血吸虫病不同流行区以传染源控制为主的综合治理策略经济效益分析  

Analysis of the economic benefits of integrated control strategies emphasizing the sources of schistosomiasis in different areas where schistosomiasis is prevalent

作　　者：朱红[1] 黄希宝[1] 蔡顺祥[1] 涂祖武[1] 陈艳艳[1] 利国[1] 夏菁[1] 张娟[1] 王伟 向代金 

机构地区：[1]湖北省疾病预防控制中心血吸虫病防治研究所,湖北武汉430079 [2]仙桃市血吸虫病防治领导小组办公室,湖北仙桃433000 [3]仙桃市血吸虫病防治所,湖北仙桃433000

出　　处：《中国病原生物学杂志》2012年第9期679-681,704,共4页Journal of Pathogen Biology

基　　金：湖北省卫生厅血吸虫病防治科研项目(No.XF2010-27)

摘　　要：目的评价以传染源控制为主的血吸虫病综合治理策略在湖沼地区不同流行类型费用-效果与费用-效益,为完善血防策略提供科学依据。方法选择湖北仙桃市沙湖片区37个血吸虫病流行村为研究对象,其中垸内组34个,垸外组3个。开展了"建三格式厕所"、"建沼气池"、"水旱轮作"、"安全饮水"等以传染源控制为主的血吸虫病综合治理措施及常规卫生血防措施。采用回顾性调查方法结合现场调查,收集疫情、经费投入与产出效益等资料,进行费用-效果与费用-效益分析。结果垸内组与垸外组的总效益费用比均>1;垸内组总投入、每100只活螺平均密度下降1%费用、每100人与每100头牛感染率下降1%费用、总效益费用比、净效益与净效益费用比均高于垸外组;其中垸内组净效益费用比为1.17。结论垸内组投入较高,但收益也较大;以传染源控制为主的血吸虫病综合治理策略在垸内组与垸外组均产生了血防、社会和直接经济效益,具有推广价值。Objectives To evaluate the cost-effectiveness and cost-benefits of integrated control strategies emphasizing the sources of schistosomiasis in different types of marshland and lake areas where schistosomiasis is prevalent and to provide a scientific basis for improvements in schistosomiasis control strategies.Methods Thirty-seven schistosomiasis-endemic villages in the ShaHu area in XianTao County were studied;34 were within embankments while 3 were outsides embankments.Integrated schistosomiasis control strategies such as ＂improved latrines and methane-generating pits,＂ ＂upland-paddy rotation,＂ and ＂safe water supplies＂ were adopted and a routine control program was implemented.Data on aspects including outbreaks,financial investment,and resulting benefits were collected from a retrospective study and field surveys in order to analyze cost-effectiveness and cost-benefit.Results The total cost/benefit ratio（BCR） for the 2 types of villages was greater than 1.Compared to villages outside embankments,villages inside embankments had greater total investment.Villages inside embankments also had a greater cost of a 1% decrease in average density per 100 live snails,cost of a 1% decrease in the rate of infection per 100 people and 100 cattle,total BCR,net benefit,and net cost/benefit ratio（NBCR）.The NBCR for villages inside embankments was 1.17.Conclusion Villages inside embankments had greater investment than villages outside embankments and also had higher returns.Integrated control strategies emphasizing the sources of schistosomiasis both in villages inside embankments and villages outside embankments bring about a three-pronged benefit of schistosomiasis control,social development,and economic benefits,so they are worth promoting.

关 键 词：血吸虫病 传染源控制 费用-效果 费用-效益 湖沼地区 

分 类 号：R532.21[医药卫生—内科学]