Epidemiology and control of marshland-type schistosomiasis

本文对我国江滩型日本赤星病流行区进行了流行病学分析。该合作研究项目的目的是描述研究地区血吸虫病的流行模式，确定感染的危险因素，并制定有效的对策。我们在湖南省仁江村做了调查，该村人口规模为1,144人，该村位于长江之滨。我们收集了居民的血液和尿液样本，并检测了抗体滴度，HLA和TNF-α作为遗传标记，以及血清IV型胶原和间充质金属蛋白酶-2（MMP-2）水平。根据世界卫生组织（WHO）的诊断标准，采用B超诊断日本血吸虫性肝纤维化，随机检测500名居民，2年内连续检测180人，其中26.8%的人血清学阳性，表明有血吸虫感染史。塞罗普 ...更多信息 （a）男性、（B）成年人和（c）农民的阳性率显著升高。属于这一组的个体表现出显著高的水接触，同时这18个月的再感染率在这一组中显著高。虽然我们研究了这个村庄中间宿主螺的栖息地，但由于村庄太小，我们没有观察到血清阳性率与可能的螺分布强度之间的显著联系（1.48km^2）。我们尝试建立了一种新的生态学参数估算方法;检测尿中抗β-内酰胺酶体抗原和抗β-内酰胺酶体抗体，并检测与肝纤维化程度相关的血清学指标。尿抗体水平与血清抗体水平有显著相关性。血清IV型胶原和MMP-2水平与肝纤维化程度相关。这些结果表明，它们可能有用的流行病学研究，因为易于处理和成本效益。少

Epidemiological analysis was done in an endemic area of marshland-type achistosomiasis japonica in China. The aim of this cooperative research project was to characterize endemic patterns of schistosomiasis in the studied area, to identify risk factors for the infection, and to develop effective countermeasure for this disease. We did survey in Rinjiang village, Hunan Province, of which population size was 1,144, and the village is located a long with the Yangzhi river. We collected blood and urine samples from residents, and tested for antibody titers, HLA and TNF-alpha as genetic markers, and serum level of type IV collagen and mesenchimal metaroproteinase-2 (MMP-2). Hepatic fibrosis induced by Schistosoma japonicum infection was diagnosed ultrasonographically based on the criteria of WHO.We tested 500 residents randomly, and 180 were tested consecutively in the two years.Of the tested subjects, 26.8% were seropositive for S.japonicum, indicating past infection of the parasite. Serop … More ositive rate was significantly elevated in (a) males, (b) adults and (c) farmers. Individuals belong to this group showed significantly high water-contact, and at the same time reinfection rate in these 18 months was significantly high in this group. Although we studied habitant areas of the intermediate snail hosts in this village, we did not observed significant association between seropositive rate and intensity of snail distribution possible because the village was too small (1.48km^2).We tried to develop new method for evaluating epiodemiological parameters ; detection of schistosome antigens and anti-schistosome antibodies in urine and detecting serum parameters correlated with degree of hepatic fibrosis. We observed that antibody level in urine showed significant association with that of serum antibody. Serum levels of type IV collagen and MMP-2 were also correlated with degree of hepatic fibrosis. Those results suggests their probable usefulness in epidemiological study because of the easy handling and cost-effectiveness. Less