湖沼型流行区以传染源控制为主的血吸虫病综合防治策略试点费用-效果评价

Cost-effectiveness of Comprehensive Measures with Emphasis on Infection Source Control for Schistosomiasis in Marshland Endemic Regions

目的评价以传染源控制为主的血吸虫病综合防治策略在湖沼型血吸虫病流行区短期的费用-效果。方法对8个血吸虫病流行村(试点村)2006-2009的防治措施、经费投入及防治效果进行调查,用项目前与项目实施后人群及家畜感染率每下降1%所需费用及总费用/综合指数作为分析指标,进行费用-效果评价。结果综合分析各试点村疫情及人口数、人均收入等因素,综合防治效果好,且经费投入低的是蒿州、皇屯及刘园村;南城、宝塔、渡口村综合效果指数较高,但其费用/指数也偏高;水府、洗马村费用/指数较低,但其综合效果指数也偏低。结论以传染源控制为主的血吸虫病综合防治措施在湖沼型流行区短期的费用效果明显,但如何结合当地疫情及社会、经济条件开展高效的项目投入,以有限的经费投入在远期产出更大的血防效果和经济、社会效益,是值得深思的问题。

Objective To evaluate the cost-effectiveness of adopting comprehensive measures with emphasis on infection source control for schistosomiasis in marshland endemic regions.Methods The prevention and control measures,financial input and control effect of eight schistosomiasis endemic villages（pilot villages）were selected and examined for their disease prevention and control,the financial input and the results of disease control between 2006 and 2009.The evaluation was based on the cost required to reduce the infection of humans and livestock,the total cost and the composite index.Results Comprehensive analysis of the epidemic and the population,per capita income and other factors of each pilot village,the effectiveness of comprehensive measures is better in the village of Haozhou,Huangtun and Liuyuan,with low cost,besides.The combined effect of index is higher in the village of Nancheng,Baota and Dukou,but its cost / index is also high.The cost / index in the village of Shuifu and Xima is low,but the combined effect of index is low,too.Conclusions The cost-effectiveness of emphasis on infections source control for schistosomiasis in marshland endemic regions is obvious in short-term.But we should consider more about how to carry effective project inputs combine with the local prevalence,the condition of society and economy,and how to produce larger effects and benefits of preventing schistosomiasis,and social,economic benefit with limited funding in the long term.