加强少数民族中疟疾防治试点的研究

A pilot study on strengthening malaria control for ethnic minorities

目的探讨加强边远贫困地区少数民族中疟疾防治的有效策略。方法采用社区动员、生物医学和行为干预并重的疟疾防治措施,改进居民疟疾防治服务经济、地理、信息和文化方面的可及性。结果居民疟疾传播与预防、症状与求医方面的知识显著提高;与干预试验前比较,评估调查前夜睡在杀虫剂处理过的蚊帐(ITNs)中、发热后24h求医和发热病例到公共卫生机构就医的比值比(OR)分别为37.85%(95%CI:27.69%～51.88%)、22.28%(6.06%～96.87%)和7.94%(1.78%～49.54%);发病率、发热病例血片阳性率和一年内有发热史人员间接免疫荧光试验阳性率OR值分别为0.16%(0.08%～0.32%)、0.20%(0.10%～0.39%)和0.34%(0.22%～0.51%)。结论社区动员、生物医学和行为干预并重的疟疾防治措施有效地降低了当地疟疾的发病和流行程度。

Objective To explore the effective strategies for strengthening malaria control and prevention for ethnic minorities in the remote and poor mountainous areas. Methods Community mobilization, biomedical and behavioral intervention for malaria control were undertaken to promote the local residents economical, geographical, informational and cultural accessibility. Results The residents’ knowledge on malaria transmission and prevention, symptoms and medical consultation got increased significantly. Compared with the parameters before the intervention,the odds ratios（OR） of people sleeping in insecticide-treated mosquito nets（ITNs） the night before the final evaluation survey, febrile patients seeking medical attention within 24 hours of onset, and utilizing the public health services for treatment were 37.85%（95%CI： 27.69%-51.88%）, 22.28%（6.06%-96.87%）and 7.94%（1.78%-49.54%） respectively. The OR of the annual incidence, the smear positive rate of febrile patients and the indirect fluorescence antibody positive rate of people with a history of fever in the past year were 0.16%（0.08%-0.32%）, 0.20%（0.10%-0.39%）and 0.34%（0.22%-0.51%） respectively. Conclusion Community mobilization in combination with biomedical and behavioral interventions for the control and prevention of malaria can effectively lower the incidence and prevalence of malaria in the local area.