关键词: 血吸虫病, 疫情, 综合治理, 效果分析, 云南省

Abstract: Objective To analyze the effect of comprehensive treatment of schistosomiasis in Yunnan Province from 2004 to 2021 for providing a basis to formulate control strategies in following stage. Methods The surveillance reports and preventive and control reports of schistosomiasis as well as the relevant data of agriculture, water conservancy, forestry and data maintained in the state land administration for comprehensive control of schistosomiasis were collected in Yunnan Province from 2004 to 2021. The control effect was evaluated based on statistical analysis of the annual control expenditure, comprehensive control measures, and the changes of population, cattle disease and snail situation. Results From 2004 to 2021, molluscide was applied to a total area of 100 061.87 hm2 in Yunnan Province. 4 146 548 people and 1 823 871 cattle underwent extended chemotherapy, and 293 731 innocuous-sanitary toilets were built. 4 277 980 cattle were raised in pens, 13 371 cattle were eliminated and 96 181 cattle were replaced by machines. In total, 64 624.40 hm2 of water area was replaced with dry land, and 925.16 km of irrigated areas were transformed. 1.266 5 million people were access to safe drinking water. 14 464.14 hm² forests were planted for snail suppression and disease prevention, and 56.99 hm² of land was leveled. In 2004, the positive rate of human blood test was 21.10%, the corrected infection rate was 2.51%. The infection rate of cattle and Oncomelania hupensis was 3.76% and 0.70%, respectively. Infected snails were found in 771 sites, and the area with snails was 4 364.79 hm². The occurrence rate of snail in individual frame and live snail density were 4.71% and 0.256 0 snails/0.1 m², respectively. In 2021, the positive rate of human blood test was 2.21%, and the corrected infection rate and cattle infection rate were both zero. No infected snails were detected after 2013. In 2021, the area with snails was 1 058.59 hm², and the rate of snails occurred in individual frame and live snail density were 1.21% and 0.034 3 snails /0.1 m² respectively. 3.986 715 2 billion yuan was used for comprehensive control of schistosomiasis in Yunnan Province from 2004 to 2021. The average annual investment was 199.832 6 million yuan from 2004 to 2008; 253.001 6 million yuan from 2009 to 2015; and 202.756 8 million yuan from 2016 to 2021, respectively. Conclusion The comprehensive control measures primarily based on control of the transmission sources of schistosomiasis in Yunnan Province have achieved remarkable results, and lead to obviously decreased infection rate of schistosomiasis in population and cattle, as well as greatly reduced areas with snails. However, some difficulties still exist, including the bottleneck in further cutting down the snail area, and prevention and control of the infection sources in livestock. Following measures should include continuously ensuring the investment of funds to further improve the comprehensive control measures and consolidate the results of schistosomiasis control. 

Key words: Schistosomiasis, Epidemic situation, Comprehensive management, Effect analysis, Yunnan Province