Abstract:

Objective To explore the socioeconomic determinants of chronic schistosomiasis japonica at household level. Methods The socioeconomic status of case and control families in lake and marsh schistosomiasis endemic areas were investigat? ed by questionnaire, socioeconomic factors were analyzed by the principle components analysis, and the wealth index were calculated to evaluate the economic status at household level. Then the relation between schistosome infection and some influencing factors were analyzed by two?level Logistic regression model. Results A total of 2 716 households in 91 villages were investigated, among which 1 050 were case families and 1 666 were control families. The values of the first eigenvector of stone/brick house, house with ≥2 floors, black/white TV, colour TV, washing machine, refrigerator, side occupation were -0.42, 0.46, -0.45, 0.46, 0.32, 0.24 and 0.16, respectively, which suggested that the first eigenvector was the comprehensive index reflecting family wealth. The results of Logistic regression model showed that there were 4 household factors significantly relating to chronic schistosomiasis, namely, the distance from residence to schistosome?infested water, source of washing water, economic status, and wet land area per capita, among which the factor that the distance from residence to schistosome ? infested water＜100 m with the highest（OR= 12.590, P = 0） . Conclusion In the lake and marsh endemic areas, health education and other intervention to the poor family liv? ing along river or lake without safe water supply should be strengthened to control schistosomiasis.

Key words: Chronic schistosomiasis japonica, Disease burden, Wealth index, Socioeconomic determinant

摘要：

目的 探讨湖沼型血吸虫病流行区家庭卫生经济因素与慢性血吸虫病的关系。方法 对有血吸虫病患者家庭（病家） 和无患者家庭 （非病家） 卫生经济状况进行入户调查， 对相关因素进行主成分分析， 计算家庭财产指数； 采用二水平 Logistic回归模型分析血吸虫感染与相关卫生经济因素的关系。结果 共调查91个行政村的2 716户家庭， 其中病家1 050 户、 非病家1 666户。砖瓦平房、 楼房、 黑白电视、 彩电、 洗衣机、 电冰箱和副业等7个指标主成份分析的第一特征向量值分别为-0.42、 0.46、 -0.45、 0.46、 0.32、 0.24和0.16， 表明第一特征向量是反映 “家庭富裕” 的综合指标。多因素分析发现住所与疫水的距离、 生活用水类型、 家庭经济状况和家庭人均水田面积等4个家庭因素与慢性血吸虫病有显著相关性， 其中住所与疫水距离在100 m以内的危险度最高 （OR = 12.590， P = 0）。结论 在湖沼型血吸虫病流行区， 应加强对临水而居、 无安全生活用水、 贫困家庭的健康教育及卫生干预。

关键词: 慢性血吸虫病；疾病负担；财产指数；社会经济因素