Yajima Aya, Cong Dai Tran, Trung Dung Do, Cam Thach Dang Thi, Montresor Antonio
Graduate School of Agricultural and Life Sciences, University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo, Japan.
Trans R Soc Trop Med Hyg. 2009 May;103(5):447-51. doi: 10.1016/j.trstmh.2009.01.007. Epub 2009 Feb 23.
Clonorchiasis is an emerging food-borne trematode infection in Vietnam. Due to the absence of cost-effective preventive measures its control largely relies on morbidity reduction by chemotherapy with praziquantel. We performed a comparative cost estimation of three different diagnostic and intervention approaches in areas of high and low prevalence of clonorchiasis in northern Vietnam in order to select more cost-effective chemotherapy. Our study confirmed that a questionnaire investigating the habit of eating raw, freshwater fish was a rapid, cost-effective and operationally feasible tool for identifying individuals at risk of clonorchiasis in both high-prevalence and low-prevalence areas. The cost of diagnosis and intervention per person and per true positive case was 20-fold higher in low-prevalence areas, regardless of the type of approach. Geographical mapping of high-risk areas prior to screening is, therefore, recommended to maximize the cost-effectiveness of the intervention activities.
华支睾吸虫病在越南是一种新出现的食源性吸虫感染。由于缺乏具有成本效益的预防措施，其控制主要依赖于通过吡喹酮化疗来降低发病率。我们对越南北部华支睾吸虫病高流行区和低流行区的三种不同诊断和干预方法进行了成本比较估算，以选择更具成本效益的化疗方法。我们的研究证实，一份调查食用生淡水鱼习惯的问卷，是在高流行区和低流行区识别华支睾吸虫病高危个体的快速、具有成本效益且操作可行的工具。无论采用何种方法，低流行区每人及每例真正阳性病例的诊断和干预成本都高出20倍。因此，建议在筛查前对高危地区进行地理绘图，以最大限度地提高干预活动的成本效益。
