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目的研究云南高原山区以传染源控制为主的血吸虫病综合防治策略的成本-效果和成本-效益,为血吸虫病防治策略的制定或调整提供科学依据。方法在高原平坝型(坝区)和高原峡谷型(山区)血吸虫病疫区各选择2个村,分别作为实验组和对照组。实验组实施改水、改厕、禁牧等综合治理措施,对照组实施常规防治措施。分析2005～2007年间2类疫区以及实验组与对照组的防治效果、成本-效果和成本-效益。结果实验组2个村3年后人群感染率分别下降93.36%和96.44%;对照组2个村分别下降83.24%和84.38%,实验组优于对照组;坝区实验组与对照组成本-效果差别不大,山区实验组优于对照组。坝区成本-效益显著高于山区,实验组和对照组效益/成本比值(BCR)相差不大。结论与常规防治策略相比,以传染源控制为主的综合防治策略具有较好血防效果和效益,在人群感染率较高时,适用于高原山区。
Objective To study the cost-effectiveness and cost-benefit of schistosomiasis control strategies based on infection source control in mountainous plateau of Yunnan Province, and to provide a scientific basis for the formulation or adjustment of schistosomiasis control strategies. Methods Two villages were selected from the Pingba-type (dam) plateau and the plateau (mountainous) schistosomiasis-endemic plains in the plateau, respectively, as the experimental group and the control group. Experimental group to implement water, toilet, animal husbandry and other comprehensive control measures, the control group to implement conventional control measures. The control effect, cost-effectiveness and cost-benefit of two kinds of epidemic areas, experimental group and control group from 2005 to 2007 were analyzed. Results The infection rates of the two villages in the experimental group decreased by 93.36% and 96.44% respectively after 3 years. In the control group, the two villages decreased by 83.24% and 84.38% respectively, the experimental group was better than the control group. The cost-effectiveness of the experimental and control groups Little difference between mountain experimental group than the control group. The cost-effectiveness of the dam area is significantly higher than that of the mountainous area, and there is not much difference between the experimental group and the control group in the benefit / cost ratio (BCR). Conclusion Compared with the conventional control strategy, the comprehensive prevention and control strategy based on infection source control has good blood-control effect and benefit. When the infection rate is high, it is suitable for plateau mountainous areas.