Holland C V, O'Shea E, Asaolu S O, Turley O, Crompton D W
Department of Zoology, Trinity College, Dublin, Ireland.
J Parasitol. 1996 Aug;82(4):527-30.
A study to compare effects of mass, targeted, and selective chemotherapy with levamisole as an intervention for the control of Ascaris lumbricoides was carried out in 3 communities in rural Oyo State, Nigeria. Selective treatment was applied in 1 village by treating the most heavily infected 20% of the inhabitants, targeted treatment in the second village involved children aged 2-15 yr, whereas mass treatment was offered to all inhabitants in the third village, excluding infants under 1 yr and pregnant women. Intensity (eggs per gram,) of A. lumbricoides infection was determined immediately before and 3 mo after the period of intervention as a means of assessing the relative efficacy of the treatment regimes. During the field study, information on resource use was also collected for a retrospective cost analysis of the 3 strategies Resources used included manpower, materials, drugs, and transport. The results of the parasitological evaluation on the effect of treatment on egg intensity were then combined with the cost analysis to provide an overall measure of the cost-effectiveness of mass, targeted, and selective interventions. The results were expressed in terms of the cost per 1,000 egg reduction in intensity and the cost per person treated. The results showed the mass and targeted approach to be considerably more cost effective than the selective approach.
在尼日利亚奥约州农村的3个社区开展了一项研究，比较大规模化疗、目标性化疗和选择性化疗联合左旋咪唑作为控制蛔虫感染干预措施的效果。在1个村庄采用选择性治疗，即治疗感染最严重的20%的居民；在第2个村庄采用目标性治疗，针对2至15岁的儿童；而在第3个村庄对所有居民进行大规模治疗，但1岁以下婴儿和孕妇除外。在干预期开始前和结束后3个月测定蛔虫感染强度（每克粪便中的虫卵数），以此评估不同治疗方案的相对疗效。在实地研究期间，还收集了资源使用信息，以便对这3种策略进行回顾性成本分析。所使用的资源包括人力、材料、药品和运输。然后，将治疗对虫卵强度影响的寄生虫学评估结果与成本分析相结合，以全面衡量大规模、目标性和选择性干预措施的成本效益。结果以每降低1000个虫卵强度的成本和每人治疗成本表示。结果表明，大规模治疗和目标性治疗方法比选择性治疗方法更具成本效益。
