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目的了解人畜扩大化疗结合健康教育防治策略在洲滩型血吸虫病流行区的远期效果,提出相应的防治建议。方法通过纵向观察比较流行区防治策略实施前后的病情和螺情以及小学生的疫水接触行为。结果居民血吸虫感染率从实施前(1992年)的10.39%降至实施结束时(1995年)的0.96%,而钉螺感染率和阳性螺密度则分别下降了64.3%和86.3%。在对策中止实施3年后,疫情出现回升,居民感染率升至6.25%,其中尤以10~15岁年龄段升幅最大、男、女性感染率分别由2.82%、1.30%升至16.30%和11.11%;钉螺感染率及阳性螺密度分别回升240.00%和928.85%。同时比较健教前后小学生疫水接触情况,结果显示健教减少了接触疫水频数,但其在对策中止3年后出现上升。结论为巩固洲滩型流行区防治效果,在易感人群重点化疗的同时,应辅以易感地带局部灭螺,并保证儿童健康教育的连续性。
OBJECTIVE To understand the long-term effect of expanding the combination of chemotherapy and health education strategies in endemic areas of schistosomiasis japonica, and to put forward corresponding prevention and treatment recommendations. Methods Longitudinal observation was conducted to compare the prevalence and severity of prey and postnatal control strategies in endemic areas with the prevalence of water exposure among primary school students. Results The infection rate of Schistosoma japonicum decreased from 10.39% before implementation (1992) to 0.96% at the end of implementation (1995), while the infection rates of snails and positive ones decreased by 64.3% and 86.3% respectively. In the three years after the suspension of the measures, the epidemic rebounded and the rate of infection among residents rose to 6.25%, especially in the 10-15 age group. The prevalence of male and female infections rose from 2.82% and 1.30% to 16.30% and 11.11 respectively %; Snail infection rate and positive spiral density rose 240.00% and 928.85% respectively. At the same time, we compared the water exposure of primary schoolchildren before and after the health education. The results showed that health education reduced the frequency of contact with water, but it rose after 3 years of suspension. Conclusion In order to consolidate the prevention and cure effect of the endemic areas in the continental beach, the local chemotherapy should be supplemented with the local snail control in susceptible areas, and the continuity of children’s health education should be guaranteed.