大理市2004～2015年血吸虫病防治效果及流行现状综合评价

发布时间：2018-05-24 11:51

本文选题：日本血吸虫 + 综合防治　；参考：《大理大学》2017年硕士论文

【摘要】：目的:通过收集相关资料,分析大理市血吸虫病综合防治效果及其影响因素并对大理市血吸虫病流行现状进行综合评价,为制定下一步防治策略和优化资源配置提供基础参考和科学依据。方法:回顾性收集2004—2015年大理市血吸虫病综合防治策略实施情况(包括卫生血防、农业血防、林业血防、水利血防),统计每年各项防治措施完成数、防治的总费用以及人、畜疫情和螺情等疫情的变化情况,对综合防治的效果及影响因素进行分析,并对2015年大理市各乡镇血吸虫病流行现状进行综合评价。采用SPSS17.0统计软件进行数据处理,进行描述性分析、费用-效果分析、多重线性回归分析以及TOPSIS法和秩和比法相结合的综合评价。结果:(1)2015年有螺面积为17.64hm~2,相较于2004年下降了93.94%,;2015年有螺框出现率、活螺密度分别为0.26%、0.1只/0.1m~2,相较于2004年分别下降了88.37%、93.63%;2015年血吸虫病人群血清学阳性率为2.00%,较2004年下降了73.22%;2015年血吸虫病人群校正感染率为0,较2004年下降了100%;2015年牛感染率为0,较2004年下降了100%。(2)以2004年的疫情数据为基准,2005-2015年各年综合效果指数分别为44.10、47.39、74.47、81.88、82.36、83.12、83.67、84.00、84.70、84.89、84.99。(3)以2004年的疫情数据为基准,2008年和2015年为考核对象,每百人群感染率下降1%的年平均费用分别为21元、20元,每百头牛感染率下降1%的年平均费用分别为486元、502元,每1hm~2钉螺面积压缩1%的年平均费用分别为773元、1269元,每1hm~2活螺密度下降1%的年平均费用分别为725元、1362元,每1hm~2的钉螺感染率下降1%的年平均费用分别为634元、1192元,每提高一个综合效果指数的年平均费用分别为13.65万元、12.93万元。(4)人群免疫学阳性率与牛感染率、无害化卫生厕所普及率有统计学关联,人群校正感染率与安全饮水普及率有统计学关联,牛感染率与无害化卫生厕所普及率、人群免疫学阳性率有统计学关联,钉螺感染率与安全用水普及率、牛感染率、人群治化疗覆盖率、无害化卫生厕所普及率有统计学关联。(5)对辖区内有血吸虫病流行的10个乡镇疫情现状进行TOPSIS法排序,疫情最轻为太邑乡,最重为银桥镇。(6)运用秩和比法对大理市各乡镇的疫情现状进行分档,得回归方程:Cipro=0.120Probit-0.383(F=105.712,P0.05,R2=0.991),疫情现状的分档结果为:银桥镇为差档,湾桥镇、上关镇、下关镇、海东镇、大理镇、双廊镇、喜洲镇为中档,凤仪镇和太邑乡为优档。结论:大理市实施“以传染源控制为主”的血吸虫病综合防治的相关措施后防治效果显著,血吸虫病的流行得到了大幅度的遏制,现阶段的疫情总体上呈低度流行状态,但伴随的防治成本也较高;在综合防治的相关措施中,可初步认为无害化卫生厕所建设、安全饮水工程、人治化疗是影响大理市防治效果的主要相关措施;现阶段大理市各镇疫情参差不齐,部分乡镇疫情处于不稳定状态,血吸虫病治理任务还很艰巨。
[Abstract]:Objective: to analyze the effect of comprehensive prevention and control of schistosomiasis in Dali and its influencing factors by collecting relevant data, and to provide a comprehensive evaluation on the epidemic situation of schistosomiasis in Dali, and provide a basic reference and scientific basis for making the next control strategy and optimizing the allocation of resources. Methods: a retrospective collection of schistosomiasis in Dali from 2004 to 2015 was conducted. The implementation of the prevention and control strategy (including health schistosomiasis, agricultural schistosomiasis, forestry schistosomiasis, water control), the total cost of each control measure, the total cost of prevention and control, the change of the epidemic situation of human, animal and snails, the effect of comprehensive prevention and control, and the epidemic of schistosomiasis in Dali in 2015. Comprehensive evaluation of the current situation. Using SPSS17.0 statistical software for data processing, descriptive analysis, cost-effectiveness analysis, multiple linear regression analysis and comprehensive evaluation of TOPSIS and rank sum ratio methods. Results: (1) in 2015, the snail area was 17.64hm~2, compared with 93.94% in 2004, and the emergence rate of the spiral frame in 2015, and the living snail in 2015. The density was 0.26% and 0.1 /0.1m~2, respectively, 88.37%, 93.63% compared with 2004. The serological positive rate of Schistosoma japonicum was 2% in 2015 and 73.22% in 2004. The corrected infection rate was 0 in 2015 and 100% compared with 2004; in 2015, the rate of bovine infection was 0, and 100%. (2) was decreased compared to 2004. According to the data, the comprehensive effect index of 2005-2015 years was 44.10,47.39,74.47,81.88,82.36,83.12,83.67,84.00,84.70,84.89,84.99. (3), based on the data of the epidemic in 2004, and in 2008 and 2015. The annual average cost of the infection rate of each hundred people was 21 yuan, 20 yuan, and the infection rate of each hundred cattle was 1%, respectively. The annual average cost was 486 yuan and 502 yuan respectively. The annual average cost of each 1hm~2 snail area compression 1% was 773 yuan and 1269 yuan respectively. The annual average cost per 1hm~2 living snail density decreased by 1% was 725 yuan and 1362 yuan respectively. The annual average cost per 1hm~2 snail infection rate decreased by 1%, respectively, 634 yuan and 1192 yuan, each increase of the annual average of a comprehensive effect index. The cost was 136 thousand and 500 yuan and 129 thousand and 300 yuan, respectively. (4) there was a statistical correlation between the positive rate of the population immunology and the rate of cattle infection, the prevalence rate of harmless sanitary toilets, and the correlation between the rate of correction of infection and the prevalence of safe drinking water, the rate of bovine infection and the prevalence of sanitary toilets, the positive rate of immunology in the population, and the infection rate of Oncomelania snails. There was a statistically significant correlation between the prevalence of safe water use, cattle infection rate, population treatment and chemotherapy coverage, and the prevalence rate of harmless sanitary toilets. (5) the status of 10 villages and towns with schistosomiasis epidemic in the jurisdiction was sorted by TOPSIS method, the lightest epidemic situation was Yiyi Township, and the most serious was yicheqiao town. (6) the status quo of the epidemic situation in Dali towns by rank sum ratio method The regression equation: Cipro=0.120Probit-0.383 (F=105.712, P0.05, R2=0.991), the results of the status of the epidemic situation are: Yinqiao town for the differential, Bay Bridge Town, Shangguan Town, Xiaguan Town, Haidong Town, Dali Town, double corridor Town, Xizhou town as the middle, Fengyi town and Tai Yi township as the best files. Conclusion: Dali to implement the "control of the source of contagion dominated" blood The epidemic of schistosomiasis has been greatly suppressed. The epidemic situation in the present stage is generally low, but the cost of prevention and control is high. In the relevant measures of comprehensive prevention and control, the construction of harmless sanitary toilets, safe drinking water engineering, and treatment chemotherapy can be considered. It is the main related measures that affect the effect of Dali's prevention and control; the epidemic situation in Dali towns is uneven at the present stage, the epidemic situation in some villages and towns is in the unstable state, and the harnessing task of schistosomiasis is still very arduous.
【学位授予单位】：大理大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R532.21

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