山丘型血吸虫病传播阻断示范区血吸虫病传播高危风险因素分析

中国寄生虫学与寄生虫病杂志 ›› 2018, Vol. 36 ›› Issue (4): 333-339.

山丘型血吸虫病传播阻断示范区血吸虫病传播高危风险因素分析

吕超¹, 周理源², 幸小英², 林丹丹³, 陈涛², 陈锐², 柯寒臣², 汪洲², 潘武², 许静¹, 秦志强¹, 祝红庆^1,^*(), 李石柱¹

1 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,卫生部寄生虫病原及媒介生物学重点实验室,上海 200025
2 瑞昌市血吸虫病防治站,瑞昌 332200
3 江西省寄生虫病防治研究所,南昌 330096

收稿日期:2017-12-12 出版日期:2018-08-30 发布日期:2018-09-06
通讯作者: 祝红庆
基金资助:
国家重点研发计划项目（No. 2016YFC1202000,No. 2016YFC1202001）;上海市公共卫生第四轮三年行动计划（No. 15GWZK0101）;国家传染病重大专项（No. 2016ZX10004222-004）

Analysis of transmission risk factors of schistosomiasis in a hilly demonstration plot of transmission interruption

Chao LV¹, Li-yuan ZHOU², Xiao-ying XING², Dan-dan LIN³, Tao CHEN², Rui CHEN², Han-chen KE², Zhou WANG², Wu PAN², Jing XU¹, Zhi-qiang QIN¹, Hong-qing ZHU^1,^*(), Shi-zhu LI¹

1 National Institute of Parasitic Diseases, China Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Center 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
2 Ruichang City Station for Schistosomiasis Control, Ruichang 332200, China
3 Jiangxi Provincial Institute of Parasitic Diseases, Nanchang 330096, China

Received:2017-12-12 Online:2018-08-30 Published:2018-09-06
Contact: Hong-qing ZHU
Supported by:
Supported by the National Key Research and Development Program of China (No. 2016YFC1202000，No. 2016YFC1202001)；the Fourth Round Three Years of Shanghai Public Health Action Plan (No. 15GWZK0101) and the National Infectious Diseases Major Projects (No. 2016ZX10004222-004)

摘要/Abstract

摘要：

目的调查长江南岸一山丘型血吸虫病传播阻断示范区内血吸虫病传播的高危风险因素。方法收集长江南岸一山丘型血吸虫病传播阻断示范区2016、2017年人畜血吸虫病疫情资料及相关数据。另在示范区内选取乌石河滩、水泥沟、田间沟、泄洪沟、干渠、荒地、荒滩等7个调查点,在相应区域内以系统抽样结合环境抽样开展钉螺调查,捡获的钉螺应用环介导等温扩增技术（LAMP）进行血吸虫核酸检测。连续3个月在7个调查点捕捉野鼠,每月投放1次鼠笼或鼠夹,每次持续3 d。捕获的野鼠取肝脏组织,匀浆后显微镜下检查虫卵,应用毛蚴孵化法检测野鼠粪便和在调查区域内检获的所有肉眼观察到的野粪。结果该示范区2016、2017年本地居民共查病12 232人次,血清血吸虫抗体阳性152例,无粪检阳性病例。本地耕牛血检688头次,血清血吸虫抗体阳性1头,无粪检阳性病畜。7个调查点共调查钉螺2 152框,捡获钉螺1 401只,其中活螺为427框1 398只,平均密度为3.27只/框。LAMP检测结果显示,24管钉螺（每管15只钉螺）混合DNA中,5管呈阳性反应,分布在水泥沟、田间沟、干渠等3个调查点。投放鼠笼或鼠夹共825个,捕获野鼠35只,分布在除乌石河滩的其余6个调查点。野鼠粪便孵化均为阴性,肝脏组织镜检发现2只野鼠感染华支睾吸虫。购得的2份野猪肝脏和1只野兔,镜检和粪便孵化均为阴性。捡获野粪137份,较多的2个调查点分别为54份和44份,野粪来自牛、羊、马、猪、犬等5种家畜,其中牛粪最多（66份）,猪粪最少（4份）。经毛蚴孵化检查,26份野粪为阳性,阳性率为19.0%,其中牛粪15份阳性,马粪、羊粪、猪粪、犬粪分别为2、3、3、3份阳性。结论示范区内人群调查未见血吸虫感染。示范区的有螺环境内存在多种家畜传染源格局,家畜野粪阳性率为19.0%,是该类地区血吸虫病传播的高危风险因素。

关键词: 血吸虫病, 野生动物, 钉螺, 野粪调查

Abstract:

Objective To analyze the risk factors for schistosomiasis transmission in a hilly transmission interruption demonstration plot located at the south bank of Yangtze River. Methods The 2016-2017 schistosomiasis endemic information in local residents and livestock in a hilly transmission interruption demonstration plot located at the south bank of Yangtze River was collected. Field investigations were also carried out at benchland, cement ditch, field drain, flood discharge ditch, trunk canal, wasteland, desolate sands in the demonstration plot, where snails were surveyed through systematic sampling in combination with environmental sampling, and wild rodents were captured using cages or traps which were placed monthly, 3 days each time, for 3 consecutive months. The loop-mediated isothermal amplification (LAMP) method was used to detect the schistosome DNA in snails. The rodents captured were sacrificed and liver tissues were collected for egg examination in tissue homogenates. Feces from wild animals in the field were collected, and examined by the miracidium hatching method. Results A total of 12 232 (5 408/6 824) local residents were examined in 2016 and 2017 in the demonstration plot, of whom 152 showed positive serological test results and none showed positive fecal examination result. A total of 688 cattle were examined by serological test, of which only 1 showed positive result, and none showed positive fecal examination result. Meanwhile, 2 152 frames of snails were investigated in the 7 selected areas and 1 401 snails were obtained, including 1 398 live snails (427 frames), with an average density of 3.27 live snails/frame. The LAMP results showed that 5 out of 24 tubes of mixed DNA resulted in positive products, distributed at 3 sites. A total of 825 cages/traps were placed, and only 35 rodents were captured, distributed at 6 sites. None of the rodents were found to be infected with Schistosoma japonicun after stool hatching, while microscopic examination of the liver tissue revealed two rodents infected with Clonorchis sinensis. The purchased 2 samples of wild boar liver and one wild rabbit also showed negative results of microscopic examination and fecal hatching. A total of 137 fecal samples were collected, mainly from two spots (54 and 44 from each). The fecal samples were from cattle, goats, horses, swines and dogs, mostly from cattle (66 samples), and least from swines (4). Twenty-six were determined as positive by hatching, infection a positive rate of 19.0%, consisting of 15 cattle feces, 2 horse feces, 3 goat feces, 3 swine feces, and 3 dog feces. Conclusion No human cases of schistosomiasis were found in the demonstration plot. There has been a scenario of multiple livestock sources of infection in the demonstration plot, with an infection rate of 19.0% in livestock feces. The infected livestock feces are a crucial factor for the transmission of schistosomiasis in this area.

Key words: Schistosomiasis, Wildlife, Snail, Investigation of field feces

中图分类号:

R532.21

吕超, 周理源, 幸小英, 林丹丹, 陈涛, 陈锐, 柯寒臣, 汪洲, 潘武, 许静, 秦志强, 祝红庆, 李石柱. 山丘型血吸虫病传播阻断示范区血吸虫病传播高危风险因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(4): 333-339.

Chao LV, Li-yuan ZHOU, Xiao-ying XING, Dan-dan LIN, Tao CHEN, Rui CHEN, Han-chen KE, Zhou WANG, Wu PAN, Jing XU, Zhi-qiang QIN, Hong-qing ZHU, Shi-zhu LI. Analysis of transmission risk factors of schistosomiasis in a hilly demonstration plot of transmission interruption[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(4): 333-339.

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年份 Years	人血吸虫病疫情 Human schistosomiasis					家畜血吸虫病疫情Domestic animal schistosomiasis
年份 Years	检查人数 No. exam’d	血检人数 No. serological test	血检阳性人数No. patients with positive serological results	粪检人数 No. stool exam’d	粪检阳性人数 No. patients with positive stool examination	存栏数 No. on hand	血检头数 No. serological tests	血检阳性头数 No. livestock with positive serological results	粪检头数 No. stool exam’d	粪检阳性头数 No. livestock with positive stool examination
2016	5 408	5 308	63	158	0	329	330	1	1	0
2017	6 824	6 824	89	289	0	329	358	0	50	0
合计Total	12 232	12 132	152	447	0	658	688	1	51	0

调查点 Spots	调查面积/m² Area of investigation/m²	调查框数 No. frames	活螺框数 No. frames with living snails	检获钉螺数 No. snails	活螺数 No. living snails	单框最高钉螺数 Maximum number of snails per frame	核酸检测管数 No. test tubes for DNA	阳性管数 No. positive	阳性比例/% Percentage/%
乌石河滩Benchland	4 500	305	45	145	145	19	2	0	0
水泥沟Cement ditch	1 500	310	78	294	294	34	5	2	40
田间沟Field drain	1 750	312	83	289	289	29	5	1	20
泄洪沟 Flood discharge ditch	1 700	315	47	167	167	17	3	0	0
干渠Trunk canal	2 400	300	70	234	234	39	4	2	50
荒地Wasteland	2 300	309	61	178	178	12	3	0	0
荒滩Desolate sands	2 000	301	43	94	91	9	2	0	0
总计 Total	16 150	2 152	427	1 401	1 398		24	5	20.8

调查点 Spot	捕捉面积/m² Capture areas/m²	共投放鼠笼（夹） No. cages (traps)	回收数 No. recovered	捕获鼠数 No. captured	鼠密度/只·m^-2 Rodent density/m²	解剖肝脏钙化数 No. liver calcification	镜检寄生虫种类 Parasite species examined by microscope
乌石河滩Benchland	3 000	120	117	0	0	0
水泥沟Cement ditch	1 500	105	96	7	0.073	0
田间沟Field drain	1 750	120	117	3	0.026	0
泄洪沟Flood discharge ditch	1 500	120	115	6	0.052	1	华支睾吸虫Clonorchis sinensis
干渠Trunk canal	2 400	135	129	10	0.078	1	华支睾吸虫Clonorchis sinensis
荒地Wasteland	2 300	120	118	4	0.034	0
荒滩Desolate sands	2 000	105	104	5	0.048	0
总计Total	14 450	825	796	35	0.044	0

调查点 Spots	调查面积/m² Area of investigation/m²	野粪种类 Wild fecal species	野粪数 No. wild feces	野粪密度/份·m^-2 Density/m²	孵化毛蚴阳性数 No. miracidium positive	阳性比例/% Percentage/%
乌石河滩Benchland	4 500	牛粪Cattle	5	0.002 7	1	25.0
		羊粪Goat	2		0
		马粪Horse	5		2
水泥沟Cement ditch	2 500	犬粪Canine	1	0.000 8	0	0.0
水泥沟Cement ditch		猪粪Swine	1		0
田间沟Field drain	3 000	牛粪Cattle	44	0.014 7	5	11.4
泄洪沟Flood discharge ditch	2 500	犬粪Canine	7	0.004 0	3	6/10
泄洪沟Flood discharge ditch		猪粪Swine	3		3
干渠Trunk canal	3 000	牛粪Cattle	13	0.004 3	8	8/13
荒地Wasteland	2 300	羊粪Goat	2	0.000 9	2	2/2
荒滩Desolate sands	2 000	羊粪Goat	33	0.027 0	1	3.7
		马粪Horse	17		0
		牛粪Cattle	4		1
总计 Total	19 800		137	0.006 9	26	19.0