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[Obstacle factors in implementation of integrated schistosomiasis prevention and control strategies with emphasis on infectious source in hilly endemic regions].

OBJECTIVE
To analyze the main obstacles existing in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source in hilly endemic regions, and to find out the current priority issues in schistosomiasis prevention and control, so as to provide the evidence for further solutions.


METHODS
Two typical hilly schistosomiasis endemic regions in Sichuan Province, including Pujiang County of Chengdu City and Dongpo District of Meishan City, were selected as research areas. A framework of obstacle factors in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infectious source in hilly endemic regions was built by literature review, and the management and technical personnel who worked on schistosomiasis prevention and control in eight different industries (health, agriculture, forestry and so on) and five levels (provincial, city, county, township and village levels) were investigated by questionnaires in the way of nominal group.


RESULTS
One hundred and fifty-three management and technical personnel in different industries and different levels were investigated. The questionnaire recovery rate (experts' positive coefficient) was 100%. The results showed that the first four problems needing to be concerned in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source were eliminating Oncomelania hupensis snails by projects, health education, examination and treatment for schistosomiasis persons, and harmless treatment of night-soil and safe water supply. The focuses of two counties in the implementation of integrated strategy measures were different. The harmless treatment of night-soil and safe water supply was the most important measure in Pujiang County, while the elimination of snails by projects was the most in Dong-po District.


CONCLUSIONS
As the differences in the situation of epidemic areas and the existed condition of the prevention and treatment progress, the comprehensive schistosomiasis control measures should be adjusted according to the local conditions in the implementation of integrated schistosomiasis prevention and control strategies with emphasis on infection source.