深圳市楼村华支睾吸虫综合干预措施效果评估

Evaluation of effectiveness of integrative intervention on Clonochis sinensis infection in a village of Shenzhen City

目的评价实施预防肝吸虫感染健康教育、鱼塘上厕所改造和淡水鱼感染肝吸虫囊蚴的监测等措施对阻断和控制华支睾吸虫病在深圳市楼村传播和流行的影响。方法项目实施前对全村6～65岁村民用血清ELISA方法筛查肝吸虫感染,对血清学检查阳性者,进行粪便病原学检查;被检者同时进行问卷调查与华支睾吸虫感染相关的行为方式,收集基本资料;项目实施中对同一目标人群实施了预防肝吸虫感染的健康教育,对生食淡水鱼生的人群进行干预,主要淡水鱼市场每年进行两次肝吸虫囊蚴感染的检测,同时对鱼塘上的厕所进行改建。结果通过两年的综合干预项目实施,楼村肝吸虫的感染率从4.75%(70/1473)下降到3.2%(47/1468);淡水鱼肝吸虫囊蚴的感染率从21.9%(38/173)下降到11%(22/200);沼螺肝吸虫尾蚴的感染率从1.6%(6/358)下降到0.9%(5/530);村民对预防肝吸虫感染的知晓率从54%提高到95%。结论预防肝吸虫感染的综合措施能够显著降低肝吸虫的感染,提高居民预防肝吸虫感染知识,对控制深圳市楼村肝吸虫病流行起到了决定性的作用。

Objective To evaluate measures of health education,toilet modification and metacercaria monitoring of fresh water fish so as to control infection and tansmission of Clonochis sinensis （C. sinensis）. Methods The infection status of C. sinensis in 1473 individuals （710 males and 763 females） were determined. The antibody of C. cinensis in blood sampling was detected with ELISA, and stool specimens of sera positive case were examined by modified Kato-Katz thick smear method. Uestionaire survey was also conducted by trained staff members for their life style and habits. Meantime health education and modication of toilets and other intervention activities were also carried out on people＇s habit of eating raw fish. Results The irffection rate of C. sinensis before intervetnioin and two years after intervention decreased from 4.75% （70/1473）to 3.2%（47/1468）,metacercaria infection rate of fresh water fish also decreased from 21.9% （38/173）to 11% （22/200）,cercaria infection rate of snial descended from 1.6% （6/358） to 0.9% （5/530）. The knowledge level of residents increased from 54% to 95%. Conclusion The integrated control measures can enhance the knowlesge level of the inhabitants and reduce the infection rate of C. sinensis