目的 评估2016—2020年江苏省农村无害化卫生户厕改造的效果。 方法 从江苏省13个设区市各随机选取1个县（市、区）,每个县（市、区）选择2个村,每个村随机选择10户及以上于2016—2020年完成户厕改建的农户,开展入户调查,了解户厕改造的一般情况、化粪池类型、有效容积和第3池粪液去向,采集第1池、第3池粪液样品,检测粪液中粪大肠菌值、五日生化需氧量（BOD5）、化学需氧量（COD）、氨氮（AN）和寄生虫虫卵等。对调查户进行问卷调查,了解居民对改厕结果的满意度和正确使用粪肥情况。统计2016—2020年评估村当地街道（镇）卫生院所上报的总肠道传染病发病率,收集评估村2015和2020年因肠道传染病所造成的经济支出。第1池和第3池粪大肠菌值、COD、BOD5和AN等指标的比较采用配对t检验。 结果 累计调查26个行政村共367户农户。化粪池类型以砖砌式和水泥预制式为主,分别占42.7%（157/367）和24.5%（90/367）;化粪池有效容积达1.5 m³的占93.0%（279/300）;第3池粪液的去向主要为田间施肥（212/290）;第1池、第3池粪液中粪大肠菌值分别为（119.8 ± 33.4）、（42.0 ± 18.5）个/ml,差异有统计学意义（t = 6.534,P < 0.01）;第1池粪液BOD5、COD和AN的浓度分别为（354.7 ± 124.8）、（1 021.8 ± 352.5）、（119.2 ± 64.3）mg/L,第3池分别为（138.6 ± 62.4）、（531.1 ± 229.6）、（96.3 ± 42.7）mg/L,第1池第3池之间的差异均有统计学意义（t = 5.042、9.631、2.455,P < 0.01）;所有粪液样品均未检获人体寄生虫虫卵。2016—2020年,评估村当地街道（镇）总肠道传染病的发病率由2016年的24.6/10万下降至2020年的4.3/10万。累计完成入户问卷调查305份,居民对改厕相关知识的知晓率为95.1%（290/305）,对改厕工作的支持率为100%（303/303）,满意率为96.7%（291/301）,家中可查阅到宣传资料的占88.5%（270/305）,知道使用第3池粪液作肥料的占96.1%（293/305）。2020年评估村由肠道传染病所支出的费用为8.1万元,较2015年的17.6万元下降了53.9%。 结论 2016—2020年,江苏省完成改造的户厕达到农村地区粪便的无害化处理标准,有助于控制肠道寄生虫病等粪-口感染性疾病传播,改善卫生条件和保障群众健康。

Objective To evaluate the effectivenss of innocent sanitary toilets improvement in rural areas of Jiangsu Province during 2016—2020. Methods Two villages from one county (city, district), which was randomly selected from each of the 13 cities in Jiangsu Province were set as investigating sites. Ten or more households with toilets renovated from 2016 to 2020 were randomly selected from each village for the household site-visit to collect the information of general condition of household toilet reconstruction, the type of septic tank and its effective volume, and the outflow of the fecal fluid of the third compartment. Fecal fluid samples from the first and third compartment were collected to examine the fecal coliform value, five-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD), ammonia nitrogen (AN) and parasite eggs. Household questionnaire was conducted to collect the information of residents’ satisfaction with toilet improvement and the way using fecal manure. The overall incidence of intestinal infectious diseases during 2016—2020 was retrieved from the data reported by local township health clinics. Furthermore, the economic expenditures caused by intestinal infectious diseases were also collected in the year of 2015 and 2020 in each investigated village. Paired t test was used for the difference comparison of fecal coliform value, COD, BOD5 and AN between the first and third tank compartments. Results Totally 367 households from 26 administrative villages were investigated. The main type of septic tank were constructed with brick and prefabricated cement parts, each type of which accounted for 42.7% (157/367) and 24.5% (90/367), respectively. The septic tanks with effective volume reaching 1.5 m³ accounted for 93.0% (279/300). The fecal fluid from the tank-third compartment was mostly used as field fertilizer (212/290). The coliform values of fecal fluid in first and third compartment were (119.8 ± 33.4) and (42.0 ± 18.5) coliform/ml, with significant difference between the compartments (t = 6.534, P < 0.01). The concentrations of BOD5, COD and AN in the fecal fluid in the tank-first compartment were (354.7 ± 124.8), (1 021.8 ± 352.5) and (119.2 ± 64.3) mg/L, while those in the tank-third compartment were (138.6 ± 62.4), (531.1 ± 229.6) and (96.3 ± 42.7) mg/L, repectively, with significant differences between the first and the third tank compartment (t = 5.042, 9.631, 2.455, P < 0.01). No human parasite eggs were detected from all fecal fluid samples. From 2016 to 2020, the incidence of overall intestinal infectious diseases in the community (towns) that the surveyed village affiliated to was reduced from 24.6/100 000 in 2016 to 4.3/100 000 in 2020. A total of 305 household questionnaires were performed and the awareness rate of toilet related knowledge, the positive support to toilet renovation and the satisfaction rate in this aspect reached to 95.1% (290/305), 100% (303/303), and 96.7% (291/301), respectively. The publicity materials were accessible in 88.5% (270/305) residents’s home, and 96.1% (293/305) residents knew that the fecal fluid in tank-third compartment were used as fertilizer. In 2020, the intestinal infectious diseases cost the surveyed village 81 000 Yuan, which decreased by 53.9% compared with 176 000 yuan in 2015. Conclusion During 2016 to 2020, the accomplishment of household toilet harmless-renovation reached to the defined standard of feces harmless sanitary management in rural areas of Jiangsu Province, which could be conducive to control the transmission of infectious diseases via night soil-mouth route, including intestinal parasitic diseases, as well as to improve sanitary conditions and protect people’s health.