Wiest P M, Wu G, Zhong S, McGarvey S T, Yuan J, Olveda R M, Peters P A, Olds G R
Department of Medicine, Miriam Hospital and International Health Institute, Providence, Rhode Island.
Am J Trop Med Hyg. 1994 Aug;51(2):162-9. doi: 10.4269/ajtmh.1994.51.162.
The impact of annual screening and treatment with praziquantel on schistosomiasis japonica was examined on Jishan Island in Po Yang Lake, Jiangxi Province. China. Prevalence of infection in the community decreased from 39% in year 1 to 33% in year 3 with a corresponding decrease in the geometric mean egg count from 51 eggs per gram of stool (epg) to 31 epg. The most dramatic changes in infection status and intensity of infection were observed in younger individuals (0-19 years of age). The prevalence of hepatosplenomegaly also significantly decreased, again primarily in younger individuals. No change in the community prevalence of schistosome-induced hepatic fibrosis was observed as determined by ultrasonography. Longitudinal cohort analysis, however, demonstrated significant improvement in treated individuals with advanced hepatic fibrosis. These data indicate that annual screening and treatment had a significant impact on infection status and morbidity and suggest that community therapy may be an effective approach to control schistosomiasis japonica in lake regions and marshlands in China. Further studies are necessary to determine the optimal and most cost-effective approach for drug delivery.
在中国江西省鄱阳湖吉山岛，研究了吡喹酮年度筛查和治疗对日本血吸虫病的影响。社区感染率从第1年的39%下降到第3年的33%，粪便每克虫卵几何平均数（epg）相应地从51个虫卵降至31个虫卵。在较年轻个体（0至19岁）中观察到感染状况和感染强度的最显著变化。肝脾肿大患病率也显著下降，同样主要发生在较年轻个体中。通过超声检查确定，血吸虫性肝纤维化的社区患病率没有变化。然而，纵向队列分析表明，患有晚期肝纤维化的治疗个体有显著改善。这些数据表明年度筛查和治疗对感染状况和发病率有显著影响，并表明社区治疗可能是控制中国湖区和沼泽地日本血吸虫病的有效方法。有必要进一步研究以确定最佳且最具成本效益的药物递送方法。
