目的 了解湖北省20个血吸虫病规范化实验室开展血吸虫病病原学检测水平,评价尼龙绢集卵孵化法和改良加藤厚涂片法(Kato-Katz法)现场检测效果,为提高血吸虫病监测体系敏感性提供技术支撑.方法 由湖北省血吸虫病诊断参比实验室统一制作血吸虫虫卵孵化质控品和Kato-Katz质控品,采用随机编号的方式分发给湖北省20个血吸虫病规范化实验室.采用单盲法检测,比较检测结果与标准结果的符合率、误诊率和漏诊率.结果 湖北省20个血吸虫病规范化实验室共检测质控品200份(阳性90份,阴性110份),检出阳性88份,阴性112份,总符合率91.00％(182/200),总误诊率7.27％(8/110),总漏诊率11.11％(10/90),检测结果与标准结果比较,差异有统计学意义(x2=133.819,P＜0.01).20个血吸虫病检测实验室中有6个出现误诊,占30.00％;有7个出现漏诊,占35.00％.尼龙绢集卵孵化法和Kato-Katz法两个检测项目的符合率分别为99.00％和83.00％,Kato-Katz法误诊率和漏诊率高于尼龙绢集卵孵化法,差异均有统计学意义(x2=10.353、5.406,P均＜0.05).洲滩型、垸内型和丘陵型3类地区病原学检测误诊率和漏诊率的差异无统计学意义(P均＞0.05).传播阻断和消除2类流行地区误诊率分别为8.96％和5.88％,误诊率差异无统计学意义(P＞0.05);漏诊率分别为7.55％和30.77％,漏诊率差异有统计学意义(x2=5.285,P＜0.05).结论 湖北省血吸虫病规范化实验室病原学检测存在误诊、漏诊现象,Kato-Katz法检测水平有待进一步提高.

目的 探究日本血吸虫毛蚴感染对湖北钉螺生存及抗氧化酶系统的影响.方法 实验组按钉螺与毛蚴数量比为1:10的比例感染钉螺,同时设对照组(未感染毛蚴的阴性钉螺),各设3组平行.在感染后的0、6、12、24、48、72 h和1、2、4、6、8、12周检测钉螺软组织中的超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和过氧化物酶(POD)活性及丙二醛(MDA)的含量,同时记录钉螺存活情况至感染后15周.结果 感染毛蚴后,每周实验组钉螺死亡率均高于对照组,至15周时实验组和对照组累计死亡率分别为43.60％和5.93％.钉螺的抗氧化酶活性均呈先上升后下降趋势:SOD活性在24 h开始高于对照组,且差异有统计学意义(P<0.05),在第4周达到最大值,第6周开始趋近于对照组水平;CAT和POD活性在72 h时开始与对照组差异有统计学意义(P均<0.01),分别于第1周和第2周达到峰值,均于第4周时趋近于对照组水平.实验组MDA含量呈持续升高趋势,与对照组相比,自第2周开始差异有统计学意义(P均<0.01).结论 毛蚴感染能够诱导钉螺产生氧化应激反应,感染早期钉螺能够通过增加体内抗氧化酶活力来缓解毛蚴感染的胁迫压力,但随着时间延长,氧化胁迫逐渐超出机体调节能力,机体出现氧化损伤,并最终导致钉螺死亡.

目的 了解湖北省60家血吸虫病规范化实验室病原学检测水平,评价尼龙绢集卵孵化法现场检测效果,为提高全省基层血防专业技术人员检测检验能力提供参考依据.方法 将日本血吸虫尾蚴采用腹部贴片法感染日本大耳兔[(1500±100)条/兔],感染后40 d,取肝脏,分离虫卵,制备虫卵悬液.取1 ml虫卵悬液孵化并计数,将虫卵悬液密度调配成每毫升能孵化出(50±10)只毛蚴,再将部分悬液稀释至2倍与4倍的体积,制备成强阳性、阳性、弱阳性等3种虫卵悬液,实验室保存的虫卵悬液经灭活后制成阴性样品.将孵化参考样品采用随机编号的方式分成60组分发给湖北省60个血吸虫病规范化实验室,采用单盲法检测孵化质量控制样品.应用SPSS 20.0软件统计不同县(市、区)实验室检测人员的检测水平,符合率、误检率和漏检率的比较采用x2检验.结果 湖北省13个市级、47个县(市、区)级血吸虫病规范化实验室共检测样品300份(阳性138份、阴性162份),检出阳性125份,阴性148份,总符合率为91.0％ (273/300),总误检率为8.6％ (14/162),总漏检率为9.4％ (13/138),差异有统计学意义(x2=201.207,P＜0.01).13个市级血吸虫病规范化实验室中有12个检测结果与标准结果一致.47个县(市、区)级血吸虫病规范化实验室中有34个检测结果与标准结果一致;存在漏检的有9个,占19.1％;存在误检的有10个,占比21.3％;同时出现漏检和误检的有6个,占12.8％.独立血吸虫病防制机构与非独立血吸虫病防制机构误检率分别为8.1％ (5/62)和9.0％ (9/100),差异无统计学意义(x2=0.042,P＞0.05);漏检率分别为12.5％ (6/48)和7.8％ (7/90),差异无统计学意义(x2=0.818,P＞0.05).传播阻断有螺县、消除有螺县、消除无螺县等3类流行区误检与漏检率分别为6.5％ (5/77)、12.1％(7/58),15.0％ (6/40)、8.6％ (3/35),16.7％ (3/18)、13.6％ (3/22),差异均无统计学意义(x2=3.330、0.414,P＞0.05).结论 湖北省血吸虫病规范化实验室尼龙绢集卵孵化法总符合率较高,县(市、区)级实验室存在误检和漏检情况.

目的 了解湖北省2018-2020年儿童蛲虫感染现状及变化趋势,为制定全省儿童蛲虫病防控策略提供科学依据.方法 根据《全国土源性线虫病监测方案(试行)》要求,在湖北省阳新县设立固定监测点,另选取10％～15％的县(市、区)作为流动监测点.各监测点按地理方位划分为东、西、南、北、中等5个片区,每片区抽取1个乡(镇、街道)的1个行政村(社区)开展监测.对各监测点中3～9岁儿童采用改良加藤厚涂片法和胶纸肛拭法进行蛲虫感染检测,采用SPSS 22.0统计学软件对不同性别、年龄、地区、不同类型儿童感染率进行比较分析.结果 2018-2020年,28个监测点共检测儿童5860名,平均蛲虫感染率为1.8％(108/5860);2018、2019和2020年感染率分别为1.6％ (37/2356)、2.3％ (40/1758)和1.8％ (31/1746).钟祥市儿童蛲虫感染率较高,为16.3％ (23/141),各地区儿童蛲虫感染率间差异具有统计学意义(x2=82.501,P＜0.01);男、女童的蛲虫感染率分别为1.8％ (58/3196)和1.9％ (50/2664),城区和乡村儿童蛲虫感染率分别为1.5％ (11/738)和1.9％ (97/5122).4～7岁年龄组儿童感染率最高,各年龄组间差异有统计学意义(x2=17.697,P＜0.05);透明胶纸肛拭法蛲虫感染检出率为1.8％(106/5860),高于改良加藤厚涂片法的0.3％ (15/5860)(x2=69.152,P＜0.01).结论 湖北省2018-2020年儿童蛲虫感染率整体水平较低,各地区感染率间差异较大,重点加强对4～7岁幼托儿童蛲虫感染的监测与精准防治.

目的 评价60％四聚乙醛水分散粒剂的室内和现场杀螺效果.方法 按照《农药登记用杀钉螺剂药效试验方法和评价》(NY/T 1617-2008)要求,采用60％四聚乙醛水分散粒剂(MWG)室内和现场喷洒法灭螺,并与50％氯硝柳胺乙醇胺盐可湿性粉剂(WPN)进行效果比较.结果 使用60％四聚乙醛水分散粒剂室内喷洒法灭螺,1、3和7 d LC50值分别为0.312(0.271～0.360)、0.216(0.190～0.245)和0.177(0.160～0.196)g/m2,0.900 g/m2浓度7 d后实验室钉螺死亡率为98.00％.使用0.900 g/m2浓度现场喷洒7 d,岳阳草洲和江陵县河滩现场钉螺死亡率分别为90.91％和85.12％.与50％氯硝柳胺乙醇胺盐可湿性粉剂对照组(1.000 g/m2)相比,岳阳草洲现场0.900、1.800 g/m2 MWG组钉螺死亡率差异均无统计学意义(χ2=2.555、3.340,P均>0.05);江陵县河滩现场1.800 g/m2 MWG组钉螺死亡率差异无统计学意义(χ2=0.989,P>0.05).结论 60％四聚乙醛水分散粒剂室内和现场喷洒试验使用0.900 g/m2浓度,其药效均达到《农药登记用杀钉螺剂药效试验方法和评价》(NY/T 1617-2008)规定的登记标准,具有较好的实验室和现场杀螺效果,为新型高效、使用方便的灭螺药物剂型.

To measure and evaluate the adsorption and leaching characteristics to a new molluscicide of salt of quinoid 2′, 5-dichloro-4′-nitrosalicylanilide (Hereinafter referred to as chlorosalicylicamide (LDS)) in three types of soil. The reports will be provided for drug registration. According to national standards of the People's Republic of China, the chemical pesticide environmental safety evaluation test guidelines of soil adsorption experiment and soil leaching method. The soil adsorption test results indicates that the adsorption constants and adsorption coefficient was 17.606 and 1 222.6 in moisture soil respectively. Adsorption rate in black and red soil were both more than 80%. Soil leaching test results indicates that Rf(The Rfsaid material in two phase distribution coefficient related values) in moisture soil was 0.158 while in black and red soil were both 0.085. According to the chemical pesticide environmental safety evaluation test guidelines, LDS was medium adsorption in moisture soil while more than 80% in black and red soil. LDS was not eas-ily to leach in moisture soil, which was not move in black and red soil. The conclusion is: within the red and black soil environment, in which pH value is relatively low, the adsorption ability of LDS is stronger and less mobility, which shows that new type of molluscicide of LDS has little effect on the environment.

Objective To evaluate the molluscicidal effect of suspension concentrate of niclosamide ethanolamine salt(SC-NE)against Oncomelania hupensis snails in laboratory and field. Methods The experiment of SCNE against the snails by using the immersing and spraying methods was performed in laboratory and field,with control groups of wettable powder of ni-closamide ethanolamine salt(WPN). Results In the laboratory,LC50(s) of SCNE for 24,48 h and 72 h by using the immersion method were 0.0926,0.0629 mg/L and 0.0549 mg/L,respectively. The mortality rates of snails for 24,48 h and 72 h by using the immersion method were all 100％ with the concentrations of 0.25 mg/L. The mortality rates of snails were all 100％ while spraying SCNE for 3 d in the laboratory with the concentrations of 0.25 g/m2. In Jiangling County,except 0.5 g/m3 SCNE immers-ing the snails for 24 h,the mortality rates of snails by using SCNE with the immersing method were all 100％. While the concen-tration of SCNE was 0.5 g/m3 or above,the mortality rates were all 100％after the use of it with the immersion method for 2 d in Gong'an County. In Jiangling County,the mortality rates of snails by using SCNE 0.5 g/m3 for 1 d,3 d,and 7 d with the spray-ing method were 87.5％,92.82％and 97.40％respectively. While the concentration of SCNE was 0.5 g/m3,the mortality rates were 85.94％,86.78％and 94.21％respectively after the use of it with the spraying method for 1 d,3 d,7 d in Gong'an Coun-ty,and the molluscicidal effect of SCNE(1.0 g/m2)was higher than that of WPN. Conclusion SCNE has a high molluscicidal effect in the laboratory and field,and it is a novel and simple formulation of niclosamide.

目的 为提高湖北省基层血防专业技术人员血吸虫病检测检验能力,保证血吸虫病查病工作质量.方法 对湖北省21个疫区县(市、区)全年血清学、病原学检测质量进行考核.结果 抽查21个流行村,共复核血清样本9 342份,总符合率98.58％,总误检率为0.94％,总漏检率为8.87％,本地检测结果与复核结果差异有统计学意义(x2 =7.226,P＜0.01).抽查13个流行村296份阳性血清,样本滴度≥1∶80的占检测总数的17.50％,垸内型、垸外洲滩型和丘陵型3类地区阳性血清样本滴度分布均无统计学意义(x2=19.79,P=0.071).抽查了15个监测点的Kato-Katz片,共复核316张,其中阳性片23张,阴性片293张,总符合率100.00％;结论 血清学、Kato-Katz片总体符合率较高;漏检率较高的原因有血清样本保存不规范和检测人员对弱阳判断存在误差;各地区需要对IHA高滴度人群进行监测与管理,要继续加强专业人才队伍建设.

OBJECTIVE To investigate the current situation of management of institutions of schistosomiasis prevention and control in Hubei Province, so as to explore the probable competency building standards for these institutions at the county and township levels. METHODS By using a combination of quantitative and qualitative methods, the institutions of schistosomiasis prevention and control at county and township levels were investigated for the institutional setup, staffing and fulfillment functions since the reform of 2004. RESULTS Among 63 schistosomiasis endemic counties (cities, districts) of Hubei Province, there were 26 independent schistosomiasis control institutions (41.27%), there were 24 institutions which were incorporated into CDC (38.10%), and there were no institutions in 13 counties (20.63%). Among 518 endemic towns, there were 299 institutions (57.72%). The total staffing size were 1 932, but there were 1 586 (82.09%) people actually working in the post, and therefore there were 346 (17.91%) empty positions. The average rates of carrying out the six functions were 91.48%-71.19%, but only 19.23% of the institutions participated in the comprehensive schistosomiasis control management project and its effect assessment. CONCLUSION According to the management model for schistosomiasis control institutions under the current institutional mechanisms, we need a rigorous industry standard to constrain, guide and standardize the management and capacity-building of the institutions in different historical periods.

黄州区和团风县均位于湖北省东部,长江中游北岸.黄州区有7个乡镇85个村为血吸虫病疫区,历史累计有螺面积60 640.26 hm2,历史累计查出血吸虫病人10 830人;团风县有2个乡39个村为血吸虫病疫区,历史累计查出血吸虫病人15 607人,历史累计钉螺面积2 370.28 hm2.黄州区和团风县于2007年达到国家血吸虫病疫情控制目标,2008年以来通过实施"整县推进、综合治理"的血吸虫病防治措施,血吸虫病疫情大幅下降,至2012年,2区县121个流行村人、畜血吸虫感染率低于1.00％以下,连续2年没有查出感染性钉螺,也未发现急感病例.

目的 掌握2011 年湖北省血吸虫病监测点疫情.方法 按照<湖北省血吸虫病监测方案>的要求,在全省血吸虫病流行区选择有代表性的207 个流行村作为监测点,开展人畜查病和钉螺调查.结果 207 个监测点居民血吸虫感染率为0.78%,耕牛感染率为0.70%,活螺平均密度为0.43 只/0.11m2,感染螺平均密度为0.000 3 只/0.11m2,钉螺感染率为0.06%.结论 与2010 年相比,2011 年湖北省血吸虫病疫情出现了明显下降,但疫情进一步下降难度加大,需加强流动人员管理,全面推行洲滩禁牧、以机带牛等措施,以切实控制传染源.

Objective To identify the schistosomiasis situation of Hubei province in 2009-2010,so as to provide evidence for schistosomiasis contro1.Methods The surveillance was carried out in 16 national surveillance sites of Hubei Province according to the national surveillance protocol.Data of the two years were analyzed.Results In the 16 national surveillance sites in 2009 and 2010,the infection rate of residents was 1.03% and 0.89% respectively.As compared with 2009,it dropped 13.59% in 2010.Fisherman had the highest infection rate among all the professionals.The average infection rate of cattle was 1.98% and 1.41% respectively.The density of infected snails and the snail infection rate descended obviously,which were 53.66% and 57.55% respectively.In 2010 the live average density had an increase of 10.43%,as compared with that in 2009. Conclusions In the surveillance sites the infection rate of both human and cattle dropped persistently,however,in a few surveillance sites the infection rate of snails remained high.Therefore,it is necessary to strengthen snail control,and promote the effect of snail eradication.

Objective To understand the situation of detection and treatment of praziquantel in schistosomiasis endemic area,and provide basis for establishing more effective control program.Methods Indirect hemagglutination assay(IHA)was used to detect schistosomiasis infection among patients aged from 6 to 65 in six villages in schistosomiasis endemic area.Positive patients were treated with praziquantel.Positive cases were treated with praziquantel.Questionnaire and discussion methods were used to understand the situation of diagnosis and treatment.Results The problem of missed diagnosis and treatment was quite serious in these six villages,it was 42.67% and 17.73% respectively.The majority of the missed diagnosis were the Migrant workers(97.09%),illness and pregnancy ranked the second,2.91%.The reason of the missed treatment was illness and pregnancy,76.55%,followed by refuse-treatment,23.45%.Praziquantel-abuse was also common.Conclusions The inspection and quality control for the diagnosis and treatment in schistosomiasis endemic area should be promoted,the detection-and treatment-rate should be enhanced.

OBJECTIVE To understand the endemic situation of schistosomiasis in surveillance sites of Hubei Province in 2010. METHODS According to The Scheme of Schistosomiasis Surveillance in Hubei Province, 207 endemic villages were selected as surveillance sites, where the surveys of residents, livestock and Oncomelania snails were carried out. RESULTS In the 207 surveillance sites, the infection rates of residents and cattle were 1.01% and 1.14%, respectively, the densities of living snails and infected snails were 0.50 and 0.000 4 snails/0.1 m2, respectively, and the infection rate of snails was 0.08%. CONCLUSIONS Compared with that in 2009, the endemic situation of schistosomiasis in Hubei Province in 2010 has decreased obviously, but as the repeatability of the disease, the control of infectious sources and the management of cattle should be strengthened, as well as the snail control.

Six villages were selected for study in conjunction with provincial surveillance and control efforts in schistosomiasis-endemic areas.An indirect hemagglutination assay(IHA) was used to detect Schistosoma japonicum infection in residents ages 6 to 65 years in six villages in schistosomiasis-endemic areas.Schistosomiasis leakage and control was considerable in six villages.Leakage was detected at a rate of 42.67% and leakage was controlled at a rate of 17.73%.Leakage was most often detected as a result of working outside the province,accounting for 97.09% of leaks detected.Sickness or pregnancy were the second most frequent reason leaks were detected,accounting for 2.91% of leaks detected.Leakage control was most often the result of sickness or pregnancy,accounting for 76.55% of leaks controlled.Leakage control was also the result of refused treatment,accounting for 23.45% of leaks controlled.Misuse of praziquantel was also somewhat common.Measures to control schistosomiasis should be adjusted in line with social changes and economic restructuring of villages.Health education should be increased and the timing of schistosomiasis detection and control should be adjusted.Tracking of individuals responsible for schistosomiasis leakage should be enhanced,and the standard use of praziquantel should be emphasized.

目的 掌握2005-2009年湖北省国家级血吸虫病监测点人群病情变化趋势,为制定全省血吸虫病防治策略提供科学依据.方法 根据<全国血吸虫病监测方案>的要求,开展16个监测点的人群病情监测工作,并将5年的人群病情监测各项指标进行统计分析.结果 2005-2009年,16个监测点人群血吸虫感染率呈逐年下降趋势,不同类型流行村人群感染率以二类村最高,洲垸型流行区显著高于丘陵型;不同年龄组人群感染率呈现随年龄增高而逐渐升高的总体趋势,而不同职业人群感染率中则以渔民为最高.三类村和丘陵型人群感染率与2005年相比略有升高.结论 应进一步加强以传染源控制为主的综合防治策略的落实,加大查治病及其他防治措施的力度,提高防治工作质量与效果,防止疫情反弹.

Objective To understand the endemic situation in the schistosomiasis surveillance sites of Hubei province in 2009..Methods According to the scheme of the Hubei provincial schistosomiasis surveillance,207 schistosomiasis surveillance sites(villages) were selected and established.Schistosomiasis in residents and cattle were investigated,and Oncomelania snails were also surveyed..Results In the 207 surveillance sites,the infection rate of residents was 1.30%,and the infection rate of cattle was 1.64%.The snail density was 0.49 / 0.1 m2,the density of infected snail was 0.0007 / 0.1 m2,and snail infection rate was 0.14%..Conclusions The endemic situation of schistosomiasis in Hubei province in 2009 was effectively controlled,but free-range cattle make the control of the sources of infection become difficult.To prevent the endemic situation rebounding,the measures of cattle management,prohibition of grazing in islet and machine replacing cattle should greatly be strengthened.

目的分析比较2005、2006年湖北省国家级血吸虫病监测点疫情,为制定全省防治策略提供科学依据。方法按《全国血吸虫病监测方案》的要求,开展16个监测点的监测工作,并将2年的监测结果进行比较。结果2005年和2006年16个监测点居民血吸虫感染率分别为1.71%和1.91%,2006年较2005年上升了11.69%;耕牛平均感染率分别为11.69%和12.06%,2006年与2005年相比上升了3.17%;活螺平均密度、感染性钉螺平均密度和钉螺感染率分别为0.850 0只/0.1 m2、0.002 5只/0.1 m2、0.29%和0.670 0只/0.1 m2、0.001 1只/0.1 m2、0.17%,2006年较2005年分别下降了21.45%、56.00%和41.59%。结论湖北省血吸虫病疫情较重,防治工作难度较大,仍然需要加大综合防治措施力度,认真落实各项防治措施。

Objective To analyze the endemic situation of schistosomiasis in the national surveillance sites in Hubei province in 2008,and provide scientific basis for establishing the control program.Methods Surveillance was carried out in 16 national surveillance sites in Hubei province according to the national surveillance protocol.Data statistics and analysis were processed by SPSS 12.0.Results In 16 surveillance sites,the infection rate of residents was 1.10%,the infection rate of cattle was 2.42%,snail density was 0.2757/0.11 m2,the density of positive snail was 0.00062/0.11 m2 and snail infection rate was 0.226%.Conclusions The infection rate of residents and cattle was below 5%,however,the infection rate of snail was still very high,schistosomiasis control by synthetic measures with emphasis on infection source control must be implemented and enhanced.

晚期血吸虫病(简称晚血)是由于反复或重度感染血吸虫尾蚴,未经及时治疗或有效的杀虫治疗,经过较长时间的病理发展过程,造成虫卵沉积、组织纤维化形成而引起相应器官功能受损及障碍的一种重型血吸虫病.湖北省由于地域地形的复杂性,居民接触疫水的频繁性,使得该省晚血病人救治工作的任务十分繁重.晚血患者患病后部分丧失或全部丧失劳动力,大多难以继续从事生产劳动,重者危及生命而严重影响家庭经济,使因病致贫现象严重[1].为了解晚血救治项目开展以来的实施效果,进一步做好晚血病人的救治工作,在每年进行的救治核查工作的基础上,对湖北省的江陵、沙市、荆州区及钟祥四县市2004～2008年间的晚血救治工作的基本情况进行了调查和分析.