我国五省农村地区开展人群干预后癫癎治疗缺口的变化

Decreased treatment gap in epilepsy after intervention in five rural areas of China

目的检验我国农村地区开展人群干预管理后癫癎治疗缺口的变化,为进一步推广癫癎社区控制经验提供依据。方法 2004年 WHO 合作项目结束后6个月,在开展项目的5个省农村示范地区,采用与基线调查完全相同的方法和标准随机抽样调查该地区癫癎流行病学状况,并对两次调查结果进行比较,以了解示范区干预前后癫癎患者的治疗情况以及治疗缺口的改变。结果本次抽样调查5个农村人群共确诊癫癎患者320例,患病率为0.62%。其中活动性癫癎的患病率为0.45%。而基线调查时癫癎患病率和活动性癫癎的患病率分别为0.70%和0.46%。采用正规治疗的癫癎患者由2000年调查时的24.8%上升至39.1%。活动性癫癎的治疗缺口由基线调查时的62.6%下降为49.8%。结论农村地区的癫癎患者经过 WHO 示范项目的干预和管理,接受正规或合理治疗的比例明显提高;活动性癫癎的治疗缺口显著下降。从而证明本方案采用的干预对策适用于我国农村地区,并有很好的推广价值。

Objective To evaluate the change of treatment gap of epilepsy after intervention in rural areas of China. Method Six months after being stopped from the intervention project in 2004, using the same method as the first survey at the baseline, a door-to-door epidemiological survey was conducted again in 5 rural areas where the intervention measures had been carried out for about 3 years. Results Three hundred and twenty cases of epilepsy were diagnosed in the total sample population, yielding a prevalence rate of 0. 62% and the prevalence of active epilepsy 0. 44%. The prevalence and the active prevalence of epilepsy in the survey in 2000 were 0. 70% and 0.46% respectively. Of the people with epilepsy, 39. 1% were treated regularly which increased about 14% than that in the baseline survey （24. 8% ）. The treatment gap for active epilepsy was 49. 8%, which decreased by 12. 8% than that in the first survey （62. 6% ）. Conclusion The treatment gap of epilepsy in the demonstration areas has decreased remarkably, proving that the intervention measures used in the study are effective and feasible in rural areas of China.