 585) in 2010 to 0 in 2015, and cattle positive rate dropped from 2.95% (166/5 629) in 2010 to 0 in 2013. In 4 expansion areas, the snail infection rate dropped to 0 after 1 year with the program implemented, with no infectious snails found for 5 consecutive years. The infection rate of cattle dropped to 0 after 1-3 years of the program implementation. Only 7 cases were found with schistosome egg positive in the expansion areas during 2015-2018. Conclusion At the low infection areas, the infection rate of schistosomiasis in people, cattle and snail could be further decreased by implementing the strategy focusing infection source control in the model demonstration area and extension areas. It is necessary to further strengthen the integrated measures for infection source control including banning livestock husbandry in marshlands, as to consolidate control achievements in these demonstration and expansion areas.

Key words: Schistosomiasis, Infection source control strategy, Demonstration areas, Expansion areas

中图分类号:

R532.21

葛军, 胡飞, 张利娟, 杭春琴, 刘克星, 李石柱, 林丹丹, 刘亦文. 江西省传染源控制策略示范区和推广区建设项目血防效果评估与分析[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(6): 625-631.

Jun GE, Fei HU, Li-juan ZHANG, Chun-qin HANG, Ke-xing LIU, Shi-zhu LI, Dan-dan LIN, Yi-wen LIU. Evaluation and analysis of schistosomiasis control in model demonstration and expansion areas with infection sources control strategy implemented in Jiangxi Province[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2019, 37(6): 625-631.

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参考文献 18

[1]	刘亦文, 葛军, 林丹丹. 江西省消除血吸虫病面临的挑战与对策[J]. 中国血吸虫病防治杂志, 2018, 30(6): 610-614.
[2]	张利娟, 徐志敏, 戴思敏, 等. 2017年全国血吸虫病疫情通报[J]. 中国血吸虫病防治杂志, 2018, 30(5): 481-488.
[3]	葛军, 林丹丹. 江西省血吸虫病的流行与发现探微——纪念毛泽东主席《七律二首·送瘟神》发表60周年[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(6): 545-551.
[4]	刘亦文, 林丹丹. 江西省血吸虫病防治经验[M]. 南昌: 江西科技出版社, 2018.
[5]	李宜锋, 杭春琴, 胡飞, 等. 血防新策略在鄱阳湖区血吸虫病传播控制中的作用[J]. 中国血吸虫病防治杂志, 2017, 29(6): 689-694, 715.
[6]	张绍基, 刘志德, 胡林生, 等. 鄱阳湖区血吸虫病流行因素和流行规律的研究[J]. 中国血吸虫病防治杂志, 1990, 2(1): 17-23.
[7]	郭家钢, 宁安, 胡广汉, 等. 水牛化疗控制鄱阳湖地区血吸虫病传播的现场实验研究[J]. 中国人兽共患病学报, 2005, 21(10): 860-862.
[8]	Wang LD, Chen HG, Guo JG, et al. A strategy to control transmission of Schistosoma japonicum in China[J]. N Engl J Med, 2009, 360(2): 121-128.
[9]	董长华, 喻华, 贺亮, 等. 江西省2008-2012年家畜血吸虫病疫情回顾及实现2015年防控目标的风险分析[J]. 中国动物传染病学报, 2013, 21(1): 66-70.
[10]	陈红根, 辜小南, 曾小军, 等. 江西省2002-2012年血吸虫病流行动态与防治形势[J]. 中国寄生虫学与寄生虫病杂志, 2013, 31(6): 458-463.
[11]	易冬华, 易平, 刘兆春, 等. 控制传染源为主的综合策略在洞庭湖区血吸虫病防治中的实践与思考[J]. 中国血吸虫病防治杂志, 2009, 21(3): 161-164.
[12]	张世清, 潘新平, 汪天平, 等. 洲岛型血吸虫病流行区实施以传染源控制为主的综合防治措施效果初步观察[J]. 中国血吸虫病防治杂志, 2009, 21(4): 259-261.
[13]	朱红, 蔡顺祥, 黄希宝, 等. 湖北省实施以传染源控制为主的血吸虫病综合防治策略初期效果[J]. 中国血吸虫病防治杂志, 2009, 21(4): 267-271.
[14]	陈红根, 曾小军, 熊继杰, 等. 鄱阳湖区以传染源控制为主的血吸虫病综合防治策略研究[J]. 中国血吸虫病防治杂志, 2009, 21(4): 243-249.
[15]	陈喆, 林丹丹. 江西省血吸虫病传播阻断地区监测现状及面临挑战[J]. 中国血吸虫病防治杂志, 2016, 28(4): 456-460.
[16]	刘晓忠, 陈喆, 林丹丹. 江西省血吸虫病监测现状及发展思考[J]. 中国血吸虫病防治杂志, 2016, 28(2): 111-114, 140.
[17]	伍来成. 九江市畜牧业发展现状与分析[D]. 南昌: 江西农业大学, 2018.
[18]	李宜锋, 林丹丹, 辜小南, 等. 南昌市中心城区一起血吸虫病突发疫情的处置及启示[J]. 江西医药, 2018, 53(9): 1008-1010.

年份 Year	查螺框数 No. surveyed cage	有螺框数 No. cage with snail	活螺数 No. living snail	阳性螺框数 No. cage with infected snail	阳性螺数 No. infected snail	有螺框出现率/% Proportion of cage with snail/%	活螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	感染螺平均密度 /只·(0.1m²)^-1 Average density of infected snail/No.·(0.1m²)^-1	钉螺感染率 /% Infection rate of snail/%
2010	86 514	7 255	16 234	30	35	8.39	0.188	0.000 405	0.215
2011^a	129 893	6 562	15 473	8	9	5.05	0.119	0.000 069	0.058
2012	123 389	8 218	10 187	5	5	6.66	0.083	0.000 041	0.049
2013	132 668	7 925	16 511	1	1	5.97	0.124	0.000 008	0.006
2014	146 348	9 161	25 786	0	0	6.26	0.176	0	0
2015	165 255	8 081	19 832	0	0	4.89	0.120	0	0
2016	133 227	4 235	6 484	0	0	3.18	0.049	0	0
2017	135 000	1 507	2 259	0	0	1.12	0.017	0	0
2018	124 382	1 040	1 510	0	0	0.84	0.012	0	0

	血检Serological test			粪检Stool examination
年份 Year	检查人数 No. examined	阳性数 No. positive	阳性率/% Positive rate/%	检查人数 No. examined	阳性数 No. positive	阳性率/% Infection rate/%
2010	87 775	11 293	12.87	15 585	175	1.12
2011^a	94 318	11 110	11.78	15 287	135	0.88
2012	107 388	8 921	8.31	8 038	63	0.78
2013	108 150	9 496	8.78	15 768	86	0.55
2014	99 033	9 706	9.80	15 418	36	0.23
2015	116 090	2 875	2.48	11 571	0	0
2016	57 032	1 920	3.37	4 886	0	0
2017	63 662	2 485	3.90	4 362	0	0
2018	38 204	1 787	4.68	7 180	0	0

年份 Year	存栏数 No. cattle	检查数 No. exam'd	感染牛数 No. positives	感染率/% Infection rate/%
2010	5 898	5 629	166	2.95
2011^a	8 414	8 281	114	1.36
2012	6 848	1 206	1	0.08
2013	231	200	0	0
2014	231	160	0	0
2015	201	199	0	0
2016	832	292	0	0
2017	918	451	0	0
2018	834	411	0	0

年份Year	推广区1期 Expansion areas stage 1				推广区2期 Expansion areas stage 2				推广区3期 Expansion areas stage 3				推广区4期 Expansion areas stage 4
年份Year	有螺框出现率/%Proportion of cage with snail/%	活螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	感染螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	钉螺感染率 /%Infection rate of snail/%	有螺框出现率/%Proportion of cage with snail/%	活螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	感染螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	钉螺感染率 /%Infection rate of snail/%	有螺框出现率/%Proportion of cage with snail/%	活螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	感染螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	钉螺感染率/%Infection rate of snail /%	有螺框出现率/%Proportion of vage with snail/%	活螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	感染螺平均密度 /只·(0.1m²)^-1 Average density of living snail/No.·(0.1m²)^-1	钉螺感染率 /%Infection rate of snail/%
2011	3.48	0.654	0.000409	0.0626	-	-	-	-	-	-	-	-	-	-	-	-
2012^a	4.37	0.123	0.000096	0.0781	5.83	0.115	0.000075	0.0650	1.47	0.029	0.000025	0.0854	7.92	0.037	0.000032	0.0864
2013^b	3.11	0.087	0	0	6.61	0.154	0.000018	0.0119	1.55	0.034	0.000025	0.0734	8.08	0.043	0	0
2014^c	5.18	0.424	0	0	5.85	0.112	0	0	1.47	0.035	0	0	1.21	0.034	0	0
2015^d	6.24	0.282	0	0	6.11	0.115	0	0	2.91	0.103	0	0	1.36	0.036	0	0
2016	5.13	0.182	0	0	8.46	0.138	0	0	2.05	0.052	0	0	1.42	0.040	0	0
2017	2.35	0.044	0	0	8.09	0.136	0	0	1.14	0.027	0	0	1.50	0.053	0	0
2018	1.03	0.017	0	0	7.00	0.114	0	0	0.97	0.024	0	0	1.37	0.038	0	0

年份 Year	推广区1期 Expansion areas stage 1		推广区2期 Expansion areas stage 2		推广区3期 Expansion areas stage 3		推广区4期 Expansion areas stage 4
年份 Year	血检阳性率/% Sero-positive rate /%	粪检阳性率/%Stool-postivie rate/%	血检阳性率/% Sero-positive rate/%	粪检阳性率/%Stool-postivie rate/%	血检阳性率/% Sero-positive rate/%	粪检阳性率/%Stool-postivie rate/%	血检阳性率/% Sero-positive rate/%	粪检阳性率/%Stool-postivie rate/%
2011	8.93（6528/73138）	0.37(56/15200)	-	-	-	-	-	-
2012^a	6.40(5550/86784)	0.41(44/10628)	6.26（7874/125862)	0.83(66/7986)	9.46(10586/111848)	0.44(41/9305)	7.92(19683/24853)	0.53(76/14481)
2013^b	5.29(4591/86784)	0.04(6/16107)	7.80(9710/124527)	0.33(66/19995)	9.87(11957/121127)	0.15(27/18396)	8.08(19611/242787)	0.08(32/37958)
2014^c	4.66(4832/102634)	0.01(2/19933)	6.74(11290/167426)	0.12(32/14396)	8.72(15971/183209)	0.06(18/31191)	6.62(21178/320013)	0.02(11/49351)
2015^d	2.66(2481/90984)	0(0/8664)	2.02(1902/94005)	0(0/14396)	2.68(2976/110911)	0(0/13533)	2.78(6935/249806	0(1/26143)
2016	3.14(1638/52181)	1.96(53/2707)	2.61(1920/73629)	0.07(4/5876)	4.36(3833/87856)	0.02(1/5638)	3.67(5926/161469)	0(0/11006)
2017	5.27(2207/41894)	0.04(2/4616)	2.63(1716/63980)	0.03(2/5793)	4.48(3566/79533)	0.01(1/6796)	4.38(6502/148352)	0.01(1/13035)
2018	4.24(1527/36032)	0(0/6653)	4.15(2139/51590)	0.02(2/10086)	6.38(4145/64948)	0(0/11780)	4.75(5620/118395)	0.01(1/18544)

江西省传染源控制策略示范区和推广区建设项目血防效果评估与分析

Evaluation and analysis of schistosomiasis control in model demonstration and expansion areas with infection sources control strategy implemented in Jiangxi Province

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[8]	郭苏影, 祝红庆, 曹淳力, 邓王平, 鲍子平, 贾铁武, 李银龙, 吕超, 秦志强, 张利娟, 冯婷, 杨帆, 吕山, 许静, 李石柱. 2020年长江中下游地区洪涝灾害后血吸虫病传播风险评估[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(6): 753-758.
[9]	施亮, 熊春蓉, 刘毛毛, 魏秀参, 张键锋, 王鑫瑶, 王涛, 杭德荣, 羊海涛, 杨坤. 基于深度学习技术的湖北钉螺视觉智能识别模型效能评价[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(6): 764-770.
[10]	李博, 张聪, 单晓伟, 易佳, 涂珍, 何汇, 唐丽, 朱红, 刘建兵. 湖北省血吸虫病规范化实验室病原学检测能力评估[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(5): 572-576.
[11]	吴家利, 李博, 刘斯, 涂祖武, 唐丽, 涂珍, 周晓蓉, 孙凌聪, 肖瑛, 朱红. 基于人群抗体水平的湖北省血吸虫病传播风险分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(5): 578-584.
[12]	胡飞, 高祖禄, 袁敏, 李召军, 李宜锋, 刘跃民, 李剑瑛, 谢曙英, 文雨松, 林丹丹. 鄱阳湖区居民血吸虫感染及肝纤维化变化趋势的研究[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(5): 629-636.
[13]	刘蓉, 张剑锋, 严晓岚, 闻礼永. SF-36和EQ-5D-5L量表在晚期血吸虫病患者生命质量评价中的比较研究[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(5): 639-645.
[14]	刘蓉, 闻礼永. 晚期血吸虫病基础和临床研究新进展[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(4): 429-436.
[15]	洪中, 吴铃铃, 王丽萍, 许静. 全球血吸虫病防控进展及面临的挑战[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(4): 514-519.

年份 Year	推广区1期 Expansion areas stage 1		推广区2期 Expansion areas stage 2		推广区3期 Expansion areas stage 3		推广区4期 Expansion areas stage 4
年份 Year	存栏数 No. cattle	感染率/% Infection rate/%	存栏数 No. cattle	感染率/% Infection rate/%	存栏数 No. cattle	感染率/% Infection rate/%	存栏数 No. cattle	感染率/% Infection rate/%
2011	15 193	2.31(381/16 505)	-	-	-	-	-	-
2012^a	13 526	2.15(106/4 930)	10 127	9.70(146/1505)	13 200	2.17(67/3 090)	23 317	8.19(98/1 196)
2013^b	11 100	1.77(18/1 020)	14 143	1.27(29/2 290)	12 148	1.41(44/3 112)	23 543	1.77(63/3 565)
2014^c	4 522	0.23(6/2 645)	13 004	0.07(1/1 353)	12 062	0.17(25/14 359)	21 076	0.37(69/18 656)
2015^d	4 522	0.12(2/1 623)	2 206	0(0/60)	4 399	0(0/44)	13 913	0.35(14/3 961)
2016	4 661	0(0/892)	910	0(0/48)	4 268	0(0/191)	11 391	0.21(5/2 375)
2017	4 281	0(0/661)	911	0.62(1/161)	4 315	0(0/334)	11 747	0(0/5 141)
2018	878	0(0/680)	153	0(0/73)	1 482	0.13(2/1 508)	8 332	0(0/2 708)