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中国包虫病防治国家规划实施效果:2004-2014 年人群和犬只干预效果分析。

Progress on the national echinococcosis control programme in China: analysis of humans and dogs population intervention during 2004-2014.

机构信息

Department of Echinococcosis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.

Chinese Center for Tropical Diseases Research, Shanghai, 200025, China.

出版信息

Infect Dis Poverty. 2020 Oct 2;9(1):137. doi: 10.1186/s40249-020-00747-7.

Abstract

BACKGROUND

A national control program for echinococcosis has been in effect since 2005 in China. This program has applied a comprehensive strategy, and good control results have been achieved. Human echinococcosis prevalence rate decrease from 1.08% in 2004 to 0.24% in 2012. The objective of this study is focusing on assessment of the programme with two indices, including patient treatment and registered dogs deworming, in endemic areas of echincoccosis control over the period of 10 years (2004-2014) in China.

METHODS

We established the database including demography at county and township levels with coverage for ten provinces and autonomous regions of China in this study. We using methods of epidemiological descriptive, instead the expectation-maximization for missing value filling for grouping available patients into those subjected to surgery and those receiving drug treatment after population screening and the dogs population after registered by deworming. We performed Microsoft Excel software and SPSS software on the results as percentages with the corresponding 95% confidence intervals (95% CIs). We also statistically analyzed the economics data on patient treatment and dogs deworming after the corresponding discount with annual bank interest rates (USD 1 = CNY 6.5, bank discount average changes of 2.3-3.3%).

RESULTS

During 2004-2014, the grant total average rate of surgical patient (after surgical operation) treatment had increased with 32.4% and with 81.3% for medical treatment with albendazole. Meanwhile, it increased by 58.6% for the deworming of registered dog since 2007. The accumulated costs amounted to USD 27.03 million after discount for patients and registered dog treatment, which is 1/4 of the total accumulated financial inputs (USD 110.67 million from the Chinese Government). Since the implementation of the national program, it has increased 57 times with respect to the annual financial inputs (costs) and 368 times with respect to all accumulated financial inputs (costs).

CONCLUSIONS

This study showed that in endemic areas, patient diagnosis and management, dog management and treatment over this period helped reduce the parasite load to control the disease. More attention should be paid to controlling wild canines during the ongoing program period and sustainable follow-up evaluations are crucial for success and continued implementation of the national program.

摘要

背景

自 2005 年以来,中国一直在实施一项棘球蚴病控制国家规划。该规划采用了综合战略,已取得良好的控制效果。人类棘球蚴病的流行率已从 2004 年的 1.08%下降到 2012 年的 0.24%。本研究的目的是评估该规划在过去 10 年(2004-2014 年)中国棘球蚴病流行地区的两个指标,包括患者治疗和登记犬驱虫情况。

方法

我们建立了一个数据库,包括中国十个省和自治区的县级和乡镇级人口统计学数据。我们采用流行病学描述方法,而不是期望最大化法,对经过人群筛查的患者进行分组,分别接受手术治疗和药物治疗,对登记的犬只进行分组,分别接受驱虫治疗。我们使用 Microsoft Excel 软件和 SPSS 软件对结果进行百分比分析,并计算相应的 95%置信区间(95%CI)。我们还对经过相应折扣(按年银行利率 USD 1=CNY 6.5,银行平均贴现率变化为 2.3-3.3%)后的患者治疗和犬只驱虫的经济学数据进行了统计学分析。

结果

2004-2014 年,手术治疗(手术后)患者的补助总平均比例增加了 32.4%,阿苯达唑药物治疗增加了 81.3%。同时,自 2007 年以来,登记犬驱虫率增加了 58.6%。经折扣后,患者和登记犬治疗费用累计达 2703 万美元,占中国政府总投入(1.1067 亿美元)的 1/4。自国家规划实施以来,年度财政投入(成本)增加了 57 倍,累计财政投入(成本)增加了 368 倍。

结论

本研究表明,在流行地区,这一时期的患者诊断和管理、犬管理和治疗有助于减少寄生虫负荷,从而控制疾病。在规划实施期间,应更加关注控制野生犬类,持续进行后续评估对于规划的成功和持续实施至关重要。

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