云南山区血吸虫病流行区用口服蒿甲醚控制血吸虫病的观察

目的 :　在山区血吸虫病流行区观察口服蒿甲醚 ( Art)对控制血吸虫病的作用。方法 :选择云南省永胜县阳河的 8个自然村为试区。该试区钉螺感染率为 0 .38% ,感染螺平均密度为 0 .0 0 86只 / 0 .11m2 ,居民感染率为 18.2 %。将 8个自然村随机配对分为 Art组和对照组 ,并以试区内3- 60岁经常接触疫水的居民为观察对象 ,经粪检血吸虫卵阳性者口服 1次吡喹酮 50 mg/ kg治疗 ,血吸虫卵阴性者服 4 0 mg/ kg。观察对象于 5月下旬接触疫水半个月后 ,按双盲法服首剂 Art 6mg/ kg,对照组服安慰剂 ,以后每半个月服 1次 ,共 10次。末次服药后 1个月作粪检。结果 :Art组789人的粪检阳性率为 2 .9% ,对照组 717人的为 12 .1% ,两者的差异显著。对照组尚有 1例急性血吸虫病发生。结论 :在山区较重的血吸虫病流行区 ,于整个传播季节口服 Art,可明显降低居民重复感染血吸虫 ,有效地控制血吸虫病。

EFFECT OF ORAL ARTEMETHER IN CONTROLLING SCHISTOSOMIASISIN YUNNAN MOUNTAINOUSENDEMIC AREA

AIM:To study the effect of oral artemether(Art) in controllig schistosomiasis in en- demic area of mountainous type.METHODS:Eight naturual villages in Yanghe District, Yongsheng County,Yunnan Province were selected as the pilots.In the pilot,the infection rate of snails and the mean infected snail density were0 .38% and0 .0 0 86 /0 .1 1 m2 ,respec- tively,while the schistosome infection rate of the residents was 1 8.2 % .The 8natural vil- lages were divided randomly into Art group and the control group by paired method.The residents aged 3- 6 0 who contacted with infested water frequently were selected as the study objects and the residents were treated orally with praziquantel after stool examination.A single dose of5 0 mg/kg was given to the egg- positive residents and40 mg/kg was given to those with egg- negative.In the last ten- day period of May,i.e.,1 5 days after the residents contacted with the infested water,the firstdosing of Artand the placebo(starch) was given at a single dose of 6 mg/kg to the residents in Art group and the control group,respectively, according to double- blind method.Afterwards,the same dose of the2 drugs was given once every1 5 days for1 0 times.Stool examination was made in the residents of the2 groups one month after the lastmedication for evaluation of the prophylactic efficacy.RESULTS:In Art group,the egg- positive rate was2 .9% (2 3/789) ,while in the control group it was1 2 .1 % (87/71 7) .The difference between the 2 groups was statistically significant.Besides,1 case of acute schistosomiasis was seen in the control group,but no infected case was found in the Art group.CONCLUSION:In heavily schistosomiasis endemic area of mountainous type, oral Art given to the residents once every1 5 days throughout the whole transmission season resulted in an apparently decrease in reinfection with schistosomiasis and effective control of schistosomiasis.