垸内水网型血吸虫病流行区居民接触疫水的定量研究

A QUANTITATIVE STUDY ON HUMAN WATER CONTACT IN DAM-CIRCLED MARSH REGIONS OF SCHISTOSOMA JAPONICUM

目的对居民接触疫水进行定量研究，为制定经济有效的防治对策提供依据。方法1997年5～11月，在坑内水网型日本血吸虫病流行区，对689名居民接触疫水行为进行了每半个月1次，每次2d的调查，内容包括接触疫水方式、时间、地点、持续时间、暴露面积。结果成年男性接触疫水以下水田、犁地等生产性为主，成年女性不仅有生产性接触，还有洗衣、洗菜等生活性接触。5月和7月是该地区的农忙时节，也是成年人接触疫水高峰季节。青少年接触疫水主要是洗衣、洗菜、抓鱼虾、玩水等非生产性接触，且在整个感染季节都处于相对低暴露状态，但其感染的发生率却很高。结论垸内水网型疫区不同人群疫水接触特点不一样，青少年可以通过积极有效的健康教育促进其行为改变，达到预防和控制血吸虫感染的目的；成人疫水接触多系生产性的或是生活必需的，根据当地特点，5～7月间，加强自我防护，并于8月份根据暴露情况及时化疗，减少血吸虫在体内存活时间，在当地是一种比较经济有效的血吸虫病防治手段。研究还表明低年龄组易感。

Objectives To make sure of the role of human water contact patterns in the dam-circled marsh region and develop cost-effective methods to provide guidelines for control pro-grammes in the region. Methods A quantitative study on human water contact was carried out in a dam-circled marsh region of Schistosoma japonicum in 2 days per half month from May 1997 to November 1997 after selective chemotherapy of 689 residents. The investigation mainly included du-ration and intensity of each water confact activities. Results Agricultural product such as trans-planting rice seedling or ploughing was the major water contact pattern of males,while females' ma-jor water contact patterns included not only agricultural product but also domestic contact such as washing clothes or vegetables. May and July were the busy months for cultivating among the whole year,and they were also the months of highest exposure to the adult. Major water contact patterns in children and young adolescents included washing clothes and vegetables, fishing and playing.However, water contact level was very low in them while their infection was quite high. Conclusions There are different patterns of water contact in different populations. For schistosomiasis con-trol,health education may be effective in children and young adolescents. In the adult,the patterns of water contact are agricultural and necessary domestic activities. So it is necessary to use self-pre-ventive motheds from May to July,and it is an economical method to conduct chemotherapy in Au-gust. This study also shows that children and young adolescents are susceptible.