【摘要】 目的探索以传染源控制为主的湖区血吸虫病综合防治新策略,观察其防治效果。方法在鄱阳湖区血吸虫病重度流行区进贤县三里乡爱国村、新和村和光辉村全面实施以机代牛、封洲禁牧、改水改厕和人居环境改造为主要内容的传染源控制措施,并辅以人畜化疗和健康教育,连续4年定期监测人群血吸虫和肠道寄生虫感染情况、钉螺感染率、水体危险性、虫卵对环境污染状况变化。结果综合防治措施实施4年后,人群血吸虫感染率显著下降,原属一类疫区的爱国村由试点前2004年的11.35%下降至2008年的0.18%,下降幅度为98.41%;二类疫区的新和村和三类疫区的光辉村均下降至0。人群血吸虫感染度亦呈逐渐下降趋势。人群蛔虫和鞭虫感染率分别由2005年的27.57%和61.98%下降至2008年的3.82%和7.47%。虫卵对环境的污染明显减轻。试点区草洲感染螺点数2004年为49个,2008年无感染螺点;感染螺平均密度、钉螺感染率、感染螺点数和水体危险性均大幅度下降。结论以传染源控制为主的血吸虫病综合防治措施可在短期内控制血吸虫病传染源,取得净化草洲、有效防制人群再感染的效果,亦有利于改变疫区农民的生产结构和生产方式,并减轻其他肠道寄生虫病流行。更多还原

【Abstract】 Objective To explore a comprehensive schistosomiasis control strategy with emphasis on infectious source control in lake regions and observe its effect. Methods A strategy including replacing bovine with tractors for farming,forbidding grazing on marshlands,renovating of latrines and water supply,and modifying living environment was performed in 3 heavy endemic villages of Sanli Township,Jinxian County that was located to the south of Poyang Lake,and the chemotherapy and health education in villagers was integrated as usual measures. The infection of Schistosoma japonicum and intestinal parasites in villagers,the infection of Oncomelania snails,the risk of water body and egg contamination of intestinal parasites in soil were monitored for 4 consecutive years. Results Four years after the comprehensive intervention,the infection rate of S. japonicum in villagers decreased significantly,i.e.,from 11.35% in 2004 to 0.18% in 2008 in Aiguo Village and the decreasing rate was 98.41%,while the infection rates decreased to 0 in Xinhe Village and Guanghui Village in 2008. The intensity of infection in villagers also showed a decreasing tendency. The infection rate of Ascaris lumbricoides and Trichuris trichiura dropped from 27.57% and 61.98% in 2004 to 3.82% and 7.47% in 2008,respectively in these villages. The egg contamination of intestinal parasites to soil was significantly lightened. It was also observed that the mean density of infected snails,the infection rate of snails,the number of spots with infected snails reduced on marshlands of the controlled area. Conclusions The comprehensive schistosomiasis control strategy can achieve a thorough control of infectious source of S. japonicum and thus get the effects on clearance of marshland and prevention of re-infection in human populations. The strategy also has advantages of improving the structure and mode of production in endemic villages as well as reducing the prevalence of intestinal parasites.更多还原