口服青蒿琥酯预防血吸虫感染优化方案的探讨

为优化青蒿琥酯现场应用预防血吸虫感染方案 ,选择铜陵市灰河乡太阳村江滩型血吸虫病重流行区 ,根据人群接触疫水特点 ,将人群分为短期接触疫水人群 (年接触疫水时间 <1个月 ) ,中期接触疫水人群 (年接触疫水时间为 2～ 3个月 )和长期接触疫水人群 (年接触疫水时间为整个感染季节 ) ,分别施以不同服药方案。3类人群按随机原则分别分为青蒿琥酯组和安慰剂对照组。预防服药前 1个月对所有观察对象进行粪检及吡喹酮 (PQT) 4 0 m g/kg顿服普治 ,各组人群均于末次服药后 1个月作粪检 ,评价预防效果。结果显示 ,短期、中期和长期接触疫水人群中 ,口服青蒿琥酯组粪检阳性率分别为 0 (0 /2 10 )、0 (0 /311)和 0 .48% (1/2 0 9) ;对照组粪检阳性率分别为 6 .2 5 % (13/2 0 8)、5 .45 % (17/312 )和 8.7% (18/2 0 7) ,3类人群的预防保护率分别为 10 0 %、10 0 %和 94.48%。研究表明 ,在江滩型血吸虫病流行区根据人群接触疫水特点而实施不同服药方案可起到较好的预防血吸虫感染的效果 ,且可避免药物的浪费 ,有利于该药的现场推广应用

PROBE ON SCHEME WITH ORAL ARTESUNATE PROTECTING PEOPLE FROM INFECTION OF SCHISTOSOME

To provide more perfect scheme for artesunate protecting people from schistosomiasis infection in field, one severe endemic village was selected in Tongling City, Anhui Province. According to the character of contacting infective water, the villagers were divided into three groups, the group of short term contacting infective water(contacting infective water less than one month a year); the group of middle term contacting infective water(contacting infective water about two to three months a year); the group of long term contacting infective water(contacting infective water more than three months a year). The scheme of oral artesunate was different among three gronps. The villgsers were allocated randomly to artesunate group and control group by pairing method. About one month before artesunate prevention stool examination was carried out for the villagers, which was followed by treatment with praziquantel at single dose of 40 mg/kg.The preventive efficacy was evaluated by stool examination one month after the last medication. The results showed that the infection rate of short term, middle term, long term contacting infective water in artesunate groups was 0(0/210), 0(0/311), 0.48%(1/209) respectively, while in control groups, the infection rate was 6.25%(13/208), 5.48%(17/312), 8.70%(18/207) respectively. The prevention rate was 100%, 100%, 94.48 % respectively in the three group. It is suggested that to carry out different scheme with oral artesunate by the character of contacting infective water could protect people from infection of schistosome in rever beach areas. It could also avoid the waste of drug, and it was benefit for artesunate applying widely in fields.