摘要
目的 研究湖沼型疫区居民血吸虫病健康促进干预模式,并观察其近期和远期干预效果.方法 选择鄱阳湖区饭湖村(实验组)和板山村(对照组)学生、16～60岁成年女性和成年男性居民为目标人群.1992年基线调查,1993-1999年和2000-2009年分别应用“信息传播+防护技能培训+奖惩激励”(模式A)和“信息传播+行为参与+行为激励”(模式B)干预实验组学生,1993-2009年分别应用“信息传播+血防价值观教育+行为激励”和“信息传播+化疗依从性教育+防护技能培训”模式干预成年女性和成年男性居民,并考核干预效果.结果 近期干预结果:实验组学生、成年女性、成年男性血防知识知晓率分别由干预前(1992年)8.99％、55.34％、67.35％提高到干预1年(1993)的94.38％、84.85％、91.92％ (P=0.000)；成年女性血防价值观正确率由干预前67.96％提高到95.96％( P＜0.01)；成年男性化疗态度正确率由干预前56.44％提高到97.98％(x2=48.722,P＜0.01),化疗行为依从率由干预前46.46％提高到92.08％ (P＜0.01)；学生和成年女性疫水接触率分别由干预前14.55％、9.47％下降到1.87％、5.07％(P＜0.01),血吸虫感染率分别由干预前13.48％、19.42％下降到2.25％、7.14％ (P＜0.05)；成年男性干预前和干预1年疫水接触率分别为38.39％、41.11％,血吸虫感染率分别为29.59％、41.41％,差异无统计学意义(P＞0.05).远期干预结果:1994-1999年模式A干预学生,接触疫水率和血吸虫感染率分别为0.50％～2.19％、1.04％～1.98％,2000-2009年模式B干预,未见接触疫水者和血吸虫感染者;1995-2009年成年女性感染率为5.05％～8.10％;1995-2009年成年男性血吸虫病化疗依从率为90.29％～97.52％,感染率为21.78％～42.31％,多数成年男性肝、脾肿大及肝纤维化趋向好转与稳定,未见新发晚期血吸虫病人.结论 健康促进干预可有效控制学生和成年女性血吸虫感染,提高成年男性血吸虫病化疗依从性,有效控制患病.
Abstract
Objective To study the health promotion intervention model of schistosomiasis for residents in lake-type endemic area, and observe the short- and long-term intervention effect. Methods Students, adult female and male of 16-60 year old in Fanhu village and Banshan village of Poyang Lake were selected as the experiment group and the control group, respectively. A baseline survey was carried out in 1992. The Model A, "Information dissemination + Protection training + Reward & Punishment", and the Model B, "Information dissemination + behavior participation + behavior motivation" were implemented to intervene the student of the experiment group during 1993-1999 and 2000-2009, respectively. Two models, "Information dissemination+schistosomiasis control view+behavior motivation" and " information dissemination+chemotherapy compliance education + protection training" were implemented to intervene to the adult female and male, respectively, and the intervention effect was evaluated. Results The short-term intervention effect: the awareness rate of anti-schistosomiasisknowledge in student, adult female and adult male of the experiment group increased from 8.99%, 55.34% and 67.35% before the intervention (1992) to 94.38%, 84.85% and 91.92% one year after the intervention (1993), respectively; the accuracy rate of anti-schistosomiasis view in adult female raised from 67.97% before the intervention to 95.96% after the intervention; the accuracy rate of attitude to chemotherapy and the compliance rate of chemotherapy in adult male increased from 56.44% and 46.46% before the intervention to 97.98% and 92.08% after the intervention, respectively. The rate of the student and adult female contacting contaminated water dropped from 14.55% and 9.47% before the intervention to 1.87% and 5.07%, respectively, and the infection rates of schistosome were dropped from 13.48% and 19.42% to 2.25% and 7.14%, respectively; the rate of contacting contaminated water and the infection rate of schistosome in adult male respectively were 38.39% and 41.11% before the intervention changed to 29.59% and 41.41%, with no significant difference. The long-term intervention effect: The rate of contacting contaminated water and the infection rate of schistosome in the student intervened by the Model A in 1994-1999 were ranged 0.50%-2.19% and 1.04%-1.98% , respectively. And no person was found of contacting contaminated water and infecting schistosome when the Model B was used to intervene in 2000-2009. The infection rate of adult female ranged from 5.05% to 8.10% during 1995-2009. The rate of chemotherapy compliance and the infection rate of schistosomiasis were 90.29%-97.52% and 21.78%-42.31% in 1995-2009, respectively. Hepatomegaly, splenomegaly and liver fibrosis of most adult male were improved and in stable condition. No new cases of advance stage of schistosomiasis were found. Conclusion Health promotion intervention may control the infection of schistosome in student and adult female, improve the chemotherapy compliance of adult male, and control the disease efficiently.
基金项目
WHO热带病研究与培训规划处-中国卫生部联合资助课题(JRMC 06-17)
WHO热带病研究与培训规划处-中国卫生部联合资助课题(JRMC 12-08)
国家科技支撑计划子课题(2009BAI78B00)
江西省卫生厅课题(20062044)
NETL
NSTL
维普
万方数据