口服蒿甲醚降低洲垸型血吸虫病流行区人群感染血吸虫的效果

REDUCTION OF SCHISTOSOMA JAPONICUM INFECTION IN AN ENDEMIC AREA IN ISLET WITH EMBANKMENT AFTER PROPHYLAXISWITH ORAL ARTEMETHER THROUGHOUT THE TRANSMISSION SEASON

目的 :在洲垸型血吸虫病流行区 ,于传播季节观察经常接触疫水人群口服蒿甲醚预防感染血吸虫的效果。方法 :选择 5岁 - 60岁的村民 789人 ,随机配对分为蒿甲醚组 ( 395人 )和对照组 ( 394人 )。预防前 1个月 ,两组人群粪检 ,其血吸虫感染率各为 2 9.5%和 2 9.2 % ,随即用吡喹酮治疗 ,虫卵阳性者 1次顿服 50 mg/ kg,虫卵阴性者顿服 4 0 mg/ kg。蒿甲醚组人群于 6月上旬接触疫水半个月后口服第 1剂蒿甲醚 6mg/ kg,以后每半个月服药 1次 ,共计 9次。对照组人群在上述时间内服安慰剂。两组人群于末次服药后 1个月作粪检 ,评价预防效果。结果 :蒿甲醚组和对照组完成 9次服药和作粪检的分别为 2 90人和 30 5人 ,虫卵阳性率则各为 1.7%和 2 6.9% ,两者间的差别具有显著意义。结论 :在洲垸型血吸虫病流行区 ,口服蒿甲醚可保护人群 ,防止重复感染 ,降低人群的血吸虫感染率。

AIM:To study the prophylactic effect of oral artemether on protecting people from Schistosoma japonicum infection in an endemic area located in an islet with embankment. METHODS:789villagers aged 5 - 6 0 years were allocated randomly to artemether (Art) and the control group by pairing method. The egg- positive rates in Art group and the control group were comparable (2 9.5 % vs 2 9.2 % ) . The firstdose of artemether 6 mg/ kg was given in the first ten- day of June to the villagers who had contacted the infested- water within 1 5 days,followed by repeated dosing once every 1 5 days for 9times. The villagers in the con- trol group were treated with placebo concurrently. Fecal examination was made for the 2 groups one month after the lastmedication for evaluation of preventive effect. RESULTS:In artemether group 5 out of 2 90 villagers who had completed 9times of medication showed egg- positive with an infection rate of 1 .7% ,while in the control group,82 out of 30 5 were positive with an infection rate of 2 6 .9% . The difference between the 2 groups was statisti- cally significant. CONCLUSION:The villagers in the schistosomiasis endemic area,an islet with embankment,were protected from superinfection of S. japonicum by administering artemether throughout the whole transmission season.