湖沼型疫区“无血吸虫感染者学校”健康促进干预模式的建立及应用  

Establishment and Application of School-based Health Promotion and Intervention Model of Schistosomiasis in Lake-type Endemic Area

作　　者：陈海婴[1] 胡广汉[1,2] 宋矿余[3] 熊志伟[1] 胡嘉[4] 杨平一 彭国华[1] 胡位陈 余松山 付国兰 刘周华 戚京成[1] 葛军 万保平 

机构地区：[1]江西省南昌市疾病预防控制中心,南昌330006 [2]江西省寄生虫病防治研究所,南昌330046 [3]南昌大学医学院微生物学教研室,南昌330008 [4]南昌大学第一附属医院,南昌330008 [5]江西省南昌县血防站,南昌330200 [6]江西省新建县血防站,新建330100 [7]江西省恒湖农场医院,新建330123 [8]江西省进贤县血防站,进贤331700 [9]江西省南昌市血防办公室,南昌330056

出　　处：《中国寄生虫学与寄生虫病杂志》2009年第2期125-129,134,共6页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：世界卫生组织热带病研究与培训规划处和中国卫生部联合资助课题(No.JRMC6-17);江西省卫生厅资助课题(No.042006,No.20062044)~~

摘　　要：目的建立湖沼型重疫区"无血吸虫感染者学校"健康促进干预模式,并观察其推广应用效果。方法试点研究阶段,选择江西省新建县恒湖小学(实验组)和板山小学(对照组)所有在校学生为研究对象,基线调查内容包括血防知识与血防态度和接触疫水行为(问卷调查),及血吸虫感染情况(用Kato-Katz法,一粪三检)。在恒湖小学应用"信息传播+防护技能培训+奖惩激励"(模式A,1993-1999)健康教育干预模式和"信息传播+行为参与+行为激励"(模式B,2000-2007)健康促进干预模式,干预后每年调查血吸虫感染情况,比较2个模式的干预效果。应用推广阶段,2005-2007年选择新建县、南昌县和进贤县等3县8所学校的所有在校学生为研究对象,应用B模式进行干预。基线调查、干预后的考核方法和指标均同上。结果试点研究阶段,基线调查(干预前)的结果显示,恒湖小学(实验组)和板山小学(对照组)的血防知识知晓率、血防态度正确率、接触疫水频率和血吸虫感染率等,两者比较差异无统计学意义(P>0.05)。恒湖小学A模式干预后1年,血防知识知晓率(94.4%)和血防态度正确率(98.9%)分别与干预前(9.0%和55.1%)相比均有较大的提高,差异均有统计学意义(P<0.01);接触疫水频率(1.9%)和血吸虫感染率(2.3%)分别与干预前(14.6%和13.5%)相比均有较大程度的下降,差异有统计学意义(P<0.01)。干预后2～7年内,每年血吸虫感染者均为1～2例;改用B模式干预后,每年血吸虫感染者均为0。推广应用研究阶段,用模式B在8所学校实施干预2年,目标人群连续2年均未检出血吸虫感染者。结论B模式可推广应用于重度疫区创建"无血吸虫感染者学校"。Objective To establish an intervention model of school health promotion, and apply it in developing “schistosomiasis-free schools”. Methods At the pilot stage, all students of Henghu primary school and Banshan primary school in Xinjian County of Jiangxi Province were selected as experiment group and control group, respectively. A baseline survey covered knowledge and attitude on schistosomiasis control, water contact behaviors and Schistosoma japonium infection rate. Two health promotion intervention models, i.e. “information communication ＋ training of protection skill ＋ reward ＆ punishment” （model A, 1993-1999） and “information communication ＋ behavior participation ＋ encouragement” （model B, 2000-2007）, were implemented in Henghu school. The effect of two models was compared by infection rate. At the application stage, all students of 8 schools in Xinjian County,Nanchang County,and Jinxian County were chosen for evaluation of the effectiveness of Model B with same methods and index. Results Before intervention there was no significant statistical difference on the passed rate of anti-schistosomiasis knowledge, correct rate of anti-schistosomiasis attitude, frequency of infested water exposure and the infection rate between Henghu and Banshan schools（P〉0.05）. In Henghu school, the intervention showed significant effect on the scores of knowledge and attitude after one year （P〈0.01）, raised from 9.0% and 55.1% before intervention to 94.4% and 98.9% after intervention, respectively. The frequency of infested water exposure and the infection rate significantly decreased from 14.6% and 13.5% before intervention to 1.9% and 2.3%, respectively （P〈0.01）. In 2-7 years after intervention, there were only one or two schistosomiasis cases each year. At the application stage, no schistosomasis cases were found among Model B target population in two successive years after intervention. Conclusion The practice of Model B can be extended to other schools in endemic area to devel

关 键 词：血吸虫病 学生 无血吸虫感染者学校 健康教育 健康促进 干预模式 应用 

分 类 号：R532.2[医药卫生—内科学]