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目的了解淮河入江水道上段血吸虫病潜在流行因素和传播风险。方法采取查阅文献、现场勘察法了解淮河入江水道上段布局、水位变化、行洪情况。采取系统抽样结合环境抽样法对淮河入江水道上段内的5个固定点和5个可疑环境点开展钉螺监测:在金湖站采用网捞法和稻草帘诱螺法开展钉螺扩散监测。采用胶体染料试纸条法对淮河入江水道上段内的渔船民和集散地人员进行血吸虫病监测,阳性者采用Kato-Katz法(1粪3检)进行血吸虫病原学检查。采用问卷法对受检人员开展人口学特征和相关因素调查。结果淮河入江水道上段年均行洪4.84次93.62 d,具有“冬陆夏水”的特征。2012—2014年共调查有螺面积1 256.68 ha(1 ha=10 000 m~2),查螺127035框,工日1 528个,打捞漂浮物1 470 kg,投放稻草帘320块,调查119条船,结果均未发现钉螺。血清学检测1 809人,胶体染料试纸条法(dipstick dye immunoassay,DDIA)检测阳性23人,阳性率为1.27%。其中,检测渔船民1 509人,阳性率为1.26%;检测施工、种植、养殖等人员300人,阳性率为1.33%,两者间差异无统计学意义(χ~2=0.01,P>0.05)。男性阳性率1.38%,女性阳性率1.08%,两者间差异也无统计学意义(χ~2=0.28,P>0.05)。阳性者主要集中在20~60年龄组,各年龄组间差异无统计学意义(χ~2=1.80,P>0.05)。粪检21例,未发现血吸虫病患者。不同文化程度人群的DDIA阳性率差异无统计学意义(χ~2=2.85,P>0.05)。1 623人有疫区工作史,占调查人数的67.61%;21人有既往病史,占调查人数的1.16%;血防知识知晓率为61.63%,渔船民的知晓率显著高于其他人群(χ~2=16.13,P<0.01)。结论淮河入江水道上段(新三河)存在血吸虫病传播因素,为血吸虫病潜在流行区,需建立长期的血吸虫病监测预警体系,开展血吸虫病传播风险的监测。
Objective To understand the potential epidemic factors and risk of schistosomiasis in the upper reaches of the Huaihe River. Methods to access the literature, on-site survey to understand the layout of the upper reaches of the Huaihe River, water level changes, flood situation. The snail monitoring was carried out on five fixed points and five suspicious environmental points in the upper section of the Huaihe River in the upper reaches of the Huaihe River by systematic sampling and environmental sampling method. Snail diffusion monitoring was conducted at Jinhu Station by using the net fishing method and straw curtain lure method. Schistosomiasis surveillance was carried out by using the colloidal dye test strip method on the fishermen and distribution centers in the upper section of the Huaihe River and the positive were tested for schistosomiasis using the Kato-Katz method (1 manure 3). Questionnaire on the demographic characteristics of subjects and related factors survey. Results The upper reaches of the Huaihe River into the waterway averaged 4.84 times per flood 93.62 d, with “winter land and summer water” features. A total of 1 256.68 ha (1 ha = 10 000 m ~ 2) snail area, 1,27035 snail shells and 1 528 working days were collected from 2012 to 2014. Salvage floating objects amounted to 1 470 kg, and 320 rice straw curtains were put into place for investigation. 119 Ship, the results were not found snails. A total of 1 809 serological tests were performed. The positive rate of dipstick dye immunoassay (DDIA) was 23 and the positive rate was 1.27%. Among them, 1,509 were detected in fishing boat population, the positive rate was 1.26%; 300 were detected in construction, planting and breeding, the positive rate was 1.33%, there was no significant difference between them (χ ~ 2 = 0.01, P> 0.05 ). The positive rate of males was 1.38%, and the positive rate of females was 1.08%. There was also no significant difference between them (χ ~ 2 = 0.28, P> 0.05). Positives mainly concentrated in the 20-60 age group, with no significant difference among all age groups (χ ~ 2 = 1.80, P> 0.05). 21 cases of fecal examination, no schistosomiasis patients were found. There was no significant difference in DDIA positive rate among different educational level (χ ~ 2 = 2.85, P> 0.05). 1 623 people have the history of the epidemic area, accounting for 67.61% of the surveyed population; 21 have a history of past illness, accounting for 1.16% of the surveyed population; knowledge of blood-borne knowledge is 61.63% and the awareness of fishing boat people is significantly higher than other groups (χ ~ 2 = 16.13, P <0.01). Conclusion The schistosomiasis transmission factor exists in the upper section of the Huaihe River intake (Xin Sanhe) and is a potential epidemic area for schistosomiasis. It is necessary to establish a long-term monitoring and warning system for schistosomiasis and monitor the risk of transmission of schistosomiasis.