台灣地區學童寄生蟲防治成果分析

Abstract

腸道寄生蟲主要盛行於熱帶及中低度開發地區，估計全球約有44.6億人感染相關疾病，並造成龐大的經濟損失。台灣地區從1971年起針對全省國小學童進行每年兩次的全面性篩檢防治計畫，到1986年為止，全省腸道寄生蟲盛行率從73%降至0.19%，成效卓著。本研究利用1976年到1985年間財團法人中華民國寄生蟲防治協會第二、三期五年計畫成果，以及1996年到2002年間全民健康保險就醫資料進行分析。從1976年到1985年間，全省的蛔蟲及鞭蟲陽性率分別從6.8%及11.4%降至0.3%及0.4%，其中以人口密度最高的都市地區防治成效最佳，且各縣市從事農業的人口比例與寄生蟲陽性率成正相關；1996年到2002年間，累計因腸道寄生蟲就醫人次共1,867人次，其中76.7%是10歲以下兒童，女性就醫人次較男性多(1,024人次對829人次)。因此，雖然我國的寄生蟲防治計畫僅針對國小學童，但仍足以控制主要的感染族群；此外，生活環境的改善對於寄生蟲盛行率也有很大的關係，都市化的生活習慣可以有效降低寄生蟲盛行率。結論：我國多數地區的腸道寄生蟲感染情形已十分少見，但山地地區仍有較高的感染率，針對山地地區進行學童篩檢治療及改善衛生習慣應可進一步降低感染率。

Intestinal helminthiasis is still prevalent in tropical and less-developed regions. It was estimated that 4.46 billion people were suffering from relative diseases in the world and consequently causing major financial damage. In Taiwan, the parasite control plan among children in primary school began in 1971, which reduced the prevalence from 73% to 0.19% in 1985. The study sample were selected from the database of the parasite control plan from 1976 to 1985,held by Parasite Control Association of the Republic of China, and NHI Registry for Beneficiaries’ Database from 1996 to 2002. During 1976 to 1985, the prevalence of Ascaris lumbricoides and Trichuris trichiura decreased from 6.8% and 11.4% to 0.3% and 0.4%, respectively; the least prevalence occurred in the urban regions. During 1996 to 2002, totally 1,867 cases infection of Ascaris or pinworm were found; 76.7% of them were under age or 10; more female cases than male (1,024 vs. 829.) Reviewing all these data, since the parasite control plan in Taiwan only involved children in primary school, which was the major infected group, still leading to the overall decrease in prevalence rate. Besides, urbanizing also contributed in the improvement of living style and kept children from reinfection. In conclusion, intestinal helminthiasis is rare in most regions in Taiwan except mountain regions. It could be reduced through more parasite control projects and health education.