Farag M K, el-Shazly A M, Khashaba M T, Attia R A
Department of Community Medicine, Mansoura University, Egypt.
Trans R Soc Trop Med Hyg. 1993 May-Jun;87(3):250-3. doi: 10.1016/0035-9203(93)90112-4.
In a population-based study in the Nile Delta of Egypt, the modified Kato thick smear technique was used to study the epidemiology of Schistosoma mansoni. After 2 years of implementation of the National Bilharzia Control Programme by the Ministry of Health, the general prevalence dropped from 47.2% to 21.9%. The peak prevalence rate has shifted downwards in magnitude (40.4% compared to 72.1%) and backwards over the age scale (5-14 in contrast to 15-19 years age group). Redistribution of various infection grades has taken place. More than three-quarters (75.6%) of the infected individuals have light infections in contrast to only one-fifth (20%) 2 years ago. The mean egg count for the entire sample population has dropped significantly (P < 0.05) from 128 to 17 eggs/g stools with no significant difference between males and females. This positive impact can be attributed largely to the case finding and treatment component of the programme. However, the incidence rate remained nearly the same before and 2 years after implementation of the programme (18.7 and 18.1%, respectively). The non-changing high incidence rate indicates that the knowledge, attitude and practice (KAP) of the population concerning water contact have not yet changed. Insufficient improvement in environmental sanitation may be a contributing factor. Continuation of serious efforts in case finding and treatment is recommended, with special emphasis on schoolchildren. This should be coupled with an intensive health education programme.
在埃及尼罗河三角洲开展的一项基于人群的研究中，采用改良加藤厚涂片技术研究曼氏血吸虫的流行病学情况。在卫生部实施国家血吸虫病控制规划两年后，总体流行率从47.2%降至21.9%。流行率峰值在幅度上向下移动（从72.1%降至40.4%），且在年龄范围上向后推移（从15 - 19岁年龄组变为5 - 14岁）。不同感染等级发生了重新分布。超过四分之三（75.6%）的感染者为轻度感染，而两年前这一比例仅为五分之一（20%）。整个样本人群的平均虫卵计数从128个/克粪便显著降至17个/克粪便（P < 0.05），男性和女性之间无显著差异。这一积极影响很大程度上可归因于该规划中的病例发现和治疗部分。然而，该规划实施前和实施两年后的发病率几乎保持不变（分别为18.7%和18.1%）。发病率居高不下表明人群关于接触水的知识、态度和行为（KAP）尚未改变。环境卫生改善不足可能是一个促成因素。建议继续大力开展病例发现和治疗工作，特别关注学童。这应与强化健康教育规划相结合。
