The Cross-sectional Study On Implementation Status Of National Schistosomiasis Control Measures

After many years on schistosomiasis control,the epidemic situation of schistosomiasis is still in dangerous.Upon the national Schistosomiasis situation,109 counties had schistosomiasis endemic.843,000 patients were reported,24,900 licestock were checked in with schistosomiasis,385,000,000,000 m~2 were propagated snail,the schistosomiasis endemic area included Hubei,Hunan,Jiangxi,Anhui, Jiangsu,Sichuan and Yunnan.Because of nature and social changes,the epidemic characters of schistsomiasis are snail diffuse evidently,the distribution of infectious snail enlarged,the infection risk of human and livestock increased,the amount of schistosomiasis patients reaching high level,the transmission of schistosomiasis seriously,the tendency of acute infection of schistosomiasis increasing,the new endemic area increasing sustaining,the endemic situation in some area which is under transmission control going back severely.Aim at the key taches of schistosomiasis transmission chain of water and snail,the infection source control strategy is established.The first measure is feces of human and livestock management that prevention feces infect land and marshland and water where people activity frequently.The second measure is preventing livestock feeding on marshland with snail.Therewith,the strategy for schistosomiasis control by integration control measures based on schistosomiasis infection source control is implemented.This study is foused on implementation status of national schistosomiasis control strategy.The survey applied cross-sectional study of epidemiology.The survey area and objects are Hunan.Hubei,Jiangxi,Anhui,Jiangsu,Sichuan and Yunnan,those counties take on schistosomiasis control,and county government departments of schistosismiasis control,finance,agriculture,foresty,water conservancy,education,health and development and innovation,professional organizatins and local residents.The objective is master the implementation status of national schistosomiasis control strategy and measures.The study content are key measures of schistosomiasis control which are joint control and prevention of schistosomiasis control,feces of human and livestock management,environment with snail management,schistosomiasis patents'cure.The survey results of residents indicats that the schistosomiasis understanding situation is 98.8%,90.3%knowing "National statute of Schistosomiasis Control". The approach of knowing "National statute of Schistosomiasis Control" are publicizing banners and information(44.8%),and preaching of "National statute of Schistosomiasis Control"(15.2%).Refering to joint control and prevention of schistosomiasis control,the best implementation measures are synchronization implementation on health education (81.6%),synchronization implementation on epidemiology investigation and epidemic situation supervise(68.0%),synchronization implementation on improving water and sanitary(59.9%).The measures which implementation difficult are synchronization implementation on livestock management(87.3%),cooperation in regions to snail research and killing snail(70.4%),synchronization implementation on examination and treatment of human and livestock(76.0%).Regrading to feces of human and livestock management,95.05%local residents support to enhance this measure.On the topic on health risk by throwing feces everywhere outside,91.52%local residents think it risk their health.The question that whether fishermen and boatmen will not throw feces to river or lake when latrine establishment on dock,48.14%residents think they will,30.44%residents think it is difficult to answer,16.24%local residents do not think they will,and 5.17%no answer.On the part of environment with snail management,the county level of government department express the implementation situation of measure of livestock feed in barn is every difficult(63.2%).The difficult reasons are unwillingness change of local people's habit of graze(38.66%),high cost of feed barn and decreasing people's income(30.50%),no support fund for feed barn from government(29.59%). Thinking on the implementation of measure on baning herd on snail land,54.0% figure difficult,21.1%show easy,24.1%mean difficult to answer.The difficult reasons are unwillingness change of local people's habit of graze(36.27%), insufficiency fund for baning herd from government(27.46%),the principal part of executing the law unclear(18.92%),no corresponding working mechanism(16.70%). The study results of county level of professional organizations show the implementation of baning herd on snail land is not good(62.4%) although local government publicize the notice of baning herd in snail land(68.0%).The difficult reasons of implementation are unwillingness change of local people's habit of graze (40.3%),insufficiency fund for baning herd from government(23.9%),the principal part of executing the law unclear(20.2%) and no corresponding working mechanism(14.9%)The mostly reasons of no publicizing snail distribution are caring impact business and capital introduction(42.25%),meanwhile the well implementation of environment with snail management is caution brand establishment in snail land (40.5%)The study results of schistosomiasis patents' cure shows that the measure of free medicine of schistosomiasis treatment is implementation well(99.0%),the measure of terminal schistosomiasis patients cure is also implementation well (92.8%).It is suggested that schistosomiasis patients should be bring into social security system(95.8%).The study results of local residents indicated that 96.2% know the measure of free medicine of schistosomiasis treatment,and 94.6%think the implementation of this measure is good.Because the economic is low in schistosomiasis endemic area,and local residents' income is low yet,the measures of free medicine of schistosomiasis treatment and terminal schistosomiasis patients cure are welcome by local residents.In implementation,the correlation government departments and professional organiztions should explain those measures to local residents,so that people can understand.The strategy and measures to schistosomiasis control by integration control based on schistosomiasis infection source control is aimed at the key sections of schistosomiasis transmission,the measures of joint control and prevention of schistosomiasis control,feces of human and livestock management,environment with snail management,schistosomiasis patents'cure are implemented.The strategy and measures are implemented in schistosomiasis endemic area,but the implementation situation is different,the examination and treatment of human and livestock do not go on synchronization.The improving of sanitary of feces of human and livestock management do not cover schistosomiasis endemic area.The difficult of implementation of environment with snail management,is baning herd on snail land. The measure of schistosomiasis patents'cure is implemented well,but local residents are lack of the noweledge of the measure and regulation.It is suggested that the schistosomiasis transmission characters,local economic level,the habit of production and life should be considered when those measures implementation,so as the strategy and measures to schistosomiasis control by integration control based on schistosomiasis infection source control will be implementation step by step.