江苏省嗜人按蚊分布地区不同疟疾防治措施的费用-效果评价

目的　研究和选择更经济、有效的适合目前嗜人按蚊分布区控制疟疾暴发流行的防治措施以及在暴发流行已得到初步控制后疟疾疫点的控制和监测措施。　方法　采用现场试点研究方法对不同疟疾控制和监测措施进行费用 -效果评价和分析。　结果　采用传染源控制结合媒介控制措施的王店乡的报告发病率、血检阳性率和年带虫发病率均显著低于采用单一传染源控制措施的桂五镇 ,嗜人按蚊密度和中华按蚊密度也明显低于桂五镇 ;传染源控制结合杀虫剂浸帐措施和传染源控制结合杀虫剂浸泡蚊帐加畜舍喷洒措施对于控制嗜人按蚊媒介区的疟疾局部暴发流行均可取得明显的防治效果。但前者费用仅为后者费用的 5 5 %。在暴发点和局部暴发流行得到初步控制后 ,继续进行疟疾监测并对疫点采取传染源控制措施与采用传染源控制结合媒介控制的综合措施的防治效果相似 ,但前者所需费用则明显低于后者。　结论　媒介控制措施对于控制嗜人按蚊媒介区的局部暴发流行具有重要意义 ,采用传染源控制结合杀虫剂浸帐措施较经济、有效。在暴发流行得到初步控制后 ,传染源的监测和及时控制则成为疟疾防治的重点。对疫点仅采取传染源控制措施较为经济、有效。

COST-EFFECTIVE EVALUATION FOR DIFFERENT MALARIA CONTROL METHODS IN THE AREAS WITH ANOPHELES ANTHROPOPHAGUS IN JIANGSU PROVINCE

Objective To study and select more effective and economic malaria control methods suitably used in the areas with Anopheles anthropophagus for control of outbreak and for malaria surveillance and foci malaria control after control of the outbreak. Methods The field pilot research has been used for cost-effective evaluation of different malaria control and surveillance methods. Results The reported malaria incidence rate,microscopically positive rate and annul parasitic incidence rate (API) were lower in Wangdian Township,where case management with vector control method has been performed for malaria control,than that in Guiwu Township,where only case management method has been used. The densities of both An. anthropophagus and An. sinensis were also lower in Wangdian Township than that in Guiwu Township. Both of case management with vector control methods,the case management with insecticide treated bednet method and the case management with insecticide treated bed-net combined insecticide spread in domestic animals houses,have successfully results for control of outbreak in the areas with An. anthropophagus vector. However,the cost of the former was only about 55% of the latter. After control of outbreak,the two methods,the case management and the case management with vector control have shown the similar results for foci malaria control in the areas with An. anthropophagus vector. However,the cost of the case management method was lower than that of the case management with vector control method. Conclusion Vector control method is more important for control of malaria outbreak in the areas with An. anthropophagus vector. The method of case management with insecticide treated bednet is effective and economic for malaria control in these areas. However,after control of outbreak,case management and surveillance is most important. The case management method is effective and economic for foci malaria control in these areas.