目的评价江滩型流行区实施江滩工业开发为主措施阻断血吸虫病传播的效果,为江滩地区阻断和消除血吸虫病提供有效对策。方法采用前瞻性现场研究的方法,选择一个江滩型血吸虫病流行区县,对圩外江滩环境实施以工业开发为主的综合治理。连续开展居民病情、家畜病情和环境螺情调查,并收集综合开发措施实施情况。分析比较实施综合开发前后血吸虫病疫情变化状况,综合评价阻断血吸虫病传播的效果。结果 2001-2015年项目区共开发江滩面积496.34hm~2,占江滩总面积的90.16%。其中,工业开发江滩面积411.80hm~2,占74.81%;农业开发江滩面积84.55hm~2,占15.36%。共对6条通江河道进行混凝土护坡4.87km,改造涵闸与建造沉螺池9座。实施工业开发为主措施后,项目区钉螺和感染性钉螺面积呈快速下降态势,2001-2007年钉螺面积下降了80.55%,年均下降13.43%,到2012年消灭了钉螺;2002-2005年查出感染性钉螺面积占97.92%(50.29/51.36),到2007年消灭了感染性钉螺。2001-2004年(开发初期)查出病人占总数的88.77%(245/276),居民感染率在0.14%-0.51%之间,期间发生急性感染病人122例;2005-2011年(开发中期)查出病人占总数的11.23%(31/276),居民感染率在0.01%~0.03%之间;2012-2015年(开发后期)未查到粪阳病人,居民感染率已降为0。15年间仅在开发前期的2003年查到粪检阳性家畜13头,当年家畜感染率为1.32%。结论江滩地区实施沿江工业开发是阻断血吸虫病传播与促进当地经济发展的共赢之策,但在实施工业开发的前期要重点加强人群感染防护,并加强家畜放牧管理,防止突发疫情的发生。 Objective To evaluate the effect of implementing the industrial development of riverside beach in Jiangtan endemic area to block the spread of schistosomiasis and provide an effective countermeasure for blocking and eliminating schistosomiasis in the river beach area. Methods A prospective field study was conducted to select a county where endemic schistosomiasis endemic to rivers and counties and comprehensive management based on industrial development was carried out on the environment outside the flood plain. Continue to carry out the investigation of residents’ condition, livestock condition and environmental snail, and collect the implementation of comprehensive development measures. Analysis and comparison before and after the comprehensive development of schistosomiasis epidemic situation, a comprehensive evaluation of the effect of blocking the spread of schistosomiasis. Results From 2001 to 2015, a total area of ​​496.34hm ~ 2 was developed in the project area, accounting for 90.16% of the total area of ​​the river. Among them, the industrial development of beach area 411.80hm ~ 2, accounting for 74.81%; agricultural development river beach area 84.55hm ~ 2, accounting for 15.36%. A total of 6 Tongjiang River concrete slope protection 4.87km, reconstruction culvert and the construction of sink pool 9. After the implementation of industrial development-based measures, the area of ​​snails and infectious snails in the project area showed a rapid decline. From 2001 to 2007, the areas of snails dropped by 80.55% and the average annual decline by 13.43%, and snails were eliminated by 2012; Infectious snail area accounted for 97.92% (50.29 / 51.36), in 2007 to eliminate the infectious snails. During the period from 2001 to 2004 (early stage of development), 88.77% (245/276) of the patients were detected and the infection rate was between 0.14% -0.51%. There were 122 cases of acute infection during the period from 2005 to 2011 (in the middle stage of development) Among them, 11.23% (31/276) of the patients were detected, and the infection rates among residents ranged from 0.01% to 0.03%. Infectious rate of residents with fecal-positive disease was not found between 2012 and 2015 (late development) In 2003, only 13 fecal positive animals were detected in 2003 before the development, when the infection rate of livestock was 1.32%. Conclusion The implementation of industrial development along Yangtze River in Jiangtan area is a win-win solution to stop the spread of schistosomiasis and promote local economic development. However, in the early stage of industrial development, it is necessary to strengthen the protection of population infection and to strengthen the livestock grazing management to prevent sudden outbreaks occur.