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目的对西干渠流域水利血防综合治理后疫情变化进行效果评估,为垸内型血吸虫病流行区防治策略实施提供参考。方法江陵县西干渠流域500 m内进行支渠水利血防治理的31个行政村为观察村,500 m外的未进行水利血防治理的167个村为对照村。有螺河道水利血防治理采取先药物灭螺,再开挖疏浚并修建沉螺池。收集2006—2014年年报资料及各类防治资料,分析人、畜、螺感染率等疫情指标。结果江陵县2005年人、畜血吸虫病感染率11.83%、6.11%,钉螺感染率0.4187%。自水利血防综合治理工程实施起,完成药物浸杀灭螺38050ha(1 ha=10000m~2),河道疏挖4 576400m~3,开新填旧完成土方开挖187 000 m~3、回填151 200 m~3。修建沉螺池12座,硬化渠道12 km。2006—2014年观察村人、畜血吸虫病感染率分别从2006年的4.39%、11.75%下降至2014年的0.50%、0,降幅达88.56%、100%。观察村2011年阳性钉螺面积21 600 m~2,较2006年降幅达94.46%(2.16/39.00)。观察村2006—2009年人群感染率与对照村人群感染率差异有统计学意义(χ~2=64.06、52.94、36.01、6.96,P值均<0.01),观察村人群血吸虫病感染率高于对照村。2010年后人群血吸虫病感染率差异没有统计学意义(χ~2=2.33、0.30、0.59,P值均>0.05)。2006—2008年观察村与对照村钉螺感染率差异有统计学意义(χ~2=827.48、395.68、164.88、6.96,P值均<0.01),观察村钉螺感染率为0.522 1%、0.283 3%、0.1670%,明显高于对照村的0.159 8%、0.088 5%、0.064 3%。项目竣工后2009—2011年观察村与对照村钉螺感染率差异有统计学意义(χ~2=37.45、9.35、33.65,P值均<0.01),观察村钉螺感染率0.044 8%、0.045 4%、0.007 0%,明显低于对照村的0.097 1%、0.065 9%、0.033 0%。结论在垸内型血吸虫病流行区对主要灌溉水系进行水利血防综合治理,这对控制血吸虫病疫情起到重要作用。
Objective To evaluate the effect of epidemic situation after the comprehensive management of water conservancy and bloodstain in the West River Drainage Basin, and provide references for the implementation of the prevention and control strategies in the epidemic area of endogenous schistosomiasis. Methods Thirty-one administrative villages within 500 m of watercourse control of branches and drains in the Qianjiang Canal drainage area of Jiangling County were observed villages and 167 villages without irrigation and blood-pressure control within 500 m were selected as control villages. Youluo water and blood prevention and treatment take the first drug snail, and then dredging excavation and construction of sink pool. Collect information of 2006-2014 annual report and various prevention and treatment data to analyze epidemic index such as human, livestock and snail infection rate. Results In Jiangling County, infection rates of schistosomiasis in humans and animals in 2005 were 11.83% and 6.11%, respectively, and the infection rates of snails were 0.4187%. Since the implementation of the project on prevention and control of water, flood and disease, the completion of the project has completed the project of snailing and snailing the soil with a dip of 38050ha (1 ha = 10000m ~ 2) and dredging 4 576400m ~ 3. m ~ 3. Build Shen pool 12, hardened channel 12 km. In 2006-2014, the prevalence of schistosomiasis in the villages dropped from 4.39% and 11.75% in 2006 to 0.50% and 0% in 2014, respectively, with a decrease of 88.56% and 100% respectively. In 2011, the positive snail area in observation village was 21 600 m 2, down 94.46% (2.16 / 39.00) from 2006. The infection rate of crowd infection in observation village from 2006 to 2009 was statistically significant (χ ~ 2 = 64.06,52.94,36.01,6.96, P <0.01), and the prevalence of schistosomiasis in observation group was higher than that in control group village. There was no significant difference in the infection rate of schistosomiasis among the population after 2010 (χ ~ 2 = 2.33,0.30,0.59, P> 0.05). The infection rates of snails in observed and control villages in 2006-2008 were significantly different (χ ~ 2 = 827.48,395.68,164.88,6.96, P <0.01). The infection rates of snails were 0.522 1%, 0.283 3% , 0.1670%, significantly higher than the control village 0.159 8%, 0.088 5%, 0.064 3%. After the project was completed, the infection rates of snail in observation village and control village from 2009 to 2011 were significantly different (χ ~ 2 = 37.45,9.35,33.65, P <0.01), and the infection rates of snails were 0.044 8% and 0.045 4% , 0.007 0%, which is obviously lower than 0.097 1%, 0.065 9% and 0.033 0% of the control villages. Conclusions In the endemic area of embankment-type schistosomiasis, comprehensive management of water, blood and flood control is carried out on major irrigation water systems, which plays an important role in controlling the epidemic situation of schistosomiasis.