• 作者： 范秉真; 徐郁坡; 鄭?鶯; 陳韻安; 許美卿
• 作者服務機構： 國立陽明醫學院寄生蟲學科; 榮民總醫院醫學研究部寄生蟲研究室
• 中文摘要： 此為海喘散包衣食鹽對金門血絲蟲病防治後追綜調查之最後報告。應用靜脈抽血及膜濾法自1981年6月至1982年5月在金門7所（高中及高職各1，初中5）中學，檢查13～18歲男女學生3,049人，及5鄉鎮63村里，防治前血絲蟲患者743人，結果均屬陰性。 對防治前血絲蟲患者743人系列性之體格檢查，發現防治前145位具有症狀患者。其中48人完全消失，症狀減低率為33%。消失症狀在淋巴系統（44～100%）顯較生殖系統（28～47%）較高，惟象皮病症狀則無變化。 在受檢148位症狀者中，53%症狀無變化，35%症狀消失，9%較前進步，2%為新發生，及 1.4%症狀轉劇。 大小金門血絲蟲病之防治均開始於1974年，小金門應用海喘散包衣食鹽法，（簡稱藥鹽法）為期半年（7～12月）。大金門採用綜合防治法連續3 (1974～1976)年，1977年改用藥鹽法為期半年（3～9月）。防治後之追綜調查，應用膜濾法在大小金門共檢查一般居民 46,752 人（包括中學生），及防治前血絲蟲患者 5,728人，除五位（未食藥鹽或量少）外均屬陰性，並解剖雌性熱帶家蚊4,207隻，亦均屬陰性。根據上述結果，流行達百年歷史之金門血絲蟲病可能已經根除。 基於在大小金門血絲蟲流行區分別實施綜合防治法及海喘散包衣食鹽防治法，結果之分析，後者之治療率、治癒率、血絲蟲消除率均可達 100%；無副作用發生，均樂於接受，且有預防效果。而前者則相反。因此，海喘散包衣食鹽防治法，實為簡單，快速、價廉、安全、有效及實用之方法，且可達到血絲蟲病根除之效果。
• 英文摘要： Follow-up observations on filariasiscontrol by DEC medicated salt in Kin-men Proper and Little Kinmen werecarried out 5 and 8 years after controlrespectively, no microfilarial (mf)carriers were found by the nucleporemembrane filtration technique (NMFT)among 743 pre-control mf carriers(PCMC) and 3,049 high school students.Clinical survey was also made among740 PCMC, the clinical rate was lowerafter control (13%) than before control(20%). The reduction rate was 33%.Of 148 clinical cases examined physi-cally, 53% were no change, 35% dis-appeared, 9% improved, 2% newlyoccurred, and 1.4% aggravated. In the past years after filariasiscontrol by DEC medicated salt a totalof 5,728 PCMC and 46,752 generalpopulation in Kinmen Proper and LittleKinmen were examined, no new mf.positive cases were detected except 5PCMC (4 did not eat and 1 ate only12-day DEC medicated salt). Beforefilariasis control program started, theinfection rate was 8.4% in man and10.3% in mosquito on Kinmen Proper.After control (3 years) by combinedmethod, the corresponding figureswere 0.7% and 0.3% respectively.The data obtained on Little Kinmenbefore control, the infection rate was9.6% in man and 9.1% in mosquito.One year after control by DEC coatedsalt, the corresponding figures on sur-vey were 0% in both man and mos-quito. From the poin of time spent andcost in service and drugs, combinedmethod used on kinmen Proper, themedication rate was 89%, cure rate 84%,reaction rate 62%, and 63 workers;and in Little Kinmen where only DECmedicated salt was given as domestickichen salt replacement, the correspon-ding figures were 100%, 100%, 0%and 8 respectivly. The cost per personof the program was higher in KinmenProper than in Little Kinmen with aproportion of NT$90/US$2.2 to NT$32/US$ 0.8. It was NT$246/US$ 6.2 toNT$145/US$3.6 for whole period of 13years. Therefore, the DEC medicatedsalt is not only the preventive agent,but also simple, rapid, safe, cheap,efficient and practical method for usein filariasis control and/or filariasiseradication in the endemic areas of theworld.
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