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目的探讨血吸虫病重疫区用线索化疗取代全民化疗的可行性。方法选择鄱阳湖区血吸虫病感染率15％～20％的6个流行村随机分成两组，实验组3个村实施以疫水接触史、血吸虫病相关症状为依据，筛选治疗对象的线索化疗；对照组3个村实施世行贷款血防项目规定的全民化疗方案，按统一方法进行效果考核和费用统计，平行对比两种化疗策略的费用效果。结果实验组人群感染率、感染度分别下降67．42％、73．42％，对照组分别下降72．15％、75．87％；实验组线索筛查与粪检阳性符合率达95．3％；线索化疗防治效果与全民化疗相近，而各项费用指标降低1／3以上。结论鄱阳湖区血吸虫病重疫区运用线索化疗策略，可以取得与“全民化疗”相近的防治效果，且节省费用和药品，易于推广实施。
Objective To investigate the feasibility of using clues chemotherapy instead of universal chemotherapy in severe endemic areas of schistosomiasis. Methods Six endemic villages with infection rates of 15% ~ 20% of schistosomiasis in Poyang Lake were randomly divided into two groups. Three villages in the experimental group were recruited to receive clues for the treatment based on the history of exposure to water and the related symptoms of schistosomiasis. Group 3 villages to implement the World Bank-funded blood-flu project provisions of universal chemotherapy program, according to a unified method of performance appraisal and cost statistics, parallel comparison of the cost-effectiveness of the two chemotherapy strategies. Results The infection rate and the infection rate of the experimental group decreased by 67.42% and 73.42% respectively, while the control group decreased by 72.15% and 75.87% respectively. The coincidence rate of the clues screening test and stool test in the experimental group reached 95.3 %; Clues to chemotherapy and prevention and treatment effect is similar to the national chemotherapy, while the cost index decreased by 1/3 or more. Conclusion The strategy of clues chemotherapy in the endemic area of schistosomiasis in Poyang Lake can achieve the similar prevention and cure effect as the “universal chemotherapy”, save the cost and medicine, and is easy to popularize and implement.