| BackgroundSchistosomiasis is a parasitic zoonoses which seriously harms the health of people and hinders the development of social economy. The epidemic areas lie in the Yangtze River Basin and12provinces, cities and autonomous regions in the south of it. In2010Shanghai Province, Zhejiang Province, Fujian Province, Guangdong Province, Guangxi Zhuang Autonomous Region had reached the standard of transmission-blocking, Sichuan Province and Yunnan Province where schistosomiasis was mainly epidemic in hilly areas (referred to the hillys) and Jiangsu Province where schistosomiasis was mainly epidemic in lakes and swamps areas (referred to the lake areas) had reached the standard of transmission control, Anhui province, Jiangxi Province, Hubei Province, and Hunan province where schistosomiasis was mainly epidemic in lakes and swamps areas had reached the standard of epidemic control.Hunan Province is one of the severe epidemic areas of schistosomiasis, and the epidemic areas of schistosomiasis lie in the Dongting Lake area and the surrounding hilly areas including38counties (cities, districts, fields) of Yueyang City, Yiyang City, Changde City, Changsha City, Zhuzhou City and Zhangjiajie City in Hunan Province Of38epidemic counties in Hunan province4had reached the standard of transmission-blocking,14had reached the standard of transmission control and20had reached the standard of epidemic control in2010.Epidemic status of schistosomiasis was effectively checked for the comprehensive control strategy of chemotherapy to human and livestock, snail-killing in susceptible areas and health education implemented widely in lake regions from the1980s to the last century. The State Council forworded the national prevention and control schistosomiasis program(2004-2015) from the Ministry of Health because epidemic status rose and fell unpredictably for serious re-infection of human and livestock, stubbornly high number of patients and sick livestock and obviously spread snails. The Ministry of Health in conjunction with the Development and Reform Commission, Ministry of Finance, Land, Water Resource, Agriculture, Forestry jointly formulated the comprehensive control strategy with emphasis on infection source and all the epidemic cities and counties throughout the country will reach the criteria of transmission control in2015based on the comprehensive control schistosomiasis key project program (2004-2008) implemented to achieve mid and long-term target.ObjectiveTo evaluate objectively the effects of the new measures in marshland and lake regions in Dongting Lake regions by longitual study on epidemic status of schistosomiasis before and after the comprehensive schistosomiasis control measures of infection source implemented, discuss schistosomiasis epidemic status and influencing factors, understand current epidemic status of schistosomiasis and intestinal parasite by field survey on implement of health education and provide scientific basis for parasite control on the spot.Methods1. The data on epidemic status of schistosomiasis in Miluo City from1996to2011were collected and analyzed by retrospective analysis to investigate the change of the prevalence rate in both residents and farm cattle and snails after the comprehensive control measures of infection source fulfilled.2. The related epidemic data on schistosomiasis in Ganzhou Village, Baitang County, Miluo City where is one of the nationwide schistosomiasis monitoring points in2011were collected and analyzed.3. The awareness of schistosomiasis of the residents in Miluo was investigated by questionnaire on the spot.4. The pupils in Baitang County, Miluo City were examinated by stool examination to examine schistosomiasis and common intestinal parasitic diseases, and at the same time the eating habits and personal health habits of the pupils were investigated by questionnaire.Results1. The routine measures could keep the average density of living snails and infected snails outside embankment0.29～0.63/0.1m2and0.0034～0.0379/0.1m2, the prevalence rate of human2.13%～3.68%, the prevalence rate of farm cattle2.20%～4.36%. The comprehensive control measures of infection source lowered the average density of living snails from0.52/0.1m2to0.18/0.1m2, the average density of infected snails from0.0041/0.1m2to0.0007/0.1m2outside embankment, decreased the prevalence rate of human from2.86%to1.25%. The prevalence rate of farm cattle increased from2.87%to5.92%during2006-2008and dropped from5.92%to1.70%during2008-2010. The acute schistosomiasis was mainly disseminately popular in Miluo City. There were43acute schistosomiasis cases in the first stage,6in the second stage and zero in2010-2011. The charateristic was similar in two stages. Most patients of acute schistosomiasis were students aged at7-14and obviously more males were infected than females. Most patients were infected through swimming and playing in water outside embankment. The high-incidence seasons were summer and autumn.2. The new measures kept no snail areas found within the embankment, the average density of living snails0.03/0.1m2, the average density of infected snails0.0011/0.1m2and the infection rate of snails4.00%outside the embankment, the prevalence rate of human1.45%, the prevalence rate of farm cattle16.67%in Ganzhou Village where is still the third type of the epidemic villages.3. The awareness rate of the policies on schistosomiasis of the respondents was higher from70%to90%. The awareness rate of the policies on schistosomiasis of the respondents was higher in each age group, and it was the highest with80%aged more than45years old and it was the minimum with about60%aged less than18years old. The awareness rate of the conventional control methods on schistosomiasis of the respondents was lower. The awareness rate of the conventional control methods on schistosomiasis of the respondents was lower in each age group, but the awareness rate increased with age increased. The awareness rate of "how to handle after contacting infected water" and "what is the safest dringking water" was higher.4. The positive rate is1.734%with3diagnosed positive with pinworm in Class1, Grade1and Schistosoma was not found in173pupils examined by stool examination.67%-90%pupils developed good eating habits and40%-82%pupils developed good personal heath habits in224responses received.Conclusions1. The effect of schistosomiasis control of comprehensive control measures of infection source was obvious in Miluo City. It is yet important for schistosomiasis prevention and control to strengthen snail-killing, reduce going outside embankment, attach importance to propaganda, implement proper chemotherapy, and protect against the acute schistosomiasis infection of children in summer and autumn.2. The comprehensive schistosomiasis control measures for infection source of positive snail spots checked and destroyed, chemotherapy to patients and sick livestock, health education, drinking water and lavatories rebuilt had achieved a certain effect in Ganzhou Village. It is important to strengthen the efforts to implement the comprehensive control measures of infection source and manage the infection source of farm cattle and other livestock and check and destroy the positive snail spots outside embankment.3. The awareness rate of the policies on schistosomiasis,"how to handle after contacting infected water" and "what is the safest drinking water" of the residents was higher in Miluo City. The awareness rate of the conventional control methods on schistosomiasis of the residents was lower, and the awareness rate increased with age increased. It is important to strength the efforts to propaganda schistosomiasis prevention knowledge and apply different health education measures to different population.4. The health education had apparent effects in school and especially the pupils generally developed good eating habits and personal health habits. The investigation showed that the prevalence rate of intestinal parasites was lower and Schistosoma was not found. It was important to pay attention to parasites which were easy to cure and difficult to prevent, improve living and learning environment of pupils and regularly carry out prevention work to pinworms. |
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