目的 分析江西省信丰县华支睾吸虫病综合防治示范区（示范区）实施3年后,人群华支睾吸虫病知识、态度、行为（知信行）效果变化及感染率变化。 方法 2016和2018年在示范区26个行政村中,每村整群抽取3周岁以上常住居民150人开展粪检和问卷调查。采用调查问卷了解研究对象的防治知识、行为与态度的变化。采用改良加藤厚涂片法（Kato-Katz法,一粪二检）检查研究对象的华支睾吸虫感染情况。选取两年均参加调查的人群作为研究对象,采用χ ²检验进行组间比较。 结果 2016和2018年均参加调查的人群共1 108人,华支睾吸虫感染率由2016年的22.5%（249/1 108）下降至2018年的9.7%（107/1 108）（P < 0.01）。两年男性感染率分别为31.9%（171/536）和13.6%（73/536）,均高于女性的13.6%（78/572）和5.9%（34/572）（P < 0.01）。调查问卷分析结果显示,人群华支睾吸虫感染防治知识知晓率由2016年的4.3%（48/1 108）上升至2018年的25.0%（277/1 108）（P < 0.01）,两年知晓人群感染率（35.4%,17/48;10.1%,28/277）均高于不知晓人群（21.9%,232/1 060;9.5%,79/831）（P < 0.01、P > 0.05）;2018年食“鱼生”者今后拒绝食用“鱼生”、感染后愿意接受治疗人群的比例分别为77.9%（141/181）、99.7%（1105/1 108）,均高于2016年的28.9%（68/235）与95.6%（1 059/1 108）（P < 0.01）;人群食“鱼生”比例由2016年的21.2%（235/1 108）下降至2018年的16.3%（181/1 108）（P < 0.01）,两年食“鱼生”人群感染率（61.3%,144/235;43.1%,78/181）均高于不食者（12.0%,105/873;3.1%,29/927）（P < 0.01）。驱虫覆盖率由2016年的69.9%（174/249）上升至2018年的89.7%（96/107）（P < 0.01）。两年均不知晓华支睾吸虫病危害的人群占73.2%（811/1 108）,两年均食用“鱼生”习惯的人群占10.3%（114/1 108）。 结论 由于示范区各项防治工作开展,人群华支睾吸虫感染率所有下降,防治知识的知晓率、食“鱼生”者今后拒绝食用“鱼生”与人群如感染后愿意接受治疗的意愿升高,食“鱼生”比例与平均感染率下降,效果显著。

Objective To evaluate assess changes in knowledge, attitude, practice (KAP) towards clonorchiasis and the status of human infection three years after the establishment of a demonstration area for clonorchiasis control in Xinfeng County. Methods In 2016 and 2018, 150 permanent residents aged 3 years or above were cluster sampled in each of the 26 administrative villages in the demonstration area, for fecal examination and questionnaire survey. The questionnaires survey was applied to understand the changes of knowledge, behavior and attitude toward clonorchiasis control among participants. The fecal examination was conducted using the modified Kato-Katz thick smear method (two slide-reading/one sample) to assess the status of Clonorchis siensis infection. The participants in the two-year suvey were included in the analysis, and the comparisons between groups were made with the Chi-square test. Results A total of 1 108 residents participated in the two surveys in 2016 and 2018. The infection rate of Clonorchis sinensis dropped from 22.5% (249/1 108) in 2016 to 9.7% (107/1 108) in 2018 (P < 0.01). The infection rate in males (31.9%, 171/536; 13.6%, 73/536) was higher than that in females (13.6%, 78/572; 5.9%, 34/572) in the two years (P < 0.01). The questionnaire analysis revealed that the awareness rate on the knowledge of clonorchiasis control increased significantly from 4.3% (48/1 108) in 2016 to 25.0% (277/1 108)in 2018 (P < 0.01). The infection rate was higher in the awareness group (35.4%, 17/48; 10.1%, 28/277) than that in the unawareness group (21.9%, 232/1 060; 9.5%,79/831) in both years (P₂₀₁₆ < 0.01, P₂₀₁₈ > 0.05). In 2018, 77.9% (141/181) of raw-fish consumers would refuse to eat raw fish again, and 99.7% (1 105/1 108) would be willing to receive treatment after infection, which was higher than 28.9% (68/235) and 95.6% (1 059/1 108) in 2016 respectively (P < 0.01). The proportion of residents eating raw fish decreased from 21.2% (235/1 108) in 2016 to 16.3% (181/1 108) in 2018 (P < 0.01), and the infection rate in those eating raw fish (61.3%, 144/235; 43.1%, 78/181) was significantly higher than that in those not eating raw fish in both years(12.0%, 105/873; 3.1%, 29/927)(P < 0.01). The deworming coverage increased from 69.9% (174/249) in 2016 to 89.7% (96/107) in 2018 (P < 0.01). The percentage of residents who were unaware of clonorchiasis in both years was 73.2% (811/1 108), and the proportion of residents eating raw fish in both years was 10.3% (114/1 108). Conclusion With the implementation of control measures in the demonstration area, there has been a decrease in the Clonorchis infection rate and increases in the awareness rate of knowledge on clonorchiasis control, as well as the proportions of people showing willingness to give up eating raw fish and to receive treatment after being infected. The proportion of behavior of eating raw fish and the average infection rate were significantly decreased. These findings suggest remarkable achievements in clonorchiasis control.