湖沼型血吸虫病重度流行区防治策略及其效果评价

目的　评价、优化湖沼型血吸虫病重度流行区的防治策略。　方法　采用回顾性调查方法对湖区 5个血吸虫病重度流行村 1995～ 1999年的防治策略及其防治效果进行调查 ,分析防治措施效果和费用效果。　结果　防治效果以“化疗 +灭螺”为主体的综合措施效果最佳 ,“化疗 +健康教育”防治措施的疾病控制效果较显著 ,单纯化疗措施对疾病控制有一定的效果 ,但综合效果较差 ;“区域灭螺 +对象治疗”人群感染率下降 1%费用和总费用 /综合防治效果指数最低 ,费用效果最好 ,而综合性较强的措施防治效果较好 ,但投入最高 ,“健康教育 +化疗”及单纯化疗投入均不高 ,综合防治效果相对较差。　结论　化疗仍是此类地区控制疾病的主要手段 ,但为达到最佳防治效果 ,必须将螺情控制措施与化疗相结合 ,并辅以健康教育等措施

EVALUATION ON CONTROL STRATEGIES AND EFFECTIVENESS IN SCHISTOSOMIASIS HYPERENDEMIC MARSHLAND AREAS

Objective To explore an optimum schistosomiasis control strategy in schistosomiasis hyperendemic marshland areas. Methods A retrospective study on schistosomiasis control strategies and its effectiveness from 1995 to 1999 was made in 5 endemic villages in which different control strategies were carried out in schistosomiasis control respectively. Results The countermeasure of "chemotherapy+snail eradication" showed the best effectiveness in both morbidity and snail control; "health education" played an important role in morbidity control; chemotherapy was a major measure in morbidity control, but complementary measures should be added to improve the effectiveness. Synthetic measures needed high cost; "snail eradcation+patients treatment" showed the lowest index in cost of 1% decrease of population infection rate and the ratio of total cost and comprehensive effectiveness index; "health education+chemotherapy " and single chemotherapy needed low cost, but low effectiveness. Conclusion In schistosomiasis hyperendemic marshland areas, the measure of "snali eradication+chmotherapy" could be the optimum schistosomiasis control strategy, complementary measures should be added according to local situation to increase its effectiveness.