【摘要】 山东省黑热病于1958年达到基本消灭后,坚持监测,继续防治,自1972年以来仅查见18例因长期误诊或治而未愈的残余病人,未再出现新感染的患者;白蛉显著减少,在85%的村庄已告绝迹。为了对防治效果作进一步的评价,1989年在13个地(市)、24个县(市区)的78个乡镇进行了免疫学监测,对10239名农村居民作利什曼素皮内试验(LDT),结果30岁以下人群无1例阳性反应(0/8020),30岁以上的居民阳性率平均为4.42%(98/2219),显示黑热病的传播早已得到有效的控制。在作LDT的人群中,对1232人同时采血作间接荧光抗体试验(IFAT),结果均为阴性。更多还原

【Abstract】 Kala-azar used to be highly prevalent in Shandong Province. According to the survey made in 1950,the average prevalence rate was 350 per 100 000. Through mass treatment and sandfly control,the prevalenc rate was brought down to 3 per 100 000 in 1958 and the disease was basically eliminated. Since 1972, only 18 residual patients have been detected and no more newly infected case has occured. In the meantime, the vector density has been reduced to such a low level that sandflies could not be found in 85% of the villages. For further evaluation of the control measures, an immunological survey on a relatively large scale was conducted in 1989 in 78 townships located in 24 counties of 13 prefectures and cities. A total of 10239 rural residents of different age had received leishmanin dermal test(LDT). None of the people under 30 years of age was positive(0/8020) , while in the people above 30 the average positive rate was 4. 4%(98/2219). This indicates that the transmission of Kala-azar has been completely interrupted since early 1960s and the province has now turned to be a non-endemic area of kala-azar. Further analysis of the data shows that LDT is of great value in the epidemiological investigation of kala-azar for the evaluation of control measures as well as for the ascertainment of past and present status of the disease and detection of subclinical infections. During the survey,blood samples were also taken from 1232 people for indirect fluorescent antibody test (IFAT). Results were all negative although 19 of them showed positive LDT. In addition, 137 previous kala-azar patients cured 2-51 years ago were examined with both LDT and IFAT through house visit, we found that the fluorescent antibodies persist after cure for about 12 years and can not be detected in all the people cured for longer than 15 years. In contrast, most of these people give positive reaction to LDT and the test is still positive in a man who had kala-azar and was cured 51 years ago. Obviously, IFAT is not so useful as LDT for epidemiological investigation or surveillance of kala-azar in areas where the disease has long been brought under control.更多还原