关键词: 血吸虫病, 传播控制, 抗体阳性, 健康教育, 鄱阳湖

Abstract:

Objective To determine the anti-Schistosoma antibody level in residents around endemic Poyang Lake after transmission of schistomosiasis has been controlled and the scientific management model for people with antibody-positive, so as to provide reference for precise prevention and control of schistosomiasis in areas with transmission controlled. Methods Two major schistosomiasis endemic townships: Nanji Township(including Xiangyang, Chaoyang and Hongwei Villages) and Changyi Township (including Changbei and Caohui Villages), were selected as the research sites. The sera were collected from residents in these villages with age over 6 years old and the indirect hemagglutination assay (IHA) was used to detect the anti-Schistosoma antibody in the sera. The identified 302 residents with antibody positive were randomly divided into three groups, praziquantel chemotherapy plus health education (joint intervention group), praziquantel chemotherapy only (chemotherapy group), health education only (education group). The antibody titers were examined annually for consecutive three years among these people from 2016 to 2018. Their knowledge, awareness and attitude towards schistosomiasis control was investigated by a questionnaire annually. Results The survey subjects were male, mainly over 40 years old, with primary and junior high school education, mostly farmers or fishermen. In 2017, there were 38.1% (37/97), 33.7% (32/95) and 40.0% (38/95) people with antibody converted to negative for joint intervention group, chemotherapy group and education group, respectively, without significant difference between groups (P > 0.05). The average titers of antibody in joint intervention group, chemotherapy group and education group in 2017 were 1 : 22.5, 1 : 26.6 and 1 : 29.9, respectively, with significant difference between the groups (P < 0.05). In 2018, the average titers of antibody in joint intervention group, chemotherapy group and education group were 1 : 24.0, 1 : 18.7 and 1 : 25.6, respectively, with significant difference between groups (P < 0.05), with 47.9% (45/94), 45.3% (43/95) and 51.7% (43/95) people with antibody converted to negative, respectively, without significant difference between groups (P > 0.05). The correct rate for the knowledge about schistosomiasis control in joint intervention group, chemotherapy group and education group increased year by year, from 84.0% (79/94), 87.5% (84/96), 88.6% (78/88) in 2016 to 85.9% (85/99), 90.7% (88/96), 90.2% (83/92) in 2017, and then all groups reached to 100%, respectively, without significant difference between groups in the same year (P > 0.05). The correct rate for schistosomiasis control behavior in joint intervention group, chemotherapy group and education group have increased from 31.9% (30/94), 22.9% (22/96), 22.7% (20/88) in 2016, to 42.4% (42/99), 44.8% (43/96), 45.7% (42/92) in 2017, and to 63.4% (64/101), 65.7% (65/99), 66.3% (65/98) in 2018, respectively, without significant between groups though (P > 0.05). Conclusion To better manage the antibody positive people in the endemic areas, the health education is important to improve the knowledge and behavior in people living in endemic areas to prevent the infection of S. japanicum, as a supplement for chemotherapy with praziquantel.

Key words: Schistosomiasis, Transmission control, Antibody positive, Health education, Poyang Lake