2004-2022年湖北省武汉市血吸虫病流行趋势分析

Epidemiological characteristics and trend of schistosomiasis in Wuhan, Hubei, 2004−2022

  • 摘要:
    目的 分析2004—2022年湖北省武汉市血吸虫病疫情变化趋势,为制定消除血吸虫病策略提供参考。
    方法 收集2004—2022年湖北省武汉市人、畜血吸虫病和钉螺调查等相关资料,采用Jionpoint回归模型分析血吸虫病疫情时间序列趋势变化,以及人、畜病情与螺情间的相关性。
    结果 2004—2022年湖北省武汉市居民血吸虫感染率年均变化率为11.91%[平均年度变化百分比(AAPC)= −11.91%,P<0.05],呈现3个阶段的波动,其中2004—2007年呈上升趋势[年度变化百分比(APC)=95.20%,P<0.05],2007—2017年(APC= −34.52%,P<0.05)和2017—2022年(APC= –1.12%,P>0.05)均呈下降趋势。2004—2022年耕牛阳性率年均变化率为 24.59%(AAPC= −24.59%,P<0.05),变化趋势有3个阶段,其中2004—2011年(APC= −29.23%,P<0.05)和2011—2014年(APC= −61.58%,P<0.05)呈下降趋势,2014—2022年呈上升趋势,但趋势差异无统计学意义(APC= 2.66%,P>0.05)。 2004—2022年武汉市实有钉螺面积年均变化率为2.47%(AAPC= −2.47%,P<0.05),其中2004—2013年和2013—2022年均呈现下降趋势(APC=−0.80%、−4.11%,均P<0.05)。 2004—2022年武汉市活螺平均密度呈现持续下降趋势(APC=AAPC= −11.76%,P<0.05)。 2004—2022年武汉市钉螺感染率年均下降18.62%(AAPC= −18.62%,P<0.05),呈现3个阶段的波动,其中2004—2011年和2011—2014年呈现下降趋势(APC=−14.97%、−60.73%,均P<0.05),2014—2022年呈上升趋势,但趋势差异无统计学意义(APC=2.93%,P>0.05)。2013—2022年武汉市无本地感染的血吸虫病病例和家畜,未发现感染性钉螺。 2004—2022年,武汉市人群血吸虫感染率与实有钉螺面积(r=0.67,P<0.01)、钉螺感染率均呈显著正相关(r=0.78,P<0.01);耕牛阳性率与实有钉螺面积(r=0.60,P<0.01)、活螺平均密度(r=0.95,P<0.01)、钉螺感染率(r=0.60,P<0.01)均呈显著正相关;实有钉螺面积与钉螺感染率(r=0.67,P<0.01)也呈正相关。
    结论  2004—2022年湖北省武汉市血吸虫病疫情呈现下降趋势,且人、畜病情与螺情显著相关。 持续压缩钉螺面积,降低活螺密度是武汉市迈向消除阶段的重点。

     

    Abstract:
    Objective To understand the epidemiological characteristics of schistosomiasis in Wuhan of Hubei province from 2004 to 2022 and provide scientific evidence for the development of local schistosomiasis elimination strategy.
    Methods The annual epidemiological data of schistosomiasis, including disease screening and treatment for human and livestock cases, and snail survey and control, in Wuhan from 2004 to 2022 were collected. Joinpoint regression analysis was used to analyze the change trends of prevalence of schistosomiasis in Wuhan from 2004 to 2022. The correlations between the prevalence of schistosomiasis and oncomelania status were analyzed.
    Results The overall infection rate of S. japonicum in human showed a decline trend in Wuhan from 2004 to 2022 average annual percent change (AAPC)=−11.91%, P<0.05, increasing firstly during 2004−2007 with annual percent change annual percent change (APC) of 95.20% (P<0.05), then decreasing during 2007−2017 with APC of −34.518% (P<0.05) and during 2017−2022 with APC of −1.12% (P>0.05). From 2004 to 2022, the annual infection rate of S. japonicum in bovines had an average decline of 24.59% (AAPC=−24.59%, P<0.05) in Wuhan, the APC was −29.23% from 2004 to 2011 and −61.58% from 2011 to 2014 (all P<0.05), then the infection rate showed an increasing trend from 2014 to 2022 (APC=2.66%), the difference was not significant (P>0.05). There was a 2.47% annual average decline in the oncomelania-infested areas in Wuhan from 2004 to 2022 (AAPC=−2.47%, P<0.05). The decrease had two stages, with the APC of −0.80% during 2004−2013 and −4.11% during 2013−2022 (all P<0.05). The density of living oncomelania showed a gradual decline year by year in Wuhan from 2004 to 2022 (APC=AAPC=−11.76%, P<0.05). During 2004−2022, there was an annual decline of 18.62% in the density of S. japonicum-infected oncomelania (AAPC=−18.62%, P<0.05), decreasing firstly during 2004−2011 (APC=−14.97%, P<0.05) and 2011−2014 (APC=−60.73%, P<0.05), then increasing during 2014−2022 without significance (APC=2.93%, P >0.05). No schistosome-infected residents, cattle, or oncomelania were found for consecutive 10 years from 2013 to 2022 in Wuhan. There were significant correlations between the infection rate of S. japonicum in human and the oncomelania-infested area (r=0.67, P<0.010), and the infection rate in oncomelania (r=0.78, P<0.01), between the infection rate of S. japonicum in bovines and the oncomelania-infested area (r=0.60, P<0.01), the density of living oncomelania (r=0.95, P<0.01) and the infection rate in oncomelanias (r=0.60, P<0.01), between the oncomelania-infested area and the infection rate in oncomelania (r=0.67, P<0.01).
    Conclusion The prevalence of schistosomiasis showed a decreasing trend in Wuhan from 2004 to 2022, and significant correlations between the prevalence of schistosomiasis and oncomelania status were found. In the future, we need to further reduce the oncomelania-infested area areas and the density of living oncomelania to facilitate the steady elimination of schistosomiasis in Wuhan.

     

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