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[以传染源控制为主的山丘型血吸虫病综合防治策略实施中的阻碍因素]

[Obstacle factors in implementation of integrated schistosomiasis prevention and control strategies with emphasis on infectious source in hilly endemic regions].

作者信息

Xu Jia, Chen Lin, Zhang Yi, Wu Jian-Jun, Wan Xue-Xiang, Zhu Rong, Xu Hui-Rong, Liu Qing, Huang Liang, Wu Zi-Song, Lu Long-Ting, Zhong Bo

机构信息

Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China.

Pujiang Center for Disease Control and Prevention, Chengdu City, China.

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2013 Dec;25(6):570-5.

Abstract

OBJECTIVE

To analyze the main obstacles existing in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source in hilly endemic regions, and to find out the current priority issues in schistosomiasis prevention and control, so as to provide the evidence for further solutions.

METHODS

Two typical hilly schistosomiasis endemic regions in Sichuan Province, including Pujiang County of Chengdu City and Dongpo District of Meishan City, were selected as research areas. A framework of obstacle factors in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infectious source in hilly endemic regions was built by literature review, and the management and technical personnel who worked on schistosomiasis prevention and control in eight different industries (health, agriculture, forestry and so on) and five levels (provincial, city, county, township and village levels) were investigated by questionnaires in the way of nominal group.

RESULTS

One hundred and fifty-three management and technical personnel in different industries and different levels were investigated. The questionnaire recovery rate (experts' positive coefficient) was 100%. The results showed that the first four problems needing to be concerned in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source were eliminating Oncomelania hupensis snails by projects, health education, examination and treatment for schistosomiasis persons, and harmless treatment of night-soil and safe water supply. The focuses of two counties in the implementation of integrated strategy measures were different. The harmless treatment of night-soil and safe water supply was the most important measure in Pujiang County, while the elimination of snails by projects was the most in Dong-po District.

CONCLUSIONS

As the differences in the situation of epidemic areas and the existed condition of the prevention and treatment progress, the comprehensive schistosomiasis control measures should be adjusted according to the local conditions in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source.

摘要

目的

分析山丘型血吸虫病流行区以传染源控制为主的综合防治策略实施过程中存在的主要障碍,找出当前血吸虫病防治工作的重点问题,为进一步解决问题提供依据。

方法

选取四川省两个典型山丘型血吸虫病流行区,即成都市蒲江县和眉山市东坡区作为研究地区。通过文献回顾构建山丘型血吸虫病流行区以传染源控制为主的综合防治策略实施障碍因素框架,并采用名义群体法通过问卷调查对卫生、农业、林业等8个不同行业及省、市、县、乡、村5个层面从事血吸虫病防治工作的管理和技术人员进行调查。

结果

共调查了153名不同行业、不同层面的管理和技术人员,问卷回收率(专家积极系数)为100%。结果显示,以传染源控制为主的综合防治策略实施过程中首先需要关注的4个问题依次为项目灭螺、健康教育、血吸虫病人查治、粪便无害化处理及安全供水。两个县在综合策略措施实施方面的侧重点不同,蒲江县最重要的措施是粪便无害化处理及安全供水,而东坡区则是项目灭螺。

结论

在以传染源控制为主的综合防治策略实施过程中,由于疫区情况及防治进展现有条件的差异,血吸虫病综合防治措施应因地制宜进行调整。

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