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目的 评价在中度流行区较高感染率人群 (≥ 10 %而 <15 % )采用“询诊”法筛检的化疗方案和在中度流行区较低感染率人群 (<10 %而 >3 % )采用 IHA法隔年筛检 1次的化疗方案的防治效果和费用 -效果。方法 在血吸虫病流行区选择人群感染率为 10 %左右的 5个行政村的沿湖 2 0个村民组作为试区 ,其中 10个村民组实行“询诊”法筛检的化疗方案 ,另 10个村民组实行 IHA法筛检的化疗方案 ;方案实施 2年后评价两种化疗方案的防治效果和费用 -效果。当人群感染率下降到较低水平后 ,两组均采取 IHA法隔年筛检 1次的化疗方案 ,观察其防治效果和费用 -效果。结果 通过 2年现场实施 ,“询诊”组人群感染率下降 66.4% ,每百人感染率下降 1%的费用为 4.86元 ,“询诊”组的防治效果是 IHA法筛检组的 1.8倍 ,费用 -效果是 IHA组的 0 .75倍。当感染率下降到较低水平后 ,IHA法筛检方案的防治效果是较高感染率时的 2倍以上 ,每百人感染率下降 1%的费用是较高感染率时的 0 .6倍以下。结论 在中度流行区较高感染率人群宜采用“询诊”法筛检的化疗方案 ;在中度流行区较低感染率人群可采用免疫学方法筛检的化疗方案
Objective To evaluate the efficacy and safety of the chemotherapy regimen screened by the “inquiry” method in people with high prevalence in the moderate endemic areas (≥ 10% and <15%) and in the lower prevalence endemic populations (<10% and> 3 %) Control effect and cost-effectiveness of chemotherapy regimens that were screened once every year using the IHA method. Methods Twenty schistosomiasis endemic areas were selected as the pilot area in 20 administrative villages along the lake with about 10% infection rate. Among them, 10 villagers were enrolled in the “inquiry” screening program and the other 10 A village group to implement the IHA screening of chemotherapy programs; two years after the implementation of the program to evaluate the efficacy of two chemotherapy programs and cost-effectiveness. When the infection rate of the population dropped to a lower level, both groups took IHA once a year screening chemotherapy regimen to observe the control effect and cost-effectiveness. Results After 2 years of on-site implementation, the infection rate in consultation group decreased by 66.4% and the infection rate decreased by 1% per 100 persons was 4.86 yuan. The prevention and treatment effect in the consultation group was 1.8 times that of IHA screening group, Cost-effectiveness is 0.75 times higher than in the IHA group. When the infection rate dropped to a lower level, the IHA screening program was more than twice as effective at higher infection rates as the 0.6% reduction at a 1% reduction in infection rates per 100 people . Conclusion In the moderately endemic areas, the higher infection rate should adopt the chemotherapy method of “inquiry” screening method; in the moderate prevalence area, the infection rate of chemotherapy in the population with lower infection rate can be screened by immunological methods