化疗控制人群感染日本血吸虫的效果分析

目的 探讨以选择性化疗为主的防制措施控制日本血吸虫病感染的效果。方法利用2000-2002年全国血吸虫病监测点资料,采用Meta分析中的随机效应模型分析化疗控制日本血吸虫感染的效果。结果经化疗后1年,居民感染率在10％以上的观察村,居民血吸虫感染率、患者和人群感染度均明显下降,分别下降20.15％、22.91％和33.93％,其95％的可信区间(CI)分别为6.95-31.48、14.69-30 34和11.69-50.68;居民感染率在6％-10％之间的观察村,化疗仍可以明显降低血吸虫感染率,下降了24.50％,其95％CI为5.35-39.83,但感染率<6％的观察村,感染率不再明显下降;患者和人群感染度在居民感染率≤10％的观察村,均维持在原有的水平。结论 以选择性化疗为主的防制措施仍能有效降低中国血吸虫病的病情,并将其控制在一个较低的水平,但很难达到阻断血吸虫病的目的。

Effect of chemotherapy on the control of schistosomiasis Japonicum

Objective To study the effect of infection control on schistosomasis Japonicum based on selective chemotherapy. Methods Data were derived from national surveillance of schistosomiasis from 2000 to 2002, and random effect modei of Meta-analysis was used to analyze the effect of chemotherapy on controlling schistosomiasis infection. Results One year after chemotherapy was started in the pilot villages where infection rate of schistosomiasis was more than 10% , the infection rates among residents and eggs per gram(EPG) of patients as well as population(geometric mean, GM) significantly reduced by 20. 15% , 22.91% and 33.93% with 95% confidence interval(CI) 6.95-31.48,14.69-30.34 and 11.69-50.68 respectively. In the pilot villages where infection rates were between 6% and 10% , the control measures largely base on chemotherapy sigmficantly reduced the infection rate, by 24.50(95% CI: 5. 35-39.83). However the infection rates were no longer reduced in the pilot villages where the infection rate was less than 6 % ; EPG of patients and residents were maintained at the onginal Ievel in the pilot villages where infection rate was 10% or less. Conclusion In Chma, the rates of schistosomiasis Japonicum infection could be effectively reduced through the control measures largely based on chemotherapy, and they were kept at a relatively low level. However, it was very difficult to interrupt the transmission of schistosomiasis.