目的 了解湖北省发热患者疟原虫血涂片制作质量和实验室人员疟原虫镜检能力,为制定和调整本省消除疟疾后监测策略和措施提供科学依据.方法 对2018-2019年湖北省全部网络报告疟疾病例血涂片和从各市(州)疾控中心抽检的疟原虫阴性血涂片进行镜检复核,从血涂片制作、染色、清洁度、镜检结果及虫种符合情况进行综合分析.结果 2018-2019年湖北省共复核疟原虫血涂片2 136张,血涂片制作、染色、清洁度合格率分别为82.77％、81.88％、85.25％,不同地区血涂片质量差异有统计学意义(x2=157.702、113.984、60.519,P均＜0.05).血涂片质量主要存在的问题是厚血膜脱落、厚薄血膜过大或过小、厚血膜溶血不全和染色过浅.2018-2019年湖北省网络报告病例285例,实验室镜检复核285例样本,疟疾镜检阳性病例258例,总体疟疾镜检阳性率为90.53％(258/285),虫种符合率为89.92％(232/258),恶性疟原虫、间日疟原虫、三日疟原虫和卵形疟原虫镜检虫种符合率分别为93.85％、100.0％、80.00％、50.00％,差异有统计学意义(x2=53.171,P＜0.05).结论 应持续加强湖北省各级医疗卫生机构疟原虫镜检培训和血涂片质量控制,促进血涂片质量进一步提高,同时增强对卵形疟和三日疟的虫种鉴别能力,以保证消除疟疾后监测阶段疟原虫镜检能力.

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 湖北省省级疟疾诊断参比实验室对各级疟疾实验室上送的输入性疟疾病例留存血样进行复核,并对诊断和复核结果进行分析,评估全省各级疟疾实验室的检测能力.方法 收集中国疾病预防控制信息系统中2016-2020年湖北省报告的输入性疟疾病例诊断单位、诊断结果和留存样品,对诊断单位进行描述性分析,并由省级疟疾诊断参比实验室对疟疾病例样品采用血涂片镜检和巢式PCR进行复核,比较各级疟疾实验室诊断结果与省级疟疾诊断参比实验室复核结果的阳性和虫种符合情况,分析不同疟原虫虫种诊断符合情况,应用SPSS 17.0软件进行统计学分析.结果 2016-2020年湖北省共报告疟疾病例608例,疟疾病例诊断单位医疗机构占89.5％ (544/608),疾病预防控制中心占10.5％ (64/608),其中地市级医疗机构诊断病例占54.6％ (332/608).2016-2020年医疗机构占疟疾病例诊断单位的比例分别为84.1％ (132/157)、84.4％ (92/109)、90.4％ (122/135)、95.2％ (157/165)和97.6％ (41/42) (x2=16.815,P＜ 0.05).省级疟疾诊断参比实验室共复核604例留存样品,其中92.4％ (558/604)的病例被各级疟疾实验室确诊为疟疾,88.5％ (494/558)感染虫种判定正确.不同年份疟疾病例诊断疟原虫阳性符合率为82.9％ (34/41) ～96.2％ (151/157)、虫种符合率为79.4％ (77/97) ～94.4％ (118/125),差异均有统计学意义(x2=9.273、13.787,P＜0.05).医疗机构的诊断疟原虫阳性符合率(93.2％,503/540)和虫种符合率(89.5％,450/503)均高于疾病预防控制中心的(85.9％,55/64)和(80.0％,44/55),省、市、县、乡级医疗机构诊断疟原虫阳性符合率分别为100％ (74/74)、93.3％ (308/330)、90.2％ (110/122)、和11/14,虫种符合率分别为100％ (74/74)、88.3％ (272/308)、86.4％ (95/110)、9/11,呈现级别越高诊断正确率越高的趋势(x2=13.092、15.598,P＜0.05).恶性疟原虫、间日疟原虫、三日疟原虫、卵形疟原虫、混合感染诊断虫种符合率分别为96.9％ (373/385)、96.0％ (72/75)、10/16、48.8％ (39/80)和0,差异有统计学意义(x2=132.880,P＜0.05).结论 湖北省疟疾病例的诊断单位主要是医疗机构,各级疟疾实验室检测能力总体较高,对非恶性疟原虫的虫种鉴别能力有待提高.

目的 了解当前湖北省人群血吸虫病抗体水平与变化趋势,评估人群血吸虫病传播风险.方法 于2016-2018年每年的9-12月,收集湖北省人群血吸虫病查病中血清抗体阳性者血清,采用间接血凝试验检测血清抗体滴度,记录抗体效价结果和阳性者基础信息;收集湖北省血吸虫病防治工作年报表中全省各疫区县(市、区)2016-2018年查病情况和达标进展资料,将血清抗体阳性报告数、血清抗体阳性率、阳性血清抗体效价构成比和流行区类型等4项指标设立为传播风险评估具体指标.以县为单位,评估各流行地区的人群病情传播风险等级,并用ArcGIS 10.5软件制作湖北省人群血吸虫病传播风险等级可视化地图.采用SPSS 26.0统计学软件分析2016-2018年血清抗体阳性者基础信息,评估重点防控人群分布特征.结果 2016-2018年湖北省血检人数分别为1728300、1531611、1498039人,血清抗体阳性数分别为41154、31532、22124例,血清抗体阳性率分别为2.38％、2.06％、1.48％,全省血清抗体阳性数呈逐年减少,血清抗体阳性率逐年下降(x2=3410.81,P＜ 0.01).2016、2017年以传播控制地区报告为主,分别占当年总血清抗体阳性数的95.47％ (39290/41154)、63.68％ (20081/31532) (x2=773.88,P＜0.01);2018年以传播阻断地区报告为主,占当年总血清抗体阳性数的99.84％ (22088/22124).其中2016-2018年血清抗体效价≥1:40者分别为4459例、4498例、2482例,占血清抗体阳性数的10.83％、14.26％、11.22％,3年间差异有统计学意义(x2=217.46,P＜0.01).人群血吸虫病传播风险等级分析结果显示,全省1级风险区5个,分别为公安县、沙市区、江陵县、松滋市和潜江市;2级风险区10个,分别为阳新县、洪湖市、嘉鱼县、荆州区、荆州开发区、汉南区、石首市、蔡甸区、汉川市和仙桃市;3级风险区10个;其余38个流行地区均为4级风险区.血吸虫病传播风险重点人群分析结果显示,2016-2018年血清抗体效价≥1:40人群中,均以男性和44～65岁年龄组人群为主,分别占血清抗体阳性数的62.43％ (7141/11439)和71.09％ (8132/11439).结论 2016-2018年湖北省人群血吸虫病血清抗体阳性数呈逐年减少,当前人群血吸虫病传播风险以4级风险区域为主,总体传播风险较低,1级风险、2级风险区域仍需加强防控,以男性和44～65岁年龄组人群为重点防控人群.

目的 了解在湖北省山丘型血吸虫病重点防控地区,人群病情小尺度空间聚集性探测的应用价值.方法 以松滋市2016—2018年血吸虫病血清学检测阳性抗体效价在1:80及以上(血阳高)病例、血吸虫病粪便检查阳性病例(粪阳)为研究对象.以该市村级小尺度为研究单元,采用Flexible不规则空间扫描统计量,分别设定参数K=2、K=6、K=10时,对人群病情进行空间聚集性探测分析.结果 松滋市2016—2018年未查出粪阳病例,血阳高病例分别为74人、206人、83人;2016—2018年血阳高病例均存在空间聚集性.Flexible不规则空间扫描统计分析探测到的聚集区域随着设定不同K值的变化而发生变化.不同参数下扫描探测结果显示松滋市血吸虫病人群病情聚集区域主要集中在老城镇、陈店镇、王家桥镇等最大似然聚集区的3个流行乡镇40个流行村.结论 Flexible不规则空间扫描统计量探测出湖北省山丘型血吸虫病流行区的人群病情在村级小尺度上存在空间聚集性,今后需继续保持与巩固血吸虫病监测、防控工作力度,早日实现全省血吸虫病消除目标.

目的 分析2014-2018年湖北省疟疾诊断参比实验室样本检测结果,为巩固湖北省疟疾诊断水平提供科学依据.方法 收集湖北省2014-2018年疟疾网报病例诊断结果和样本,由省级疟疾诊断参比实验室通过镜检和巢式PCR对每份样本进行检测,分析不同年份和不同地区网报阳性结果和虫种符合情况,分析省级镜检和巢式PCR结果.结果 2014-2018年湖北省共网报疟疾病例674例,省级疟疾诊断参比实验室复核672例,确定疟疾病例633例.总体阳性符合率为94.20％,各年和各地、市(州)阳性符合率均高于80.00％,不同地、市(州)间的阳性符合率差异有统计学意义(x2= 42.49,P＜0.001).总体虫种符合率为89.73％,不同年份和不同地、市(州)间虫种符合率差异均有统计学意义(均有P＜0.001).省级疟疾诊断参比实验室镜检与巢式PCR结果一致率为88.89％,两种方法检测结果一致率在不同虫种间的差异有统计学意义(x2 =57.37,P＜0.001).结论 湖北省2014-2018年疟疾网报病例诊断质量总体较高,对非恶性疟原虫的虫种鉴别能力有待提高.

目的 分析湖北省重点县人群血吸虫病乡村级尺度空间聚集性,为下阶段血吸虫病防控工作提供决策支持.方法 以湖北省公安县、江陵县为代表,以乡村级尺度为研究单元,选取两县2015年血吸虫病粪便检查阳性病例(粪阳)和2016—2018年血吸虫病血清学检测阳性抗体效价在1:80及以上(血阳高)病例为研究对象.采用Kulldorff圆形扫描统计量对人群血吸虫感染情况进行空间聚集性分析.结果 公安县2015年粪阳病例,2016—2018年血阳高病例均在乡村级尺度上存在空间聚集性,其中以公安县沿长江流域分布的东北区域麻豪口镇、闸口镇、杨家厂镇、夹竹园镇、斗湖堤镇等5个流行乡镇覆盖的86个流行村最为突出.江陵县2015年粪阳病例,2016、2018年血阳高病例在乡村级尺度上均存在空间聚集性,其中以江陵县沿长江流域分布的西南区域普济镇、熊河镇等2个流行乡镇覆盖的57个流行村最为突出.结论 湖北省公安县、江陵县的人群血吸虫病病情在乡村级尺度上存在空间聚集性,与以往研究相比,人群病例聚集性呈现缩小与下降趋势.故疫情现况对各地在推进血吸虫病消除工作进程中实施精准防治提出了更高要求.

目的 测定与评价新型灭螺药氯代水杨胺(LDS)在水-沉积物中的降解特性,为该药登记提供环境影响资料.方法依据中华人民共和国国家标准《化学农药环境安全评价试验准则》第八部分:水-沉积物系统降解试验.结果好氧条件下,寡营养和富营养水-沉积物体系中氯代水杨胺总量的降解速率分别为0.026d-1、0.034d-1,降解半衰期分别为26.7和20.4d;厌氧条件下,寡营养和富营养水-沉积物体系中氯代水杨胺总量的降解速率分别为0.023d-1、0.025d-1,降解半衰期分别为30.1和27.7d.结论氯代水杨胺在好氧条件下的降解速率快于厌氧条件,富营养体系中的降解速率快于寡营养体系.氯代水杨胺在上述两种水-沉积物体系中的降解均较快.水-沉积物体系中的药物降解速率在21d前主要受水相中药物降解速率影响,而在21d后水相和沉积物相共同起作用.

OBJECTIVETo investigate the space-time patterns of schistosomiasis after the stage of transmission controlled in Hubei Province, so as to provide the reference for precise controlling.METHODSThe data of human schistosomiasis cases in Hubei Province from 2015 to 2016 and basic information of human schistosomiasis cases and serum antibody titer of human schistosomiasis cases in 2016 were collected and analyzed. The spatial clustering of human schistosomiasis was detected by the Flexible spatial scan statistics and Kulldorff circular scan statistic, respectively.RESULTSTotally 64 819 serological positive cases from 51 counties and 1 504 stool hatching positive cases from 17 endemic counties were reported in Hubei Province in 2015, and 39 365 serological positive cases were reported from 48 counties in 2016. All of them were identified as the research objects. No stool hatching positive cases were reported from the routine work in the whole province in 2016. There were 1 603 cases of the highest antibody titer (1∶80 or more), with the proportion of 4.07%. According to the results of Kulldorff spatial clustering analysis, there were eight and six spatial clustering areas in the distribution of serological positive cases and stool hatching positive cases in 2015, respectively. The numbers of spatial clustering areas in the distribution of serological positive cases and the cases of the highest antibody titer (1∶80 or more) were eight and five in 2016, respectively. According to the results of Flexible spatial clustering analysis, there were three and two spatial clustering areas in the distribution of serological positive cases and stool hatching positive cases in 2015, respectively. The numbers of spatial clustering areas in the distribution of serological positive cases and the cases of highest antibody titer (1∶80 or more) were two and one in 2016, respectively.CONCLUSIONSThe distribution of human schistosomiasis cases is not balanced, and there is spatial clustering in Hubei Province. So the key area for prevention and control is on the middle and lower reaches of the Yangtze River in the future.

Objective To analyze the epidemiological data of the sentinel surveillance in the suspected high-risk waters in Wuhan, Hubei Province from 2014 to 2016,and explore the role of the sentinel mice technique in the monitoring and warning for the key waters of schistosomiasis. Methods According to the method of "Surveillance Program of Sentinel Rats in Schistosomiasis Endemic Area of China",the Wuhan Section of the Yangtze River,the Fu-Lun River System,the Dongjing-Tongshun River System and Jingshui River System were chosen as the surveillance sites. The water infectivity was tested by using the sentinel mouse method during the flood season. Results The recovery rate of sentinel mouse in 2014 and 2016 was 100. 00%,and the recovery rate in 2015 was 90. 56%. No positive sentinel mice was detected in 3 years. Conclusion The water infection in the key waters of schistosomiasis from 2014 to 2016 in Wuhan,Hubei Province was at a low level. The sentinel mice method was of great significance in the monitoring and early warning of schistosomiasis,and should be strengthened.

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.

Objective To investigate the water infectivity in key water regions, and analyze the transmission risk of schistosomiasis in suspicious and high-risk environments in Hubei Province in 2016. Methods Schistosome-endemic areas of the Yangtze River, the Hanbei River and the Fu River were chosen as the surveillance and forecast sites. The water infectivity was detected by using the sentinel mice during the flood season. The infection status of residents in the villages around the surveillance sites and the activities of human beings and domestic animals were surveyed. The emergency response system was initiated when the water infectivity areas were detected. Results From May to June, among the ten surveillance sites of the first batch, two positive spots with infected mice were found, accounting for 20%. All the recovered mice (totally 200) were dissected: five mice were infected, with a total infection rate of 2.5%. Totally five schistosome adult worms were collected, with mean worm burden of 1 worm per infected mouse. The site with cercariae-infected water body started the emergency response and no epidemic occurred. From August to September, among the eight surveillance sites of the second batch, the recovered mice (totally 160) were dissected, and no infected sentinel mice were found. Conclusion The sentinel mice method plays an important role in analyzing the schistosomiasis transmission risk in Hubei Province.