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目的研制提高重疫区成年男性居民血吸虫病化疗依从性、有效控制疾病的健康教育干预模式,并观察其远期干预效果。方法应用实验研究方法 ,对1993-2009年应用“血吸虫病化疗依从性干预+防护技能培训”健康教育模式干预实验组目标人群的效果进行纵向观察。结果干预前(1992年)实验组和对照组居民血防知识知晓率、化疗态度正确率、疫水接触率和血吸虫感染率均无显著差异,实验组发现3例晚期血吸虫病人。干预1年后(1993年)实验组居民血防知识知晓率由干预前的67.35%提高到91.92%(χ2=18.553,P<0.01),化疗态度正确率由干预前的56.44%提高到97.98%(χ2=48.722,P<0.01);化疗行为依从率由干预前的46.46%提高到92.08%(χ2=49.074,P<0.01);干预4年后,多数成年男性居民肝、脾肿大及肝纤维化趋向好转和稳定,未见新发晚期血吸虫病人;干预17年后,目标人群血吸虫病化疗依从率均达90%以上;干预前后目标人群接触疫水主要方式均为捕鱼,接触疫水率和血吸虫感染率均未见下降。结论应用“血吸虫病化疗依从性干预+防护技能培训”健康教育模式干预可显著提高重疫区成年男性居民血吸虫病化疗依从性,有效控制患病。
Objective To develop a health education intervention model to improve schistosomiasis compliance and disease control in infantile epidemic area and to observe its long-term intervention effect. Methods The experimental research methods were used to study the effect of applying “schistosomiasis chemotherapy compliance intervention + protective skill training” health education model to the target group in the experimental group from 1993 to 2009. Results Before intervention (1992), there was no significant difference in knowledge about blood-borne knowledge, correct attitude of chemotherapy, contact rate of infected water and infection rate of schistosomiasis among experimental group and control group. In the experimental group, 3 cases of advanced schistosomiasis were found. One year after the intervention (1993), the awareness rate of residents’ knowledge on blood-borne diseases was increased from 67.35% before intervention to 91.92% (χ2 = 18.553, P <0.01), and the correct rate of chemotherapy attitude was increased from 56.44% before intervention to 97.98% χ2 = 48.722, P0.01). The compliance rate of chemotherapy was increased from 46.46% before intervention to 92.08% (χ2 = 49.074, P <0.01). After 4 years of intervention, the majority of adult male residents had enlarged liver and spleen and liver fibrosis The trend of improvement and stability, and no new advanced schistosomiasis patients; 17 years after intervention, the target population of schistosomiasis compliance rates were over 90%; before and after the intervention target population exposure to water are the main ways of fishing, contact with the epidemic rate And schistosomiasis rates did not decline. Conclusion The application of “schistosomiasis chemotherapy compliance intervention + protection skills training” health education model intervention can significantly improve the incidence of schistosomiasis chemotherapy compliance of adult male residents in the endemic area, effectively control the disease.