基于公共卫生服务均等化的血吸虫病防治研究Ⅱ：血吸虫病防治服务探讨  

Study of schistosomiasis control based on the equality of public health services II ： evaluation on schistosomiasis control service

作　　者：胡合华 鲍子平[2] 贺民[1] 张华明[1] 刘雄[1] 张瑕[1] 刘军[1] 肖传云[1] 王加松[3] 蔡顺祥 朱红 曹淳力[2] 许静[2] 李石柱[2] 

机构地区：[1]湖北省江陵县血吸虫病预防控制所、中国疾病预防控制中心寄生虫病预防控制所湖沼型血吸虫病防治实验基地,江陵434100 [2]中国疾病预防控制中心寄生虫病预防控制所、卫生部寄生虫病原与媒介生物学重点实验室、世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海200025 [3]湖北省荆州市疾病预防控制中心,荆州434000 [4]湖北省血吸虫病防治所,武汉430079

出　　处：《国际医学寄生虫病杂志》2014年第6期347-351,共5页International JOurnal of Medical Parasitic Diseases

基　　金：国家重大科技专项（2008ZX10004-11）;国家传染病重大专项（2012ZX10004220,2012ZX10004-201）;上海市加强公共卫生体系建设三年行动计划;上海市卫生局科研计划课题资助项目（20124405）;湖北省荆州市医药卫生科技计划项目（20121PE1-1）;志谢中国疾病预防控制中心寄生虫病预防控制所周晓农研究员给予本研究悉心指导,特此致谢!

摘　　要：目的通过对两类血吸虫病防治（简称血防）服务实施者的工作效果进行探讨，为推动血防工作纳入公共卫生服务均等化提供科学依据。方法在湖北省江陵县选择血吸虫病疫情相仿的虾湖村和万场村，分别按县级血防机构为模式一和乡（镇）卫生院为模式二的血防服务实施主体，采用观察法比较两种血防服务实施主体查灭螺、查治病等服务工时；采取小组访谈方法了解该县所有血吸虫病流行村卫生人员的血防服务内容和意愿；采用优劣势分析法（strengths weakness opportunity threats，SWOT）对上述结果进行分析。结果江陵县虾湖村和万场村的常住人口分别为571人和618人，2011年人群推算感染率分别为1．72％和2．01％．两村的血吸虫病疫情相仿。在模式一情况下，每百名居民所需投入血检服务工时为2．57：每百名居民所需投入治疗服务工时为2．67；每百名居民所需投入粪检服务工时为11．94：每百名居民所需投入健康教育服务工时为2．49。在模式二情况下．每百名居民所需投入血检服务工时为2．82；每百名居民所需投入治疗服务工时为3．13；无技术力量开展粪检和查灭螺工作：每百名居民所需投入健康教育服务工时为17．78。对全县10所乡（镇）卫生院、88个村卫生室的负责人员进行访谈，共有90名乡（镇）卫生院院长及村卫生室负责人参加访谈，其中29人参与血防查病现场采样：41人参与对血检阳性患者的治疗；48人参与血防健康教育；无人参与血防查、灭螺工作。县级血吸虫病防治机构具有整体的综合防治观念，熟知综合防治知识和技能，以及血吸虫病检查等专项技术，但是无法实时了解居民的疫水接触等不卫生行为，而且，在短期内收集全体居民的血样和粪样困难很大。在实施基本公共卫生服务均等化的工作中，乡（镇）卫生院和村卫生�Objective To evaluate the effects of schistosomiasis control service by 2 sorts of implementer for the purpose of bringing schistosomiasis control into the content of equality of public health services. Methods Xiahu and Wanehang villages with similar schistosomiasis endemic situation in Jiangling County were selected as study sites. The implementers were county level of schistosomiasis control as model 1, town- ship health center and village clinic as model 2. The working hours of snail survey and control, disease exami- nation, and treatment were compared by observation method between 2 sorts of impiementers. The village clinic staff was interviewed on schistosomiasis control and willingness by focus groups interview. The above data was analysized by strengths weakness opportunity threats （SWOT）. Results The residents Xiahu and Wanchang villages were 571 and 618, the calculated human infection rates were 1.72% and 2.01%, the schis- tosomiasis endemic situation was similar. In model 1, the working hours of schistosomiasis examination was 2.57, the working hours of treatment was 2.67, the working hours of stool examination was 11.94, the working hours of health education was 2.49. In model 2, the working hours of schistosomiasis examination was 2.82, the working hours of treatment was 3.13, the working hours of health education was 17.78, without ability for stool examination, snail survey and control. 90 staff from 10 township health centers and 88 village clinics was interviewed. Among them, 29 staff participated in schistosomiasis examination, 41 staff participated in treat- ment, 48 staff participated in health education. No staff participated in snail survey and control. The profes- sional of county agency of schistosomiasis control had overall concept of comprehensive control, mastered the knowledge of schistosomiasis control and technique of examination, but had the difficulty for human blood and fecal samples collection in short time and controlling the unhealthy behavior of water contact in real time

关 键 词：血吸虫病 防治 服务 均等化 

分 类 号：R199.2[医药卫生—卫生事业管理]