洲滩型流行区人畜扩大化疗结合健康教育防治效果的纵向观察

LONGISTUDINAL SURVEY ON CONTROL EFFECT OF EXTENDING CHEMOTHERAPY IN HUMAN AND CATTLE COMBINED WITH HEALTH EDUCATION IN ISLET AREA

目的了解人畜扩大化疗结合健康教育防治策略在洲滩型血吸虫病流行区的远期效果,提出相应的防治建议。方法通过纵向观察比较流行区防治策略实施前后的病情和螺情以及小学生的疫水接触行为。结果居民血吸虫感染率从实施前(1992年)的10.39%降至实施结束时(1995年)的0.96%,而钉螺感染率和阳性螺密度则分别下降了64.3%和86.3%。在对策中止实施3年后,疫情出现回升,居民感染率升至6.25%,其中尤以10～15岁年龄段升幅最大、男、女性感染率分别由2.82%、1.30%升至16.30%和11.11%;钉螺感染率及阳性螺密度分别回升240.00%和928.85%。同时比较健教前后小学生疫水接触情况,结果显示健教减少了接触疫水频数,但其在对策中止3年后出现上升。结论为巩固洲滩型流行区防治效果,在易感人群重点化疗的同时,应辅以易感地带局部灭螺,并保证儿童健康教育的连续性。

Objective To understand the long-dated effects of the extending chemotherapy combined with health edu- cation in endemic area of islet,and bing forth the corresponding advices of control.Method we performed the longistudinal survey of the prevalence in residents and snails and the behaviors of students’ contacting affect- ed waters before and after the strategy fulfilled.Result The prevalence in residents was decreased from 10.39% in 1992(the year that the control measures began)to 0.96% in 1995(the year that the control mea- sures were ended),and the infection rate of snail and the density of positive snail were reduced 64.3% and 86.3% respectively.After stopping the control measures for three years,the infection rate in residents rose to 6.25%,especially that of the children between the age of 10 and 15 years rose highest:the infection rate in male and female increased from 2.82% and 1.30% to 6.30% and 11.11% respectively.The infection rate of snail rose 240.00%,and the density of positive snail 928.85%.The survey of students’ conacting affected water showed that health education can reduce the contacting frequency,but it takes on rising trend after stop- ping the control measures.Conlusion In order to consolidate the control effect,we think that we should con- trol snail in focal transmission area and hold the continuity of health education in students on the basis of the chemotherapy of human and cattle.