边远贫困山区少数民族疟疾诊治干预效果分析

目的 探讨改进边远贫困山区少数民族疟疾诊断和治疗可及性策略.方法 免费提供疟疾诊断和治疗;培训当地本民族的村疟防员制作发热病人血片,为疟疾病人送药并监督服药,开展以入户为主的面对面健康教育.结果 村卫生人员与居民比从干预前的1:1 116.75改变为干预后的1:248.17;发热开始24 h内求医病人比例,使用公共卫生机构发热病人比例和对疟防服务满意村民比例分别从基线的23.03%(95%CI=18.81～27.71).56.94%(95%CI=52.55～61.25)和82.65%(95%CI=81.23～86.31)提高到干预后评估调查的86.95%(95%CI=68.47～96.57),91.30%(95%CI=74.13-98.51)和96.81%(95%CI=93.08～98.82).结论 改进当地经济、地理、信息和文化方面疟疾诊治可及性,与其他措施一起有效地降低了当地疟疾的发病和流行程度.

Effective analysis of malaria diagnosis and treatment intervention for ethnic minorities in remote mountainous areas

Objective To explore strategies of improving malaria diagnosis and treatment accessibility for ethnic mi-norities in remote mountainous areas. Methods Malaria diagnosis and treatment were given freely. Local village malaria control workers from the same ethnic group were trained to prepare blood smears of febrile patients, send anti-mkarial durgs, monitor treatment for malaria patients, and deliver face to face health education by visiting their fellow villagers house by house. Results Village health worker-resident ratios changed from 1:1116. 75 prior intervention to 1: 248. 17 post inter-vention. Proportions of febrile patients seeking treatment within 24 hours of fever onset, of using public health facilities a-mong febrile patients and of villagers who were satisfied with malarial control service increased from baseline 23.03(95% CI =18.81 -27.71),56.94% (95% C1 =52.55 -61.25) ,and 82.65% (95% CI=81.23 -86.31) to 86.96% (95% CI= 68. 47-96. 57) ,91.30 % (95 % CI=74. 13-98.51), and 96. 81% (95 % CI=93.08-98. 82) after the intervention. Con-clusion Improved accessibility of malaria diagnosis and treatment in economics,commute,information and attitude declined malaria incidence and prevalence with other measure together.