麻风病血清流行病学调查与化学预防的实施

Serous epidemiological investigation of leprosy and evaluation of the chemoprophylaxis

目的:评价化学预防的保护性,本研究依据血清流行病学调查,对两个麻风病高流行村麻风病接触者和一般人群实施利福平化学预防。方法:采用临床查体、检测血清酚糖脂-1(PGL-I)抗体和鼻分泌物麻风菌,了解人群的麻风菌感染状况,为评价预防治疗效果提供科学依据。结果:YG村临床普查率达98%,发现早期病人2例;接触者血清PGL-I抗体阳性率76%,麻风菌鼻携带率35%,预防服药率达98%。HG村临床普查率91%,发现早期病人1例,人群血清PGL-I抗体受检率54%,其中血清PGL-I抗体阳性率33%,服药率达85%。结论:对亚临床感染率较高的人群实施化学预防很有必要。预防后的发病率与血清学等实验室数据可为评价预防治疗提供依据。

Objective： Chemoprophylaxis with rifampicin （RFP） is administrated to all contacts and general pepalation in the two endemic villages based on serum epidemiological investigation of leprosy for evaluation of protection of chemoprophylaxis. Methods： Clinical examination, detection of phenolic glycolipid- 1 （PGL- I） antibody in sera and M. leprae in nasal secretion were applied for all people to understand infection with M. leprae in general population of endemic villages and providing the evidence for evaluation on prophylaxis. Results： The census rate was as high as 98% and 2 new cases of early skin lesion were detected in YG village. The positivity rate of PGL - I antibody was 76% and the rate of M. leprae nasal carriage 35% in contacts. RFP prophylaxis with one dose per month for 3 months was administrated to 98% of contacts in the YG village. In GH village, clinical examination was covered 91% of population and one early case was newly detected. 54% of population was accepted serological test, in which 33% were PGL - 1 antibody positive and 10% of contacts were found as M. leprae nasal carriage. Double dose of RFP was administrated for 85% population. Conclusion： Chemoprophylaxis is necessary to implement in people of sub-clinical infection with M. leprae. The incidence and serological test after chemoprophylaxis will be provided for evaluation of chemoprophylaxis.