2013-2017年武汉市血吸虫病监测点疫情分析
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摘要
目的分析武汉市2013-2017年血吸虫病监测点疫情动态趋势,为科学制定防治措施提供依据。方法收集全市12个血吸虫病流行区的28个监测点人群、家畜查治病和钉螺、野粪监测数据进行统计分析。结果 2013-2017年本地居民累计血检76 824人,阳性1 470人,1 462名粪检,粪检阳性33人,各年人群感染率分别为0. 13%、0. 05%、0. 03%、0%、0%;血检阳性率分别为1. 77%、1. 72%、2. 39%、2. 23%和1. 48%,下降16%; 2015年5例粪阳病人全部为垸内型,2016年、2017年血阳率垸内亚型大于垸外(χ~2=88. 69,P <0. 001),2013-2015年粪阳与2016-2017年血阳人群年龄主要集中于50岁以上,职业主要集中于农民和渔船民。连续5年未发现阳性家畜。全市未发现感染性钉螺,活螺平均密度由0. 048降至0. 032只/框,垸外洲滩亚型由0. 21逐年降至0. 018只/框,垸内亚型呈波浪状起伏; 2015-2017年垸内有螺框出现率高于垸外(χ~2=200. 61,P <0. 001)。未发现阳性野粪。结论武汉市血吸虫病疫情平稳下降,人、畜、螺疫情处于低流行状态,今后应继续筑牢防控监测体系,并加强对重点地区、重点人群的管控力度。
Objective To analyze the dynamic trend of the schistosomiasis surveillance sites in Wuhan from 2013 to 2017,so as to provide scientific basis for devising control strategies. Methods Twenty-eight administrative divisions which covered the whole city were selected as surveillance sites,and then analyzed the data of residents and livestock,wild manure and the distribution of snails. Results From 2013 to 2017,a total of 76824 residents received indirect hem agglutination( IHA) test with 1470 showing positive results,and 1462 received etiological test with 33 showing infections. The infection rate of each year was 0. 13%,0. 05%,0. 03%,0%,0%,respectively,and positive antibody rate of blood test was 1. 77%,1. 72%,2.39%,2. 23%,1. 48%,respectively. 5 patients all belonged to inside embankment in 2015. From 2016 to 2017,inside embankments were higher than marshland types at antibody positive rate level( χ~2= 88. 69,P < 0. 001). The fecal positives from 2013 to 2015 and the positive antibody populations from 2016 to 2017 were mainly concentrated in the age of 50 or older.The occupations were mainly concentrated in farmers and fishermen. All of cattle received etiological test and showed negative results in 2013 ~ 2017. No infectious snails were found,and the average density of the live snails was declined from 0. 048 to0. 032 per frame. The subtype of outer continental flats of embankment decreased from 0. 21 to 0. 018 snails per frame year by year,and the subtype of inner embankment fluctuated in waves. Inside embankments were higher than marshland types at rate of frames with snails( χ~2= 200. 61,P < 0. 001) with no positive wild manure. Conclusion There is a trend to decline steadily at schistosomiasis in Wuhan,and the epidemic situations of human beings,livestock and snails are in a low epidemic state. In the future,the prevention and control monitoring system should be built,and the control of key areas and key populations should be strengthened.
Objective To analyze the dynamic trend of the schistosomiasis surveillance sites in Wuhan from 2013 to 2017,so as to provide scientific basis for devising control strategies. Methods Twenty-eight administrative divisions which covered the whole city were selected as surveillance sites,and then analyzed the data of residents and livestock,wild manure and the distribution of snails. Results From 2013 to 2017,a total of 76824 residents received indirect hem agglutination( IHA) test with 1470 showing positive results,and 1462 received etiological test with 33 showing infections. The infection rate of each year was 0. 13%,0. 05%,0. 03%,0%,0%,respectively,and positive antibody rate of blood test was 1. 77%,1. 72%,2.39%,2. 23%,1. 48%,respectively. 5 patients all belonged to inside embankment in 2015. From 2016 to 2017,inside embankments were higher than marshland types at antibody positive rate level( χ~2= 88. 69,P < 0. 001). The fecal positives from 2013 to 2015 and the positive antibody populations from 2016 to 2017 were mainly concentrated in the age of 50 or older.The occupations were mainly concentrated in farmers and fishermen. All of cattle received etiological test and showed negative results in 2013 ~ 2017. No infectious snails were found,and the average density of the live snails was declined from 0. 048 to0. 032 per frame. The subtype of outer continental flats of embankment decreased from 0. 21 to 0. 018 snails per frame year by year,and the subtype of inner embankment fluctuated in waves. Inside embankments were higher than marshland types at rate of frames with snails( χ~2= 200. 61,P < 0. 001) with no positive wild manure. Conclusion There is a trend to decline steadily at schistosomiasis in Wuhan,and the epidemic situations of human beings,livestock and snails are in a low epidemic state. In the future,the prevention and control monitoring system should be built,and the control of key areas and key populations should be strengthened.
引文
[1]李洋,罗华堂,周水茂,等. 2005-2014年武汉市血吸虫病监测点疫情分析[J].医学动物防制,2016,32(7):823-825,828.
[2]杨军晶,周晓蓉,代凌峰,等. 2016年湖北省血吸虫病监测点疫情分析.热带医学杂志,2017,17(6):818-820,827.
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[4]金嘉宁,党辉,张利娟,等. 2016年全国血吸虫病监测点疫情分析[J].中国寄生虫学与寄生虫病杂志,2017,35(6):542-548.
[5]单晓伟,蔡顺祥,刘建兵,等. 2009-2014年湖北省血吸虫病监测点疫情分析[J].热带医学杂志,2016,16(11):1448-1451.
[6]曹淳力,鲍子平,严俊,等. 2007-2014年湖北省血吸虫病传染源综合治理效果分析[J].现代预防医学,2016,43(8):1429-1431,1435.
[7]郑敬环,彭介入,蒲晨,等.广汉市血吸虫病健康教育效果分析[J].现代预防医学,2017(22):4139-4142.
[8] Zhou XN,Xu J,Chen HG,et al. Tools to support policy decisions related to treatment strategies and surveillance of Schistosomiasis japonica towards elimination[J]. PLOS Neglected Tropical Diseases,2011,5(12):e1408.
[9]曹淳力,鲍子平,沈利,等.流动人口血吸虫病防治知识及行为分析[J].现代预防医学,2014,41(23):4317-4320.
[10]神学慧,傅忠宇,戴建荣,等.羊在日本血吸虫病传播中的作用Ⅵ:基于消除感染性羊阻断血吸虫病传播的实例[J].中国热带医学,2017,17(5):464-469.
[11]单晓伟,蔡顺祥,周晓蓉,等. 2009-2014年湖北省血吸虫病监测点螺情分析[J].中国血吸虫病防治杂志,2016,28(3):234-236,280.
[12]李洋,王浩,罗华堂,等.湖沼型血吸虫病流行区应对特大洪涝灾害措施及成效[J].热带病与寄生虫学,2017,15(3):161-163.
[13]黄轶昕,孙乐平,洪青标,等.洪涝灾害后长江下游洲滩钉螺消长和扩散趋势纵向观察[J].中国血吸虫病防治杂志,2004,16(4):253-256.
[14]曹淳力,李石柱,周晓农.特大洪涝灾害对我国血吸虫病传播的影响及应急处置[J].中国血吸虫病防治杂志,2016,28(6):618-623.
[15] Spear RC,Seto EY,Carlton EJ,et al. The challenge of effective surveillance in moving from low transmission to elimination of schistosomiasis in China[J]. International Journal for Parasitology,2011,41(12):1243-1247.
[2]杨军晶,周晓蓉,代凌峰,等. 2016年湖北省血吸虫病监测点疫情分析.热带医学杂志,2017,17(6):818-820,827.
[3]长江日报.我市12个血吸虫疫区已提前一年实现目标[EB/OL].[2018-09-05]. http://www. wuhan. gov. cn/whszfwz/xwxx/whyw/201802/t20180227_187800. html.
[4]金嘉宁,党辉,张利娟,等. 2016年全国血吸虫病监测点疫情分析[J].中国寄生虫学与寄生虫病杂志,2017,35(6):542-548.
[5]单晓伟,蔡顺祥,刘建兵,等. 2009-2014年湖北省血吸虫病监测点疫情分析[J].热带医学杂志,2016,16(11):1448-1451.
[6]曹淳力,鲍子平,严俊,等. 2007-2014年湖北省血吸虫病传染源综合治理效果分析[J].现代预防医学,2016,43(8):1429-1431,1435.
[7]郑敬环,彭介入,蒲晨,等.广汉市血吸虫病健康教育效果分析[J].现代预防医学,2017(22):4139-4142.
[8] Zhou XN,Xu J,Chen HG,et al. Tools to support policy decisions related to treatment strategies and surveillance of Schistosomiasis japonica towards elimination[J]. PLOS Neglected Tropical Diseases,2011,5(12):e1408.
[9]曹淳力,鲍子平,沈利,等.流动人口血吸虫病防治知识及行为分析[J].现代预防医学,2014,41(23):4317-4320.
[10]神学慧,傅忠宇,戴建荣,等.羊在日本血吸虫病传播中的作用Ⅵ:基于消除感染性羊阻断血吸虫病传播的实例[J].中国热带医学,2017,17(5):464-469.
[11]单晓伟,蔡顺祥,周晓蓉,等. 2009-2014年湖北省血吸虫病监测点螺情分析[J].中国血吸虫病防治杂志,2016,28(3):234-236,280.
[12]李洋,王浩,罗华堂,等.湖沼型血吸虫病流行区应对特大洪涝灾害措施及成效[J].热带病与寄生虫学,2017,15(3):161-163.
[13]黄轶昕,孙乐平,洪青标,等.洪涝灾害后长江下游洲滩钉螺消长和扩散趋势纵向观察[J].中国血吸虫病防治杂志,2004,16(4):253-256.
[14]曹淳力,李石柱,周晓农.特大洪涝灾害对我国血吸虫病传播的影响及应急处置[J].中国血吸虫病防治杂志,2016,28(6):618-623.
[15] Spear RC,Seto EY,Carlton EJ,et al. The challenge of effective surveillance in moving from low transmission to elimination of schistosomiasis in China[J]. International Journal for Parasitology,2011,41(12):1243-1247.