重度疫区＂无血吸虫感染者学校＂干预模式研究

Study on an intervention model of ＂schools without infected students with schistosoma japanica＂ in heavy endemic areas

目的 研究重度疫区＂无血吸虫感染者学校＂干预模式,有效控制和预防学生感染血吸虫.方法 选择鄱阳湖血吸虫病重疫区新建、南昌、进贤和高新等4县（区）12所小学为研究现场,整群随机将其中10所小学分为实验组,另2所小学为对照组,所有在校学生为研究对象.2005年进行基线调查,2006-2008年对实验组应用＂信息传播＋行为参与＋行为激励＂模式进行干预,并考核干预效果.结果 干预前（2005年）,实验组和对照组目标人群血防知识知晓率分别为14.75%（324/2196）、16.58%（91/549）,两组差异无统计学意义（x2=1.14,P＞0.05）;血防态度正确率分别为14.71%（323/2196）、11.84%（65/549）,两组差异无统计学意义（x2=2.98,P＞0.05）;接触疫水率分别为15.44%（18 988/122 976）、15.03%（4622/30 744）,两组差异无统计学意义（x2=3.13,P＞0.05）;血吸虫感染率分别为9.65%（212/2196）、10.56%（58/549）,两组差异无统计学意义（x2=0.41,P＞0.05）.干预后第1年（2006年）,实验组和对照组血防知识知晓率分别为97.79%（2032/2078）、18.11%（98/541）,两组差异有统计学意义（x2=1794.31,P＜0.01）;血防态度正确率分别为99.09%（2059/2078）、13.49%（73/541）,两组差异有统计学意义（x2=2077.45,P＜0.01）.干预后1～3年（2006-2008年）,实验组连续3年未见接触疫水者和血吸虫感染者;同期对照组接触疫水率分别为16.12%（4884/30 296）、11.11%（3079/27 720）、12.25%（3451/28 168）,血吸虫感染率分别为8.87%（48/541）、7.47%（37/495）、7.95%（40/503）.结论 ＂信息传播＋行为参与＋行为激励＂健康促进模式干预可有效控制和预防重疫区学生感染血吸虫.

Objective To study an intervention model of ＂schools without infected students with schistosoma japanica＂, to control and prevent students from schisotosoma infection. Methods Twelve primary schools of four heavy endemic counties （districts） with schistosomiasis in the Poyang Lake areas were selected as the study fields, of which, ten schools were the experimental groups, and the other two schools were the control groups by cluster random sampling. All enrolment students were the target population. The baseline survey was carried out in 2005, and an intervention model, ＂information dissemination ＋ behavior participation ＋ behavior encouragement＂ ,was applied in the experiment groups in 2006 - 2008, then the effect of intervention was assessed. Results Before intervention （ 2005 ） , the antischistosomiasis knowledge awareness rate of experimental and control groups were 14. 75% （ 324/2196 ） and 16. 58% （91/549）, and the different was not significant （ x2 = 1.14, P ＞ 0. 05 ） ;the rate of accurate attitude of anti-schistosomiasis were 14. 71% （ 323/2196 ） and 11.84% （ 65/549 ） in experimental and control groups ,and the difference was not significant （ x2 = 2. 98, P ＞ 0. 05 ）; the rate of contacting infected water were 15.44% （18 988/122 976） and 15.03% （4622/30 744） in experimental and control group and the difference was not significant （ x2 = 3.13, P ＞ 0. 05 ）; and the infection rate of schistosomiasis of experiment control groups were 9. 65% （212/2196）and 10. 56% （58/549） ,the difference was not significant （ x2 =0.41,P＞0.05 ）. After one year intervention （2006）, the anti-schistosomiasis knowledge awareness rate of experimental and control groups were 97. 79% （2032/2078） and 18. 11% （98/541）, and the different was significant （ x2 = 1794. 31, P ＜ 0. 01 ）; the rate of accurate attitude of anti-schistosomiasis were 99. 09%（2059/2078） and 13.49% （73/541）in experimental and control group, and the difference was significant （ x2 = 2077.45, P ＜ 0. 01 ）. After 1 - 3 years intervention （ 2006 - 2008 ）, there were no any contactors with infected water and infectors with schistosome in students of the experiment group in successive 3 years. While in the control group of the same period, the rate contacting infected water were 16. 12% （4884/30 296）,11.11%（3079/27 720） and 12.25% （3451/28 168）; the infection rate of schistosomiasis were 8.87%（48/541） ,7. 47% （ 37/495 ） and 7.95% （40/503）, respectively. Conclusion The intervention model of health promotion,＂ information dissemination ＋ behavior participation ＋ behavior encouragement＂ ,can effectively control and prevent students from infecting schisosome japonica in heavy endemic areas with schistosomaisis.