Gundersen S G, Birrie H, Torvik H P, Scherbaum H
Department of Infectious Diseases, Ullevaal Hospital, University of Oslo, Norway.
Trans R Soc Trop Med Hyg. 1990 Nov-Dec;84(6):819-25. doi: 10.1016/0035-9203(90)90095-v.
A simplified combination of human mass treatment with oxamniquine and focal snail control has been applied in a local Schistosoma mansoni control programme in a primary health care setting in the Dalati and Agallu Metti areas of the Ethiopian Blue Nile Valley. Teams of local health personnel and farmers did the daily work under intermittent supervision. Monthly snail surveys near the major villages disclosed a seasonal pattern with many infected snails during the dry season in upper stagnant sections of tributary rivers (1000-1200 m altitude) with favourable temperatures, and few snails in the rainy season. The highest prevalences and intensities of human infection were found in the 15-19 year age group living in the lower altitudes around 700 m. 5067 individuals (50-80% of the local population) were treated with 20-40 mg oxamniquine per kg body weight during the rainy seasons of 1985 (Dalati) and 1986 (Agallu Metti). In the Dalati area cross sectional surveys in 1985 and 1986, before and after the mass treatment, showed a reduction in prevalence from 42.4% to 11.4%, while in the Agallu Metti area a stratified random sample showed a prevalence reduction from 65.4% in 1986 to 7.8% in 1987 and a reduction in the prevalence of moderate to heavy infection (greater than 100 eggs per gram of stool) from 36.9% to 1.4%. Beginning in 1986 niclosamide was applied focally wherever infected snails were found and the monthly snail surveillance continued until 1989. As a result of this combined approach overall snail infection rates were reduced from 11.2% (Dalati) and 32% (Agallu Metti) to zero and 2% respectively. In 1989 the human prevalence was still only 8.6% in Agallu Metti. This programme has shown that it is feasible to control S. mansoni in these very remote localities through the primary health care system.
在埃塞俄比亚青尼罗河谷的达拉蒂和阿加卢梅蒂地区的初级卫生保健机构中，一项简化的人体群体服用奥沙尼喹和局部螺蛳控制相结合的措施已应用于当地的曼氏血吸虫病控制项目。当地卫生人员和农民团队在间歇性监督下开展日常工作。在主要村庄附近每月进行的螺蛳调查揭示了一种季节性模式：在支流上游停滞区域（海拔1000 - 1200米）的旱季，温度适宜，有许多受感染的螺蛳；而在雨季，螺蛳数量很少。人类感染率和感染强度最高的是居住在海拔约700米较低地区的15 - 19岁年龄组。在1985年（达拉蒂）和1986年（阿加卢梅蒂）的雨季，5067人（占当地人口的50 - 80%）接受了每千克体重20 - 40毫克奥沙尼喹的治疗。在达拉蒂地区，1985年和1986年大规模治疗前后的横断面调查显示，患病率从42.4%降至11.4%；而在阿加卢梅蒂地区，分层随机抽样显示患病率从1986年的65.4%降至1987年的7.8%，中度至重度感染（每克粪便中虫卵数大于100个）的患病率从36.9%降至1.4%。从1986年开始，凡发现受感染螺蛳的地方都进行局部氯硝柳胺处理，每月的螺蛳监测持续到1989年。由于这种综合措施，总体螺蛳感染率分别从11.2%（达拉蒂）和32%（阿加卢梅蒂）降至零和2%。1989年，阿加卢梅蒂地区的人群患病率仍仅为8.6%。该项目表明，通过初级卫生保健系统在这些非常偏远的地区控制曼氏血吸虫病是可行的。
