COMPLIANCE AND ABSENTEEISM IN SCHOOL-CHILDREN - IMPLICATIONS FOR HELMINTH CONTROL
COMPLIANCE AND ABSENTEEISM IN SCHOOL-CHILDREN - IMPLICATIONS FOR HELMINTH CONTROL
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DOI：
10.1016/0035-9203(93)90464-2
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发表时间：
1993-03-01
影响因子：
2.2
通讯作者：
BUNDY, DAP
中科院分区：
文献类型：
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作者：
NOKES, C;BUNDY, DAP
流行病学调查的有效性和基于感染诊断的蠕虫控制计划的成功取决于准确的筛查程序。所有以学校为基础的控制计划的成功，无论是否涉及事先诊断，都取决于学校出勤率和入学率。使用在牙买加 3 所农村学校进行的一项调查的经验数据，研究了依从性和缺勤可能影响蠕虫感染估计值和治疗覆盖率的程度。对每个 9 至 12 岁的儿童连续采集两份粪便样本，并使用加藤厚涂片技术筛查蠕虫感染的存在和强度。在招募参加该研究的 696 名儿童中，94% 的人同意参加，但其中只有 90% 的儿童实际上提供了粪便样本用于诊断，并且只有 74% 的人返回了第二次粪便。与未感染的儿童相比，感染中度至重度鞭毛虫的儿童不太可能完全遵守该方案。与未感染的同学相比，他们遵守规定的时间也更长，缺课的次数也更多。加大采样力度提高了所有感染儿童和重度感染儿童的依从性。通过让他们选择遵守，严重感染的儿童在抽样程序中的代表性不足。这对于控制计划和流行病学调查的设计具有重要意义。
The validity of epidemiological surveys and the success of helminth control programmes based on the diagnosis of infection depend upon an accurate screening procedure. The success of all school-based control programmes, whether they involve prior diagnosis or not, depends on the level of school attendance and school enrolment. The degree to which compliance and school absenteeism may affect estimates of helminth infection and the coverage of treatment was investigated using empirical data from a survey conducted in 3 rural schools in Jamaica. Two sequential stool samples were requested from each child aged 9 to 12 years and screened for the presence and intensity of helminth infection using the Kato thick smear technique. Of the 696 children recruited into the study, 94% agreed to participate but only 90% of these children actually provided a stool sample for diagnosis and only 74% returned the second stool. Children infected with moderate to heavy loads of Trichuris trichiura were less likely to comply fully with the protocol than the uninfected children. They also took longer to comply and were absent from school more often than their uninfected counterparts. Increasing the sampling effort increased the compliance of all infected, and heavily infected, children. By giving them the option to comply, heavily infected children were under-represented by the sampling procedure. This has important implications for the design of control programmes and epidemiological surveys.