CAJ | 학술논문

目的：探索高邮市新民滩血吸虫病疫情变化规律，为湖沼型血吸虫病流行区防治工作提供科学依据。方法收集高邮市新民滩1970—2008年血吸虫病防治工作数据以及与防治相关的当地重大历史事件，分析有螺面积、有螺框出现率、活螺平均密度，以及人畜粪检阳性率和免疫学阳性率的变化，对不同阶段血吸虫病防治与流行规律进行综合分析。结果在疫情控制（1970—1975年）、传播控制（1976—1994年）、传播阻断（1995—2008年）阶段中，防治措施从普查普治调整为综合治理、分类查治，人畜血吸虫病患病率及血清学阳性率均显著下降，但钉螺情况的指标出现反复回升。在三个阶段中，有螺面积占调查面积的比例最大值分别为79.42%、30.30%、8.10%；有螺框出现率最大值分别为10.48%、2.97%、1.45%；活螺平均密度最大值分别为0.6123只/0.1 m2、0.3284只/0.1 m2、0.0773只/0.1 m2。在实现传播控制后第12年（1988年）螺情出现回升，在实现传播阻断后第6年（2001年）螺情出现回升。1970年人群粪检阳性率最高，达35.98%（1505/4183）；1975年下降至3.76%（261/6940）；此后逐年下降，1984年为0（0/581）。人群血吸虫抗体水平总体呈下降趋势，环卵沉淀试验（circumoval precipitin test， COPT）阳性率在1984年最高，为8.97%（200/2230），1995年为0.26%（6/2300），2004年降为0（0/711），至2008年连续25年（1984—2008年）未发现粪检阳性血吸虫病患者。结论要对湖沼型血吸虫病流行区适时因地制宜地改进防治措施，加强联防联控与疫情预警监测，防止螺情回升。
목적：탐색고유시신민탄혈흡충병역정변화규률，위호소형혈흡충병류행구방치공작제공과학의거。방법수집고유시신민탄1970—2008년혈흡충병방치공작수거이급여방치상관적당지중대역사사건，분석유라면적、유라광출현솔、활라평균밀도，이급인축분검양성솔화면역학양성솔적변화，대불동계단혈흡충병방치여류행규률진행종합분석。결과재역정공제（1970—1975년）、전파공제（1976—1994년）、전파조단（1995—2008년）계단중，방치조시종보사보치조정위종합치리、분류사치，인축혈흡충병환병솔급혈청학양성솔균현저하강，단정라정황적지표출현반복회승。재삼개계단중，유라면적점조사면적적비례최대치분별위79.42%、30.30%、8.10%；유라광출현솔최대치분별위10.48%、2.97%、1.45%；활라평균밀도최대치분별위0.6123지/0.1 m2、0.3284지/0.1 m2、0.0773지/0.1 m2。재실현전파공제후제12년（1988년）라정출현회승，재실현전파조단후제6년（2001년）라정출현회승。1970년인군분검양성솔최고，체35.98%（1505/4183）；1975년하강지3.76%（261/6940）；차후축년하강，1984년위0（0/581）。인군혈흡충항체수평총체정하강추세，배란침정시험（circumoval precipitin test， COPT）양성솔재1984년최고，위8.97%（200/2230），1995년위0.26%（6/2300），2004년강위0（0/711），지2008년련속25년（1984—2008년）미발현분검양성혈흡충병환자。결론요대호소형혈흡충병류행구괄시인지제의지개진방치조시，가강련방련공여역정예경감측，방지라정회승。
Objective To explore the pattern of schistosomiasis endemic changes so as to provide sci-entific basis for schistosomiasis control in lake and marshland regions. Methods The data from 1970-2008 reflecting the prevention and control activities in Xinmin Beach of Gaoyou City and important historical events related with schistosomiasis control were collected retrospectively. The patterns of control and epidemiology of schistosomiasis at various control stages were comprehensively analyzed through calculating the snails infested areas, percentage of frame with snails, average density of living snails, stool positive rates and immunological rates in human beings etc. Results Control measures were adjusted from general survey and treatment to integrated control, classified survey and treatment in different stages of infection control (1970-1975), trans-mission control(1976-1994) and transmission interruption(1995-2008), resulting in the significant reduction of prevalence rates of schistosomiasis both in human beings and livestock as well as the serological positive rate in human beings. However, the indicators of snails rebounded repeatedly. During these three stages, the largest ratio of detected snails areas accounting for surveyed areas were 79.42%, 30.30%, 8.10%, respectively, while the maximum value of percentage of frame with snails and average density of living snails were 10.48%, 2.97%, 1.45% respectively and 0.612 3 snails per 0.1 m2, 0.328 4 snail per 0.1 m2, 0.077 3 snails per 0.1 m2 respectively. Indicators of snails were rebounded in 1998 (12 years after reaching transmission control crite-ria) and 2001(6 years after interruption the transmission of schistosomiasis). The stool positive rate in human beings was 35.98%(1 505/4 183) in 1970, reaching the highest level, and decreased to 3.76%(261/6 940) in 1976. Since 1984, no stool positives were found. The antibody positive rates determined by circumoval precip-itin test presented a decreasing trend, from 8.97%(200/2 230) in 1984 to 0.26%(6/2 300) in 1995 and then 0(0/711) in 2004. Conclusion Appropriate interventions should be adjusted and implemented adapting to local setting and control stages. To prevent snails rebound, cooperative prevention and control and surveillance should be strengthened.