湖沼型血吸虫病流行区用蒿甲醚预防感染日本血吸虫的现场研究

OBSERVATION ON THE EFFECT OF ARTEMETHER ON CONTROLLING SCHISTOSOMIASISJAPONICA IN AN ENDEMIC AREA OF MARSHLAND

目的 :观察湖沼型血吸虫病流行区用蒿甲醚预防日本血吸虫感染的效果。方法 :1996年4— 11月 ,选择安徽省贵池市唐田乡 2个村为试点 ,选择 6岁— 65岁村民随机配对分为蒿甲醚组和对照组。在服蒿甲醚前 2 0 d,经粪检查病 ,并服单剂吡喹酮 4 0 mg/kg— 50 mg/kg治疗。于 5月下旬口服第 1剂蒿甲醚 6mg/kg,以后每半个月服 1次 ,共 10次 ,对照组口服相同剂型的安慰剂。结果 :口服蒿甲醚 4 33例粪检全部阴性 ,无急性血吸虫病发生 ;对照组 4 52人的粪检感染率为8.9% ,并发生 1例急性血吸虫病。口服蒿甲醚对肝、肾功能、网织红细胞和心电图未见明显异常。结论 :在整个传播季节每半个月口服 1次蒿甲醚 6mg/kg,对湖沼型重度血吸虫病流行区人群有较好的预防作用 ,为制定防治湖区血吸虫病策略提供一种新的措施。

AIM:To study the prophylactic effectof artemether againstinfection caused by Schisto- soma japonicum,in an endemic area of marshlands.METHODS:From April to November, 1 996 ,2 villages in Tangtian township of Guichi City,Anhui Province were selected as the pilot site.A total of92 0 villagers aged6 - 6 5 years were selected as subjects and allocated randomly to artemether group and the control group by pairing method.About 2 0 days be- fore artemether prevention stool examination was carried out for the villagers of both groups,which was followed by treatment of all the examinees with praziquantel at a single dose of40 - 5 0 mg/kg.In artemether group,an initial dose of6 mg/kg was given in the last ten- day period of May,pursued by repeated dosing once every1 5 days for1 0 times.Placebo (starch) 6 mg/kg was given to villagers in the control group simultaneously.The preventive efficacy was evaluated by stool examination4weeks after the last medication.RESULTS:In artemether group no egg positive case (0 /4 33) was seen,while in the control group 40 vil- lagers were revealed egg- positive with an infection rate of8.8% (40 /4 5 2 ) .Furthermore,1 case of acute schistosomiasis was present in the control group,but none in artemether group.No apparent changes in hepatic and renal functions,reticulocyte count or electrocar- diograph was evidenced after completion of artemether administrartion.CONCLUSION:In hyper- endemic area of schistosomiasis in marshlands,artemether 6 mg/kg given orally once every1 5 days to villagers throughout the whole transmission season resulted in promising protection,that the drug could preventthem from schistosome infection.The study provides an effective measure for planning new strategies to be used in schistosomiasis control.