Wu G L, Yuan J H, He Q, Wu F D, Zhang S J, Wei R M, Li G H, Xiang J Y, Jiang X L, Wiest P M
Nanjing Medical College.
Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 1991;9(4):274-7.
Since the primary objective of mass chemotherapy in schistosomiasis control is reduction of schistosome-induced morbidity, it would be reasonable to assess the impact of a control program on the morbidity in a given population by investigating hepato-splenomegaly associated with schistosomiasis in a schistosomiasis endemic area. In this paper, the authors described the relationship between the prevalence, intensity and morbidity of Schistosoma japonicum infection in terms of stool egg count and ultrasonographically detectable hepatosplenomegaly in a community-based study. It was found that the epidemiological pattern of the infection in this study community was quite different from our usual understanding, that is, the prevalence remained relatively high (39.4%) when the intensity became lower. This unusual pattern might be resulted from intermittent and sporadic chemotherapy associated with frequent exposure of people to the infection in an area of high transmission. It was surprised to note that despite the praziquantel treatment carried out over the past years, the prevalence of hepatosplenomegaly induced by schistosomiasis in this community was still very high, suggesting that intermittent and sporadic chemotherapy might render little impact on schistosomiasis-induced morbidity. The investigation also showed that ultrasonography was a sensitive tool for assessing morbidity associated with schistosome infection.
由于在血吸虫病防治中大规模化疗的主要目标是降低血吸虫引起的发病率，那么通过调查血吸虫病流行地区与血吸虫病相关的肝脾肿大情况，来评估控制项目对特定人群发病率的影响是合理的。在本文中，作者在一项基于社区的研究中，根据粪便虫卵计数以及超声检查可检测到的肝脾肿大情况，描述了日本血吸虫感染的流行率、感染强度与发病率之间的关系。研究发现，该研究社区的感染流行病学模式与我们通常的认知大不相同，即当感染强度降低时，流行率仍相对较高（39.4%）。这种不寻常的模式可能是由于在高传播地区，人们频繁接触感染源，同时进行的化疗是间歇性和零星的。令人惊讶的是，尽管在过去几年中进行了吡喹酮治疗，但该社区血吸虫病引起的肝脾肿大流行率仍然很高，这表明间歇性和零星化疗可能对血吸虫病引起的发病率影响甚微。调查还表明，超声检查是评估与血吸虫感染相关发病率的敏感工具。
