中国寄生虫学与寄生虫病杂志 ›› 2009, Vol. 27 ›› Issue (4): 2-302.

• 论著 • 上一篇    下一篇

鄱阳湖区以传染源控制为主的血吸虫病综合治理策略费用-效果/效益分析

林丹丹1,曾小军1,陈红根1,洪献林2,陶波3,李宜锋1,熊继杰4,周晓农5
  

  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-08-30 发布日期:2009-08-30

Cost-effectiveness and Cost-benefit Analysis on the Integrated Schistosomiasis Control Strategies with Emphasis on Infection Source in Poyang Lake Region

LIN Dan-dan1,ZENG Xiao-jun1,CHEN Hong-gen1,HONG Xian-lin2,TAO Bo3,LI Yi-feng1,XIONG Ji-jie4,ZHOU Xiao-nong5
  

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-08-30 Published:2009-08-30

摘要:

目的 评估以传染源控制为主的血吸虫病综合防治策略的费用-效果和费用-效益,为调整和完善血防策略提供科学依据。 方法 在江西省进贤县选择实施新策略的爱国村和新和村为干预组,以采取常规血吸虫病控制措施的星子县西庙村和渚溪村为对照组。干预组实施“以机代牛、封洲禁牧、改水改厕、沼气池建设”等以传染源控制为主的血吸虫病综合治理措施,并辅以人群查治、健康教育措施(以下简称新策略);对照组实施人、畜查治,健康教育和易感地带灭螺等措施。采用回顾性调查和现场调查相结合的方法收集资料,调查干预组和对照组的常规血吸虫病防治费用、综合治理费用及各项措施的单位费用/效益。对两组进行费用效果和效益的比较分析,并进行效益预测和敏感性分析。 结果 干预组平均每100人、每100头牛、每100只钉螺感染率下降1%的总费用分别为480.01元、6 851.24元和683.63元,分别为对照组的2.70、4.37和20.25倍。虽然干预组和对照组的效益费用比(BCR)均小于1,但干预组(0.94)远大于对照组(0.08);敏感性分析显示,干预组BCR在接近1的区域变动,而对照组在0.5以下变动。干预组的总BCR在第4年可达1.13,实现成本回收。 结论 以传染源控制为主的综合防治策略具有更佳的防治效果和远期效益,可产生血防、社会(生态)和经济等三重效益,并具持效作用。

关键词: 血吸虫病, 传染源, 综合防治策略, 费用效果, 费用效益, 鄱阳湖区

Abstract:

Objective To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Methods Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. Results The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio(BCR) was lower than 1(0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. Conclusion The integrated control strategy focusing on infection source control brings about triplex benefits in schistosomiasis control, social development (and ecological protection) and econimic efificacy, and shows better effects and benefits than the conventional control strategy.

Key words: Schistosomiasis, Infectious source, Integrated control strategy, Cost-effectiveness, Cost-benefit, Poyang Lake region