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。

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.