血吸虫病低度流行区化疗对象筛查方法的比较及费用-效果分析

Cost-Effectiveness Analysis on Different Schistosomiasis Case Screen Methods in Hypo-Endemic Area

目的寻找血吸虫病低度流行区简便、有效、经济、适用的化疗对象筛查方法。方法分别以粪检、询检、间接血凝法 (IHA)及胶体染料试纸条法 (DSIA)对居民进行血吸虫病筛查 ,并分析和评价。结果各项评价指标 IHA均优于其它方法 ,与粪检总符合率为 93 .5 1 % ,阳性预告值为 2 4.49% ;DSIA各指标略低于 IHA;询检法相对较差。卫生经济学费用 -效果分析 ,IHA检出 1例感染者所需费用明显高于其他方法。结论 IHA具有简便、有效的优点 ,在感染率 <5 %的低度流行区是一种较可取的筛查方法 ,但所需费用仍较高 ;DSIA较 IHA更为简便、快速、廉价 。

Objective To develop simple, effective, low cost and practical case screen scheme for chemotherapy in schistosomiasis hypo endemic areas. Methods The residents in hypo endemic villages were screened with Kato Katz method as standard of being infected and then inquiry examination, IHA and DSIA technics were taken respectively. The results of the examinations and the cost effectiveness were assessed. Results All the appraisal indices of IHA were better than the others. Its total coincidence rate with stool examination was 93.51%, positive predictive value 24.49%. DSIA indices was lower than that of IHA, and inquiry examination was the lowest. Cost effectiveness analysis showed that the case screen cost of IHA was higher than that of the other technics except Kato Katz method. Conclusion Because of simple, effective and practical in hypo endemic areas, IHA technic was confirmed to be a kind of better case screen method but its cost was higher than that of the other methods. DSIA was also a good technic. It was simpler, less expensive, more rapid and sensitive but less specific than IHA technic.