摘要
目的了解江西省血吸虫病国家监测点疫情变化趋势,为全省血吸虫病防治工作提供科学依据。方法根据《全国血吸虫病监测方案(2014年版)》要求,在江西省39个流行县(市、区)设立国家血吸虫病监测点,于2015-2018年每年的10-11月对监测区域的本地人群、流动人群、螺情和家畜等血吸虫病传播相关因素进行监测。采用间接血凝试验对6岁以上常住居民和流动人群进行血吸虫病血清学筛査,血清学阳性者采用尼龙绢袋集卵孵化法(一粪三检)和改良加藤厚涂片法(一粪三检)进行粪检;采用塑料杯顶管孵化法(一粪三检)检测家畜血吸虫感染情况;采用解剖镜检法观察活螺感染情况,环介导等温扩增技术(LAMP)检测钉螺体内血吸虫核酸。结果2015-2018年,江西省血吸虫病国家监测点累计开展本地人群和流动人群血清学检测分别45086、31272人次,检出阳性者分别2080、556例,阳性率为4.61%、1.78%;不同年份本地人群和流动人群血检阳性率为4.01%~5.58%、1.24%~2.36%,均以2017年最髙,差异均有统计学意义(P<0.01);男性血检阳性率分别为5.41%(1251/23124)、2.15%(394/18322),均高于女性的3.77%(829/21962)、1.25%(162/12950)(P<0.01)。>55岁年龄组人群血检阳性率分别为6.22%(902/14504)、2.37%(152/6421),均高于其他年龄组(P<0.01);农、渔职业组人群血检阳性率分别为6.06%(1932/31868)、3.09%(383/12408),均髙于他职业组的1.12%(148/13218)、0.92%(173/18864)(F<0.01)。本地人群累计发现粪检阳性病例6例,男性和女性各3例,以55岁以上(5例)为主,全部为农渔职业(6例),均位于鄱阳湖周边地区;流动人口未发现粪检阳性者。2015-2018年累计监测家畜4128头,未发现粪检阳性家畜=开展钉螺调査共10510.11hm^2,査出有螺总面积2907.58 hm^2,活螺密度0.16~0.66只/(0.11m^2),LAMP检测活螺23007只,检测混合样品935管,发现阳性混合样品4管(均来自2015年庐山市新华村东乌龟洲)。结论目前我省血吸虫病传播风险仍主要集中在鄱阳湖周边地区,流行区髙危人群仍然以从事农渔职业、55岁以上、男性人群为主,血吸虫病传播风险依然存在。
Objective To understand the endemic status and epidemiological trend of schistosomiasis within national surveillance sites in Jiangxi Province so as to provide a scientific basis for the better prevention and control of schistosomiasis in the whole province.Methods According to the National Schistosomiasis Surveillance Program(2014 edition),total 39 national schistosomiasis surveillance sites were set up in 39 endemic counties(cities,districts)in Jiangxi Province to surveil the transmission and infection of schistosomiasis in local population,livestock and snails,and to investigate the factors related to the transmission during October to November,2015-2018.Indirect hemagglutination assay(IHA)was used to detect antibody against Schistosoma in local residents and mobile population with age over 6 years old within these surveillance sites.Modified Kato-Katz and egg concentrated/hatch method were used to examine the eggs in the feces of people and livestock in triplicate.Infection of snails was determined by tissue dissection under microscope and LAMP was used to detect parasite DNA.Results Total 45086 residents and 31272 mobile population in the selected schistosomiasis surveillance sites in Jiangxi Province were involved in the survey during 2015-2018,with average 4.61%(2080/45086)serological positive for residents and 1.78%(556/31272)positive for mobile population.The range of serological positive for local residents in different year was 4.01%-5.58%,and for mobile population was 1.24%-2.36%,all with highest in 2017,with statistical difference among different years(P<0.01).The serological positive rate for local resident male 5.41%(1251/23124)and mobile male 2.15%(394/18322),which were significantly higher than female residents of 3.77%(829/21962)and mobile population of 1.25%(162/12950)(P<0.01).People>55-year-old had positive serological rates of 6.22%(902/14504)for local residents and 2.37%(152/6421)for mobile population,which were higher than those of other age groups(P<0.01).The serological positive rate in farmers and fishers was 6.06%(1932/31868)for residents and 3.09%(383/12408)for mobile,which were significantly higher than those of other occupational groups of 1.12%(148/13218)and 0.92%(173/18864),respectively(P<0.01).Only 6 fecal egg positive cases was found in the local residents with 3 male and 3 female,5 of them with age over 55 years old.All of them were farmers and fishers living around Poyang Lake.No case was found in mobile population.Total 4128 livestock were monitored during 2015-2018 and no cattle was found egg positive in their fecal samples.A total of 10510.11 hrrf area were examined for snail,2907.58 hm^2 of them contained snails.The density of live snails was 0.16 to 0.66/(0.11 m^2).23007 live snails were tested by LAMP,and 935 tubes of mixed samples were detected,4 of them were positive and all from East Turtle Island,Xinhua Village,Lushan City in 2015.Conclusion At present,the risk area of schistosomiasis transmission in Jiangxi province is mainly located around Poyang Lake.Males with age over 55 engaged in agriculture and fishing work are the main risk population for Schistosoma infection.Risk of schistosomiasis transmission still remains in Jiangxi Province.In the future,the schistosomiasis monitoring system should be further strengthened and the high-risk populations in the lake area should be regularly monitored in order to achieve the goal to block the transmission of schstosomiasis in the province in near future.
作者
袁敏
李宜锋
吕尚标
胡飞
杭春琴
陈喆
林丹丹
党辉
吕山
YUAN min;LI Yi-feng;LV Shang-biao;HU fei;HANG Chun-qin;CHEN Zhe;LIN Dan-dan;DANG Hui;LV shan(Jiangxi Provincial Institute of Parasitic Diseases,Nanchang 330096,China;National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention,Chinese Center for Tropical Diseases Research,WHO Collaborating Centre for Tropical Diseases,National Center for International Research on Tropical Diseases,Ministry of Science and Technology,Key Laboratory of Parasite and Vector Biology,Ministry of Health,Shanghai 200025,China)
出处
《中国寄生虫学与寄生虫病杂志》
CAS
CSCD
北大核心
2019年第6期652-657,共6页
Chinese Journal of Parasitology and Parasitic Diseases
基金
江西省重点实验室计划项目(No.20192BCD40006)
江西省卫生计生委科技计划项目(No.20166027)~~
关键词
血吸虫病
国家监测点
疫情
江西省
Schistosomiasis
National surveillance sites
Endemic situation
Jiangxi Province
