Liu Lu, Yang Guo-Jing, Zhu Hong-Ru, Yang Kun, Ai Lin
Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province 214064, People's Republic of China.
National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, and Key Laboratory on Biology of Parasite and Vector, Ministry of Health, and WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China.
Infect Dis Poverty. 2014 May 7;3:16. doi: 10.1186/2049-9957-3-16. eCollection 2014.
Schistosomiasis japonica is still endemic in the People's Republic of China (P.R. China) in five provinces of lake and marshland regions and in two provinces of mountainous regions. Studies elucidated that individual and community perception, attitudes towards schistosomiasis, and hygiene behaviors were crucial factors for preventing schistosomiasis. This study sought to assess the knowledge of, attitudes towards, and practices (KAP) relating to schistosomiasis in two subtypes of a mountainous region in Eryuan County, Yunnan Province, P.R. China. The study's aim is to make suggestions for establishing more specific and effective control measures for disease transmission and interruption in two subtypes of a mountainous region with low-level infection rates.
A cross-sectional study of 3,000 inhabitants was carried out in the Yongle (plateau basin) and Xinzhuang (plateau canyon) communities of Eryuan County, Yunnan Province in November and December 2011. Stratified cluster random sampling was undertaken using a uniform set of quantitative questionnaires administered by trained assistants. This was further supported with qualitative data from in-depth interviews (IDIs) conducted with ten farmers and ten students. All participants were examined for schistosomiasis using both a serological test (indirect hemagglutination assay [IHA]) and a stool examination (Kato-Katz).
The total schistosomiasis knowledge rate in Yongle (83.4%) was significantly lower than that in Xinzhuang (95.5%). In both communities, among the respondents aged 15 years or below, more than one third didn't know the name, endemic areas, and animal reservoirs of schistosomiasis. The majority of respondents in Eryuan acquired their schistosomiasis knowledge from doctors, followed by handouts and hearing from others. The infection rate was once the highest in Yongle, but is now the highest in Xinzhuang, where there are more risk factors for schistosomiasis, such as frequently grazing cattle, digging vegetables or cutting grass in the field, as well as raising cattle by free grazing.
In short, Eryuan County's overall knowledge rate of schistosomiasis was found to be high. Due to various dominating risk factors, different control strategies should be designed keeping in mind the two different subtypes of endemic areas for schistosomiasis in mountainous regions, namely plateau basins and plateau canyons.
日本血吸虫病在中国仍流行于五个湖泊和沼泽地区省份以及两个山区省份。研究表明，个人和社区认知、对血吸虫病的态度以及卫生行为是预防血吸虫病的关键因素。本研究旨在评估中国云南省洱源县某山区两种亚型地区居民对血吸虫病的知识、态度和行为（KAP）。研究目的是为在低感染率的山区两种亚型地区制定更具体、有效的疾病传播控制和阻断措施提供建议。
2011年11月和12月，在云南省洱源县永乐（高原盆地）和新庄（高原峡谷）社区对3000名居民开展了一项横断面研究。采用分层整群随机抽样，由经过培训的助手使用统一的定量问卷进行调查。通过对10名农民和10名学生进行深入访谈获取的定性数据进一步支持了该研究。所有参与者均通过血清学检测（间接血凝试验[IHA]）和粪便检查（加藤厚涂片法）进行血吸虫病检测。
永乐地区的血吸虫病知识总知晓率（83.4%）显著低于新庄地区（95.5%）。在两个社区中，15岁及以下的受访者中，超过三分之一不知道血吸虫病的名称、流行地区和保虫宿主。洱源县的大多数受访者从医生那里获得血吸虫病知识，其次是宣传资料和他人讲述。感染率曾在永乐地区最高，但现在新庄地区最高，新庄存在更多血吸虫病危险因素，如频繁放牛、在田间挖菜或割草以及散放牛。
简而言之，洱源县的血吸虫病总体知晓率较高。由于存在各种主要危险因素，应针对山区血吸虫病流行地区的两种不同亚型，即高原盆地和高原峡谷，设计不同的控制策略。
