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目的对山丘地区血吸虫病不同阶段与不同时期防治投入与产出进行评价,为山丘地区消除血吸虫病防治措施优化可能提供参考。方法在4个行政村采用回顾性与现场调查法收集2001-2011年防治血吸虫病措施产生的投入与支出资料,采用问卷调查法调查患病人群个人支出,居民经济来源差异及职业分布变化。所有费用经贴现后,按分类村进行成本效果分析。结果不同阶段,各防治措施总费用呈现维持阶段高于综合治理阶段和防治初期。不同时期,人群感染率及阳性螺面积下降1%与0.1 hm2的成本,二类村高于一类村;耕牛感染率下降1%成本,二类村低于一类村。患病居民分析表明传播控制达标前后,按年龄组分,40～50岁年龄组患病人数占比均最大,30～40岁年龄组在0支出费用组差异有统计学意义(2=6.26,P=0.012);按文化程度分,初中组在2 000～4 000元费用组中差异有统计学意义(2=4.49,P=0.041),高中组在0～500元费用组中差异有统计学意义(2=5.45,P=0.032)。居民人均收支差显示种植业为当地主要经济来源。结论山丘地区防治措施成本效果变化不均衡性提示,目前要减少单一感染率下降为目标的投入,提高综合传染因素监测及环境改造措施投入。
Objective To evaluate the prevention and treatment inputs and outputs of schistosomiasis in different stages and different periods in mountainous areas and provide references for the optimization of prevention and treatment measures for schistosomiasis in hills. Methods The retrospective and field survey methods were used to collect the data of input and expenditure caused by schistosomiasis prevention and control measures in 2001-2009 in four administrative villages. The questionnaires were used to investigate the personal expenditures, the sources of income of residents and the changes of occupational distribution. All costs are discounted, according to the cost-effective village analysis. The results of different stages, the total cost of prevention and control measures showed that the maintenance phase is higher than the comprehensive control stage and early stage of prevention and treatment. In different periods, the population infection rate and the positive spiral area decreased by 1% and the cost of 0.1 hm2. The second type of village was higher than the first type of village. The cattle infection rate decreased by 1%. The second type of village was lower than the first type of village. Analysis of the prevalence of residents before and after the spread control reached the age group, 40 to 50 age group accounted for the largest proportion of the total number of patients, 30 to 40 age group in the 0 expenditure group differences were statistically significant ( 2 = 6.26 , P = 0.012). According to the level of education, there was a significant difference in the junior middle school group in the fee of 2 000 ~ 4 000 yuan ( 2 = 4.49, P = 0.041) There was statistical significance (2 = 5.45, P = 0.032). Per capita household income and expenditure differential shows that the planting industry is the main source of local economy. Conclusion The imbalanced cost-effectiveness of prevention and control measures in hillside areas suggests that the current goal of reducing the single infection rate is to reduce the input of comprehensive infection factors and to improve the input of environmental rehabilitation measures.