四川省血吸虫病流行区传染源控制策略实施现状及障碍因素研究

发布时间：2018-05-15 09:32

本文选题：文献计量学 + 血吸虫病　；参考：《中国疾病预防控制中心》2014年硕士论文

【摘要】：本研究通过分析山丘型血吸虫病流行区四川省2004-2012年的疫情数据、传染源控制为主的综合措施实施情况,了解传染源控制为主的综合措施在四川省取得的防治成效。通过文献计量学的方法,对在中国知网和万方数据库中检索到的有关血吸虫病防治的文献进行分析,总结归纳血吸虫病防治策略发展变化过程、不同时期的研究热点和传染源控制措施在实施过程中存在的障碍因素。根据文献总结的障碍因素初步建立障碍因素框架,并基于此设计专家咨询问卷,通过三轮专家咨询(德尔菲法)最终建立障碍因素指标群,并进一步采用小组访谈和深度访谈的方法,确定四川省传染源控制为主的综合防治策略在实施过程中的主要障碍因素及对策。第一部分四川省血吸虫病疫情及传染源控制综合措施实施情况的分析通过分析2004-2012年四川省血吸虫病疫情年报数据、传染源控制综合措施实施情况,结果显示四川省主要开展了人群查治病、查灭螺等卫生措施,以及结合农、林、水等多部门实施了建设卫生厕所及沼气池、家畜圈养、环境改造等以传染源控制为主的综合性防治措施,人、耕牛疫情显著下降,但钉螺总面积在2008-2012年基本保持不变。目前四川省处在由传播控制到传播阻断的阶段,需要在实施传染源控制措施的同时,重点关注钉螺控制问题。第二部分中国血吸虫病防治策略演变的文献计量学研究通过检索血吸虫病防治相关文献以及查阅血吸虫病防治资料汇编,将我国血吸虫病防治历程划分为三个阶段：第一阶段(1950-1978)以消灭钉螺为主的综合防治策略。第二阶段(1979-2003)以人畜同步化疗为主的综合防治策略。第三阶段(2004年至今)“以传染源控制为主”的血吸虫病综合防治策略,该阶段研究重点是血吸虫病疫情监测、防治策略的转变以及传染源控制为主的综合策略的现场防治效果。通过检索2004-2012年“以传染源控制为主”的血吸虫病综合防治策略的相关文献,归纳山丘型地区传染源控制为主的血吸虫病综合防治策略执行中的障碍因素框架,将障碍因素分为3个类别8个子类别28个障碍因素。第三部分四川省“以传染源控制为主”的血吸虫病综合防治策略实施中存在的障碍因素研究根据文献分析得到的障碍因素框架设计专家咨询问卷,由专家根据问题的重要性对指标进行九分制评价,经过三轮专家咨询得到3个类别8个子类别21个障碍因素并确定其权重。根据专家咨询确定的主要障碍因素设计了现场访谈提纲,采取小组访谈和深度访谈的方式,访谈对象涉及省级、市级、县级、乡镇级及村级的行政官员、血吸虫病专业防治人员和疫区群众,访谈结果显示目前传染源控制策略在山丘型地区实施中存在的主要障碍因素是：(1)综合防治资金缺乏,后续工作推进困难(2)健康教育形式传统单一,群众审美疲劳,接受度低(3)流动人口可控性低,宣传、查病成难点(4)卫生厕所、沼气池建设资金缺乏,本次研究所获得的障碍因素,将为巩固山丘型地区血防工作提供重要的线索及制定防治规划的重要科学依据。
[Abstract]:In this study, through the analysis of the epidemic data of 2004-2012 years in Sichuan province and the implementation of the comprehensive measures based on the control of infectious sources in the epidemic area of hilly schistosomiasis, the effectiveness of the comprehensive measures based on infectious source control in Sichuan province was understood. The literature on the prevention and control of schistosomiasis, summarized and summarized the development and change process of schistosomiasis control strategy, the research hot spots in different periods and the obstacle factors in the implementation of the control measures of infectious sources. Based on the obstacle factors summarized in the literature, the barrier factors were initially set up, and based on this design expert consultation questionnaire, three The wheel expert consultation (Delphi method) finally established the barrier factor index group, and further adopted the group interview and the depth interview method to determine the main obstacle factors and Countermeasures in the implementation process of the integrated control strategy of Sichuan Province Based on infectious source control.
The first part is the analysis of the implementation of comprehensive measures for schistosomiasis control and infectious source control in Sichuan province.
By analyzing the data of the annual report of the epidemic situation of schistosomiasis in Sichuan Province in the past 2004-2012 years and the implementation of the comprehensive measures for the control of infectious sources, the results show that Sichuan province mainly carried out the treatment of the disease of the population, the hygienic measures of checking the snail, and the implementation of the construction of sanitary toilets and the biogas pool, the livestock enclosure and the environmental transformation, and the environmental transformation, and so on. The comprehensive prevention and control measures based on the system, people and cattle have decreased significantly, but the total area of Oncomelania hupensis remains unchanged in 2008-2012 years. At present, Sichuan is in the stage from transmission control to transmission blocking. It is necessary to focus on the control of Oncomelania snails while implementing the control measures of infectious sources.
The second part is a bibliometric study on the evolution of schistosomiasis control strategies in China.
Through the retrieval of related literature on schistosomiasis control and the compilation of the data of schistosomiasis control, the course of prevention and control of schistosomiasis in China was divided into three stages: the first stage (1950-1978) to eliminate the integrated control strategy of Oncomelania Snail Control. The second stage (1979-2003) integrated control strategy based on the same step chemotherapy of human and animal. (2004) From year to date, the comprehensive prevention and control strategy of schistosomiasis is based on the control of infectious sources. The focus of this stage is the monitoring of the epidemic situation of schistosomiasis, the change of control strategy and the effect of field prevention and control of the comprehensive strategy based on the control of infectious sources.
Through the retrieval of the relevant literature on the comprehensive prevention and control strategy of schistosomiasis based on infectious source control for 2004-2012 years, the framework of obstacle factors in the implementation of the integrated control strategy of schistosomiasis based on the control of contagious source in mountain areas was summarized, and the obstacles were divided into 3 categories and 8 subcategories and 28 barriers.
The third part is about the obstacle factors in the implementation of comprehensive control strategy for schistosomiasis control in Sichuan province.
The expert consultation questionnaire was designed for the frame design of obstacle factors according to the analysis of the literature. According to the importance of the problem, the expert evaluated the index by nine points. After three rounds of expert consultation, we got 21 obstacles and the weight of the 8 subcategories of the 3 categories.
According to the main obstacle factors determined by the expert consultation, the field interview outline was designed, the group interview and the deep interview were adopted. The interviewees involved the provincial, municipal, county, township and village level administrative officials, schistosomiasis professionals and the people in the epidemic area. The interview results showed that the current control strategy of the source of infection was in the hilly area. The main obstacles in the implementation are: (1) the lack of comprehensive prevention and control funds, the difficulties in the follow-up work (2) the traditional form of health education, the people's aesthetic fatigue, low acceptance (3) low controllability of the floating population, the difficulty of publicity, the difficulty of checking disease (4), the lack of funds for the construction of the biogas pool, and the obstacle factors of this study will be the gong Schistosomiasis control in Hilly and hilly areas provides important clues and important scientific basis for formulating prevention and control plans.

【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R532.21

【参考文献】