【摘要】 目的了解鄱阳湖区血吸虫病流行特征,为制定血吸虫病防治对策提供科学依据。方法回顾性收集环鄱阳湖地区血吸虫病监测点2010-2019年的监测数据,分析该地区及南湖区和北湖区血吸虫病流行特征。结果 2010-2019年,鄱阳湖区设立了12个国家级血吸虫病监测点（其中南湖区8个、北湖区4个）。监测点本地居民、钉螺的血吸虫感染率分别从2010年的0.79%、0.15%下降至2019年的0,本地居民及钉螺感染率总体呈逐年下降趋势(Z_居民=168.427,Z_钉螺=47.394,P均=0.000);其中南湖区和北湖区居民血检阳性率、感染率随年间变化均呈逐年下降趋势(Z_{南湖区血检阳性率}=530.304,Z_{北湖区血检阳性率}=240.496;Z_{南湖区感染率}=103.404,Z_{北湖区感染率}=89.938,P均=0.000)。进一步分析显示,北湖区的居民血检阳性率和感染率总体均高于南湖区,差异有统计学意义(χ_{血检阳性率}²=42.776,P<0.01;χ_感染率²=5.403,P<0.05);南湖区和北湖区的家畜粪检阳性率分别为2.92%～3.66%和1.45%～10.29%,两者差异无统计学意义（χ²=0.108,P> 0.05）;北湖区总的查出有螺面积比、平均有螺框出现率、平均活螺密度分别为69.32%、15.98%和0.76只/0.1 m²,南湖区分别为42.08%、3.31%和0.05只/0.1 m²,均以北湖区为较高,差异均有统计学意义(Z_{有螺面积比}=-2.497,P<0.05;Z_{有螺框出现率}=-2.497,P<0.05;Z_活螺密度=-2.803,P<0.01)。结论鄱阳湖区血吸虫病流行水平总体呈下降趋势,但流行因素依然存在,且北湖区的流行水平高于南湖区。今后应继续加强该地区血吸虫病流行与传播特征的监测,为精准防控血吸虫病提供依据。更多还原

【Abstract】 Objective To investigate the epidemiological characteristics of schistosomiasis in the Poyang Lake area, so as to provide a scientific basis for the development of the schistosomiasis control strategy. Methods The data pertaining to the surveillance of schistosomiasis in the national surveillance sites around the Poyang Lake areas from 2010 to 2019 were retrospectively collected, and the epidemiological characteristics of schistosomiasis were analyzed around the Poyang Lake areas and in southern and northern regions of the Poyang Lake. Results A total of 12 national schistosomiasis surveillance sites were assigned in Poyang Lake regions from 2010 to 2019, including 8 sites in southern regions and 4 in northern regions. The schistosomiasis infection rate of local residents, domestic and snails in the monitoring sites dropped from 0.79%, and 0.15% in 2010 to 0 in 2019. The infection rate of local residents and snails showed an overall downward trend(Z_esident=168.427, Z_snail=47.394, P_both=0.000); the positive rate of blood test of residents in northern and southern regions of the Poyang Lake show a downward trend year by year(Z_south=530.304,Z_north=240.496, P_both= 0.000), the positive rate of the infection rate of residents in northern and southern regions of the Poyang Lake region showed a downward trend year by year(Z_south=103.404, Z_north=89.938,P_both=0.000). The overall sero-prevalence and prevalence of human S. japonicum infectionswere both higher in northern regions than in southern regions of the Poyang Lake region（χ²=42.776, P<0.01; χ²=5.403, P<0.05）, and there was no significant difference in the egg-positive rate of livestock between southern（2.92% to 3.66%） and northern regions（1.45% to 10.29%） of the Poyang Lake region（χ²= 0.108, P<0.05）. In addition, there were significant differences between northern and southern regions of the Poyang Lake region in terms of the proportion of settings detected with snails（69.32% vs. 42.08%, Z =-2.497, P<0.05）, mean occurrence of frames with snails（15.98% vs. 3.31%, Z =-2.497, P<0.05）, and means density of living snails（0.76 snails/0.1 m² vs. 0.05 snails/0.1 m², Z =-2.803, P<0.05）. Conclusion The prevalence of schistosomiasis appears an overall tendency towards a decline in the Poyang Lake region; however, the epidemic factors of schistosmiasis remain, and the prevalence of schistosomiasis is higher in northern regions than in southern regions of the Poyang Lake region. The epidemiological and transmission characteristics of schistosomiasis should be further intensified in the Poyang Lake region to provide insights into precision schistosomiasis control.更多还原