Hhihig m qua nghien cihi gdp piian nang cao nang iiTc bao ve, GJiam sdc sufc iiiide cong ddng iii Tay Nguyen Bao ve va cham soc sufc khoe cong dong la mot van de quan trong trong thUc t
Trang 1Hhihig m qua nghien cihi gdp piian nang cao nang iiTc bao ve,
GJiam sdc sufc iiiide cong ddng iii Tay Nguyen
Bao ve va cham soc sufc khoe cong dong la mot van de quan trong trong thUc tiln phat trien kinh
te - xa hpi hien nay, dac biet la v6l viing dat co vj tri chien li/pc va nhieu tiem nang nhi/Tay Nguyen Vei ly do do, de tai TN16/T03 do GS.TS Pham Gia Khanh lam chu nhiem da dUdc thiic hien trong giai doan 2016-2019, thuoc ChUdng trinh KH&CN Tay Nguyen 2016-2020
Ket qua nghien ciilu cua de tai da giup danh gia mo hinh benh tat, phan tich nguy cd biing phat djch benh do hien tUdng di, bien dpng dan cif va cac hien tupng thdi tiet khi hau cUc doan tai khu vUc bien gidi cac tinh Tay Nguyen Dong thdi, gop phan xay dUng va phat trien cac mo hinh ket hdp quan - dan y ciing nhu cac mo hinh nang cao nang iUc y te tuyen cdsdde sin sang doi pho khi co djch benh xay ra Ben canh do, thong qua thUc hien de tai, da xay dUng dUdc cac quy trinh bao che
va san xuat thanh cdng 7 san pham ho trd dieu trj mpt so benh thUdng gap is lay Nguyen tif nguon
dUdc lieu ban dja, gop phan xoa doi giam ngheo cho ngUdi dan cac tinh Tay Nguyen
Cham soc silc khde cong long ol Tay
Nguyen-Vklec^pthlit
Cac tinh Tay Nguyen co vai tro
dac biet quan trong ve quoc phong,
an ninh, cung nhieu tiem nang phat
trien l<inh te - xa hqi Tuy nhien, do
tac dpng cua di, bien dong dan so va
hien tupng thdi tiet l<hi hau cue doan,
nen cuoc song con ngUdi d viing dat
nay vSn cdn nhieu khd khan, dac biet
la van de bao ve, cham soc sUc khoe
cpng dong Ben canh do, vdi idi the
ve dja iy, thd nhudng va khi hau, Tay
Nguyen cd nguon duoc iieu ty nhien
rat phong phu va da dang nhung viec
khai thac iai khong hieu qua, dan den
nguy cd can kiet
Trudc thuc trang nay, de tai
"Nghien cUu cac giai phap nang
cao nang iUc bao ve, cham soc sflc
khoe cong dong vimg bien gidi Tay
Nguyen va tao san pham hang hda
tir nguon dUdc lieu ban dia" (ma sd
TN16/T03) da dUdc phe duyet thuc
hien, vdi 2 muc tieu chinh: (1) Xac
dinh'mo hinh benh tat va giai phap
tSng cudng nang iuc bao ve, cham
sdc SLfc khde cpng dong vimg bien gidi Tay Nguyen do tac dong cua di, bien dong dan so va hien tuong thdi ti^t khi hau cue doan; (2) Xay dung quy trinh chuyen giao cdng nghe tao san pham hang hda tir nguon dudc
iieu ban dia, gdp phan xda ddi giam ngheo, dam bao an ninh bien gidi Trong 3 nam thuc hien (2016-2019), nhdm nghien ciru da tich cue trien khai dong thdi cac noi dung nghien ciru tai thuo dia cung nhu
Xet nghiem mau cho ngi/cri dan tai 28 xa bien gidi khu vu'c l a y Nguyen
Trang 2IUdng edng viee do so, De IhUc hien
muc tieu thd nhat, eac nha khoa hpe
cua de tai da dung phUdng phap
nghien cUu md ta eat ngang ve thuc
trang md hinh benh tat cua dan
cU song tai khu vUc bien gidi Tay
Nguyen va thUc trang 5 benh truyen
nhiem- sot md, sot xuat huyet, sot
ret, Leptospira, benh Zika Dong thdi
phan tich moi lien quan giOa benh
djch vdi hien tupng di, bien ddng dan
cU va hien tapng thdi tiet khi hau cue
doan, De tai cijng thUc hien phUdng
phap nghien eUu can thiep cdng
dong de xay dUng 2 md hinh: Nang
cao nang lUc cham sdc sUe khoe cho
tram y te xa va Ket hdp quan - dan
y trong phdng chong sot ret khu vuc
bien gidi Tay Nguyen Vdi muc tieu
tao san pham hang hda Xd nguon
dUdc lieu ban dja, nhdm nghien edu
da thuc hien phUdng phap kiem
nghiem tren cd sd Dupc dien Viet
Nam V va xay dung tieu chuan ed sd
cac nguyen lieu dau vao eua eac bai
thuoc: hd trd benh fim mach, hd trd
chUe nang gan, hoat huyet, chdng
dot quy, chdng say nong; tU dd tao ra
cac san pham hd trd dieu tri
Nhutig ket qua noi bat cua U tai
TN16/T03
Trong 3 nam qua, nhdm nghien
CLfu da tien hanh kham tong quat,
tu van dieu trj va phat thudc mien
phi eho 1,680 hp gia dinh (6 650
ngudi) tai 28 xa bien gidi khu vuc
Tay Nguyen, Ty ie hd gia dinh cd ft
nhat 1 ngadi bj benh trong thang,
28,51% Theo nghien cUu cua de
tai ve md hinh benh ngoai cdng
dong, nhom tudi bi benh cao nhat 6
Tay Nguyen la tre em dadi 10 tudi
(36,19%); benh cap tinh hay mac la
hoi Chang cam cum (29,08%), viem
phdi - phe quan (17,29%), tieu chay
(12,60%); benh man tmh phai dieu tri
la benh da day (10,08%), cac benh
XUdng khdp (7,36%) Nghien cuu ve
cd cau benh tai cac cd sd y te cho
thay ve cd ban vSn la md hinh benh
tat cua cac nudc dang phat trien: cac benh nhidm triing van pho bien va chiem ty le ldn, rieng cac benh irong ChUdng trinh tiem chung md rong da giam ro ret Benh khdng nhigm triing ngay cang tang (khoi u, benh cd quan tao mau, ndi tiet, chuyen hoa,
dj tat bam sinh va bat thadng nhiem sac the); cac benh dinh dUdng giam
dan Ty suat tu" vong ndi ehung d Tay
Nguyen la 7,91-8,25%o, trong dd ty suat tij' vong d tre em dadi 5 tudi la 37,80-40,10%o Cae nguyen nhan hang dau gay ta vong d tre em la; tai nan (27,45%), benh thdi ky chu sinh (22,70%), benh ho hap (12,91%), benh than kinh (9,50%), benh khoi u (8,79%) Trong khi nguyen nhan gay tLf vong hang dau d ngudi ldn la: khoi
u (24,01%), he tuan hoan (20,14%), lai nan va ngd ddc (13,10%), benh
ho hap (10,88%)
Nghien cifu ve thuc trang mpt so
benh truyen nhifem hay gap d l<hu vUc
bien gidi Tay Nguyen cho thay, benh sot xuat huyet Dengue dat dinh vao thang 8 va 9, hau het benh nhan d tudi >15; da so la sot xuat huyet dang nhe, ed mat cija 4 type vi rut, Dl va
0 2 chiem Uu the, muoi/lec/esaegypf/
cd mat quanh nam Vdi benh sot ret,
ty le mac eua cpng dong la 1,82%, ty
ie cd ky sinh trung la 1,52%, cao nhat
d iUa tudi >15 (60,00%), Vdi benh sot
mo, nghien cau cho thay cd khang
the khang O tsutsugamushi\iju hanh
trong cdng dong vdi ty le ehung la 12,17%'(Gia Lai 16,72%, Dak Ndng 9,05%, Dak Lak 14,42% va Kon Tum
8,67%) Tai 4 tinh nghien cau deu thu dupc loai md ed kha nang truyen
benh sot mo la Leptotrombidium
(Lep.) deliense va Ascoschoengastia (Laurentella) indica Benh sot mo
xuat hien vao tat ca cac thang trong nam, eao nhat la tU thang 5 den
thang 10 Vdi benh Leptospira tai khu
vuc bien gidi Tay Nguyen, nghien eUu eho thay ty le ngudi mang khang
the khang Leptospira la 10,86% (cao
nhat tai Gia Lai 15,20%, tiep den la Nong 8,12%) NhOng ngudi (am nghe ndng, lam ray quan nhan ed nguy ed
phdi nhiim vdi Leptospira cao hdn
cac nganh nghe khae (sU khac biet
ed y nghTa thong ke)
Ket qua nghien eUu ve anh hUdng eua di, bien dpng dan cu den benh
djch d Tay Nguyen cho thay ty le
ngudi di cU mac benh trong vdng 4 tuan cao hdn 42% so vdi ngudi khdng
di cu (su khac biet ed y nghTa thdng ke) Benh nao mo cau lien quan nhieu den van de di eu trong nude vdi ty le mac benh ehu yeu 5 nhdm dan di eU (57,14%) Benh sot ret khu vue bien gidi cd lien quan nhieu den giao luu bien gidi, ty le cd ky sinh
triing sot ret d ngUdi ed giao lUu qua
bien gidi cao gap 2 lan nhom khdng giao lUu bien gidi (2,21%/1,10%); ty
le nhi§m ky smh triing sot ret d nhdm ngudi dl theo dudng tieu ngach cao gap 2 so vdi nhdm di qua caa khau (67,98%/33,02%)
Ve anh hUdng cua thdi tiet khi hau cue doan den sue khoe cdng
43
Trang 3dong, ket qua nghien cUu cho thay,
Sd gia lang nhiet dp co anh hudng
tdi su gia tang ty le mac cac benh
lay n h i i m va khdng lay: khi nhiet dd
>35"C, eU tang 1°C thi sd lUdt kham
benh/10,000 dan tang 1,7-2 lan
Ve nang cao nang lUe cham soc
sUc khde eiJa cac tram y te xa bien
gidi Tay Nguyen, de tai TN 16/T03 da
xay dung thanh cdng md hinh nang
Tram y te xa la - Puch, huyen Chu
Prdng, Gia Lai Sau khi ap dung md
hinh 12 thang, sd lUdf kham benh tai
Tram y te da tang 19,45%; ty le SIJ
dung djch vu y te cdng tang 49,66%,
mUe dp hai long eua ngadi dan tang
thanh cong md hinh ket hpp quan
- dan y phdng chong sot ret tai xa
Quang True, huyen Tuy Ddc, tinh
Dac Nong; phoi hpp vdi Sd Y te Dac
Ndng tap huan va ban giao test chan
doan sot ret cho can bp y te xa, tuyen
truyen phong chdng sot ret Sau 12
quan ly, phat hien ca benh tai cpng
ddng da cd hieu qua rd ret: giam ty
2 3 , 9 1 % ; giam ty le nhidm ky sinh
trung sot ret trong cdng dong 37,58%;
kiem soat mac ky sinh triing sot ret
do giao lUu bien gidi dat 64,47%,.,
Nhom nghien cUu eung da xay
dung thanh edng 7 quy trinh bao che
cac san pham tU nguon dUpc lieu ban
dia Tay Nguyen Cac san pham nay
da dupe Bd Y te cap giay phep lUu
hanh, bao gdm: 2 loai cao khd djnh
chuan (cao khd chong say ndng va
cao chdng ddt quy), 3 san pham
bao che dang vien (vien KARDl
Q10, COOLSUN, CRATON) va 2
loai tra tui loe (tra CRAKONTUM va
tra CYNAKONTUI^) Day la eac san
pham cd gia tri trong cham sde sUc
khde eung nha gdp phan xda ddi,
giam ngheo cho khu vUcTay Nguyen,
Ban chu nhiem de tai cung da ky ket
hpp dong vdi 3 doanh nghiep (Cong
iy CP DUpc - Vat tU y te D i k L i k ,
Mot so san pham h6 trO dieu trj cua de tai TN16/T03
Cdng ty TNHH Phan Ngan Toan va Cdng ty Phat tnen hoat chat sinh hpc Viet Nam) de chuyen giao cdng nghe
va dUa san pham cua de tai ra thj tradng,
Trong khudn khd cua de tai
T N I 6/T03, da tham gia dao tao thanh cdng 1 TS va 2 Thac sy De tai cung
da cdng bo 14 bai bao khoa hpc tren cac tap chi chuyen nganh ed uy tin trong va ngoai nudc, trong dd cd
3 cong bo tren cac tap ehi qudc te thuoc he thong ISl
Vdi nhQng ddng gdp het sUc thiet thuc cho cdng ddng vung bien gidi Tay Nguyen va eho nen khoa hoc nude nha ngay 2/3/2020, de tai TN16/T03 da dupc nghiem thu vdi ket qua xuat sac
Mpt Sd kien nghj
Qua thuc hien de tai TN16/T03 cho thay de nang cao nang luc bao
ve, cham soc sUc khoe cpng dong vimg bien gidi Tay Nguyen va tao san pham hang hoa tU nguon dUdc lieu ban dja, can thuc hien eac bien phap sau:
1 Cac tram y te xa can dUdc tang
cUdng cd sd vat chat, trang thiet h\,
thudc thiet yeu theo chuan qudc gia
ve y te xa nhSm nang cao chat lUdng hoat dgng, dac biet la tai cac xa vimg
sau, vung xa
2 Tang eUdng dao tao, tap huan,
bd sung ve chuyen mdn eho cae bac
sT hien dang edng tac tai tram y te xa Ndi dung, chUdng irinh can tap trung vao cac chuyen khoa va theo dac thii
cd cau benh cua tUng dja phUdng, kien thUc ve quan ly tram y te xa
3 Then khai nhan rpng bien phap ket hdp quan - dan y trong phong chdng benh djch d vimg bien gidi, ndi
cd eac ddn vj lUc lUpng vu trang dUng chan,
4 Y te cd sd va quan y bien phdng can tang cadng quan ly doi tupng giao lUu bien gidi de kiem scat cac benh truyen nhiem do giao lUu bien gidi Can cd cd che phoi hpp y
te giL?a cac tinh bien gidi cung nhu sU giup dd cua quan y bien phdng nhIm quan ly cd hieu qua ngudi giao luu bien gidi,
5 Tiep tuc phat trien vung dUdc heu cung nhu nghien eUu quy trinh
san xuat eae san pham khac Xd
ngudn dUpe lieu tai Tay Nguyen ^r
Ban chu nhiem de tai TN16/T03
" ^:^m So 5 nam 2020