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目的了解湖沼型地区血吸虫病疫情状况及其影响因素,为研究相应的防治策略及有效干预措施提供参考。方法在洞庭湖及长江中游5个湖沼型县市采用分层整群随机抽样方法选取22个乡镇121个血吸虫病流行村为监测点,调查区域内的地理环境、人畜感染状况、家畜饲养方式、垸内外钉螺分布及相关影响因素,分析血吸虫病疫情变化及其原因。结果 2012-2013年5个县市共调查6~65岁常住居民119 708人次、耕菜牛(主要传染源)19 828头次、钉螺孳生环境21 033.92hm2次,至2013年,监测区域内人畜平均感染率分别为0.85%和0.48%,未发现感染性钉螺,较2012年分别下降了32.98%、64.55%和100.0%,疫情比往年有明显下降(P<0.05),但仍高于同年全国其他地区。影响血吸虫病的主要因素仍是敞放于有螺地带的家畜(R复相关=0.64,P<0.05)以及疫水接触频率较高的职业人群(RR=1.75)。结论湖沼型地区仍是今后一个时期内血吸虫病防治的重点,需继续加强以家畜传染源控制为主、查治病、查灭螺等综合性防治措施。
Objective To understand the epidemic situation of schistosomiasis and its influencing factors in lake-marsh area, and to provide reference for the corresponding prevention and cure strategies and effective intervention measures. Methods A total of 121 schistosomiasis endemic villages in 22 towns and townships were selected as the monitoring points by stratified cluster random sampling in 5 lakeshore counties in the middle reaches of the Yangtze River. The geographical environment, the status of human and animal infections, the ways of raising livestock, The distribution of snails in and outside the embankment and related influential factors, analysis of the epidemic situation of schistosomiasis and its causes. Results From 2012 to 2013, 5 counties and cities surveyed 119 708 permanent residents aged 6 ~ 65 and 19 828 crab grazing (main source of infection), and 21 033.92hm2 environment of Oncomelania were investigated. By 2013, the average human and livestock in the monitoring area The infection rates were 0.85% and 0.48% respectively. No infectious snails were found, which decreased by 32.98%, 64.55% and 100.0% respectively compared with that in 2012. The outbreaks were significantly lower than those in previous years (P <0.05) area. The main factors influencing schistosomiasis were still remained in the snail zone (R complex correlation = 0.64, P <0.05) and the occupational population with high contact frequency (RR = 1.75). Conclusion Lake marsh area is still the focus of prevention and treatment of schistosomiasis in a period in the future. It is necessary to continue to strengthen the comprehensive prevention and control measures based on the control of livestock sources of infection, investigation and treatment of diseases and check snails.