Ket qua cho thay co moi lien quan giffa gidi tfnh, kien thffc, thai dp, hanh vi Sn goi ca va thffc hanh chung ciia doi tu'dng vdi tinh trang nhiem SLG nho p gidi.. Nhom cd kien thffc, th
Trang 1TAP QUAN AN GOI CA SONG vA NGUY C a N H I 6 M S A N LA GAN NHO CUA NGU'Cri D A N T R E N 15 TUOI TAI MOT XA KHU VU'C NAM TRUNG BO
T 6 M TAT
Nghien cirtJ mo ta cat ngang 6ifdc tien hanh tff
thang 6/2012 den thang 12/2012 vdi c3 mau phong
van la 375 ngu'di dan vdi myc tieu la xac dmh cac yeu
Tuy An, Phu Yen
Ket qua cho thay co moi lien quan giffa gidi tfnh,
kien thffc, thai dp, hanh vi Sn goi ca va thffc hanh
chung ciia doi tu'dng vdi tinh trang nhiem SLG nho (p
gidi Nhom cd kien thffc, thai do, thffc hanh dat co
nguy cd nhiem thap hdn nhom khdng dat
SUMMARY
ACTION OF EATING D R A W FISH D I S H AND
RISKY FACTORS OF O P I S T H O R C H I S
V I V E R R I N I I N F E C T I O N AT ONE COMMUNE
OF SOUTH-CENTRAL REGION OF V I E T N A M
A cross-sectional study was conducted from June
2012 to December 2012 (sample size 375 objects) to
at An Hoa Commune, Tuy An Distnct, Phu Yen
Province
Results showed that there are a relationship
between sex, knowledge, attitude and action of eating
draw fish dish and general practice with Opisthorehis
viverrini infection (p < 0.01) Male has a higher
infectious risk than women (more than 3.3 times)
Groups which passed knowledge, attitude and practice
are in lower risk infection than un-passed groups
I OAT VAN OE
Benh san la gan (SLG) nhd la mdt trong
nhffng benh ky sinh trung gay anh hffdng rat Idn
den sffc khoe cua con ngffdi Ngffdi b| mac benh
san la gan nhd la do an phai ca nffdc ngpt cd chira
au triing san la gan nhd chffa dffdc nau ehfn
Tren the gidi benh san la gan nhd hien dang
gay anh hffdng trffc tiep ft nhat 23 trieu ngffdi ya
!^ moi de dpa den sffc khoe ciia hang tram trieu
ngffdi khac [1] Tai Viet Nam, nam 1998 cd
khoang 500.000 ngffdi bj nhiem benh SLG nhd
tap trung d cac tinh dong bang Bac bp va mien
Trung [2] Oen nam 2006, benh san la gan nhd
* SdYte Khanh Hda
Le Hiru Tho*
da du'dc phat hien ft nhat d 25 tinh, gdm 15 tfnh phia Bac va 10 tinh mien Trung-Tay Nguyen vdi
ty le nhiem tff 0,2-37% [3],[4] Vat chu trung gian cd n h i l m au triing san la gan nhd la cac loai
ca nhu': ca tram, ca trdi, ca me, ca chep, ca giec
Phu Yen la mpt tinh ven bien Nam Trung bp,
cd nhieu sdng ngdi va ao hd tff nhien nen cd nhieu Ioai ca nffdc ngot va ngffdi dan da phan sdng bang nghe ndng Hdn nffa, hp cd tap quan
an gdi ca sdng va coi day la mdt mdn an dac san ciia minh Day cd the la nguyen nhan dan den viec tang nguy cd nhiem san la gan nhd trong cpng dong, anh hffdng den sffc khde ciia ngffdi dan, gay khd khan trong cdng tac cham sdc sffc khde cdng ddng, anh hffdng den sff phat trien kinh te - xa hdi ciia dia phffdng Vi vay, chiing tdi thffc hien de tai nghien cffu nay vdi myc tieu
"mdta mpt sdyeu tdnguy cd lien quan den nhiem san ia gan nhd tai xaAn Hoa."
II OOI TUgWG VA PHU'aNG PHAP NGHIEN CUTJ
2 1 Dja d i e m , d d i t f f d n g va t h d i g i a n
n g h i e n cu'u
2.1.1 Dja diem nghien ciTu: tai xa An
Hda, huyen Tuy An, tinh Phu Yen
2.1.2 Ddi tu'dng nghien CtJ'U: Ngffdi dan
tff 16 tuoi trd len trong xa nghien cffu
2.1.3 Thdi gian nghien cthi: tff thang
6/2012 den thang 12/2012, 2.2 Phu'dng p h a p n g h i e n cu'u
2.2.1 Thiet ke nghien cud: cat ngang md ta
Chpn mau va c3 mau: Dffa tren danh sach 3.152 hp gia dinh ciia xa, chpn mau ngau nhien
he thdng vdi sd hd la 125 hd vdi cd mau la 375 2.2.2 Ky thuat ap dung trong nghien cut:
Phdng van tat ca ddi tffdng ve kien thffc, thai
dd va thffc hanh benh SLG nhd Quan sat tap quan an gdi ca ciia ngffdi dan tai diem nghien cffu
2.2.3 Npi dung nghien cii'u
Ndi dung nghien cffu: Nghien ciru ty le nhiem SLG nhd bang ky thuat xet nghiem phan Kato-katz Nghien cffu yeu t d nguy cd bang ky thuat phdng van theo cau hdi KAP
2.3 Xff ly so l i e u
So lieu dffdc nhap Epidata va xff ly tren
Trang 2III KET QUA NGHIEN CU'U
Bang 1 Ty le nhiem san la gan nho chung d xa An Hoa (n=384)
GI6i
Nam
NiJ
Tong cong
S6XN
186
384
S o ( + )
38
14
52
Ty le (»/o)
20,4 7,1
13,5
P
OR
p < 0,01
OR = 3,3
Xet nghiem 384 ddi tddng cd 52 trddng hdp nhiim san la gan nhd chiem 13,5% Tyle nhiem d nam la 20,4%, d ni/la 7,1% Nhiem san la gan nhd d nam cao hdn d nd, sd khac biet cd y nghia thong ke (p
< 0,01)
Bang 2 Lien quan qiiJa l<ien thirc va tinh trang nhiem SLG nho
Kien thii'c
Khong dat
Oat
Tinh trang nhiem san la gan nho
Co
40 (17,17%)
12 (7,95%)
Khong
193 (82,83%)
139 (92,05%)
Tong so
233
151
>t = 6,64 p<0,01 OR =2.4 CI 95%= (1,1 - 5,0)
Trong so ngddi cd kiin thdc dat chi cd 7,95% nhiem san, so ngddi^co kien thdc khong dat chiem 17,17% nhiem san Cd moi lien quan gida kien thdc va tinh trang nhiem san la gan nhd vdip < 0,01, nguy cd nhiem san d ngddi cd kien thdc khdng dat cao gap 2,4 lan ngddi cd kiin thdc dat
Bang 3 Lien quan qiUa thai do va tinh trang nhiem san la gan nho
Thai do
Khong dat
Dat
Tinh trang nhiem san la gan nho
Co
39 (16,96%)
13 (8,44%)
Khong
191 (83,04%)
141 (91,56%)
Tong so
230
154
Z = 5,7 p<0,05 OR =2,2 CI95%= (1,1 - 4,5)
So ng&di cd thii do dat chiim 8,44% nhiem san, so ng&di co thai dp khdng dat co tdi 16,96% nhiem san Nguy cd nhiem san d ng&di cd thai dp khdng dat cao gip 2,2 lan ng&di co thai dp dat Mil lien quan nay cd y nghia thdng ki (p < 0,05)
Bang 4 Lien quan giffa tien sff an gdi ca va tinh trang nhiem san la gan nhd
Vung
Dong bang
Ven bien
Cong
An goi ca
Co an Chu'a an
Co an Chu'a an
Co an Chua an
Nhiem san la gan nho
19
0
33
0
52
0
Khong nhiem
40
138
36
118
76
256
P
OR
p <0,001
p <0,001
p <0,001
Trong^ sd 128^ ng&di an gdi ca cd 52 ng&di nhiem SL G nhd, khdng cd tr&dng hdp nao ch&a tung an goi
ca ma bi nhiem san Cd mil lien guan gi&a tiin s&an goi ca va tinh trang nhiem SLG nhd (p < 0,001)
Bang S Lien quan giffa tan sdan gdi ca va tinh trang nhiem SLG nhd (n - 128)
Vung Mu'c do an goi ca Nhiem san la
gan nho
Khong
Ddng bang 5 lan trd len/ nam
Dffdi 5 lan/ nam
p < 0,01
OR = 7,4 Ven bien 5 lan trd len/ nam
Dffdi 5 lan/ nam
p < 0,05
OR = 3,3
Dffdi 5 lan/ nam
Co moi lien quan gi&a tan sd an goi ca va nhiem ji.^ miw, ,,^uw » i,^ ^^ u- ^ ,ai, ^w ,cn t
p < 0,01
OR = 5,1
em SL G nhd, ng&di angoi ca t& 5 lin trd len trong 1 nSk
Trang 3Bang 6 Lien quan giu'a thu'c hanh chunq va tinh tranq nhiem SLG nho
Thu'c hanh
Khonq dat
Oat
Tinh trang nhiem san la gan nho
Co
52 (22,32%)
0
Khonq
181 (7768%)
151 (100,0%)
Tong so
233
151
/ = 3709 p < 0,001 Ng&di cd th&c hanh khdng dat ty le nhiem SLG nhd la 22,32%, Khdng cd tr&dng hpp nao thu'c hanh dat ma nhiem SLG nhd Cd mdi liin guan gi&a thuehanh va tinh trang nhiem SLG nhd vdi p < 0,001
IV BAN LUAN
Theo ket qua bang 2 chung tdi thay cd mdi
lien quan giffa tien sff an gdi ca va ty le nhiem
SLG nhd vdi p < 0^001 Tuy nhien ngoai cac yeu
to la cd an gdi ca va tan sd an gdi ca thi ty le
dp nhiem au trung d ca Viec quan ly phan tot,
klidng phdng ue bira bai, khdng diing phan bac
bdn cay trong trong nong nghiep s e j a m giam ty
\% ca cd au trung va cffdng dp nhiem au trung
CLia ca Ty Ie cd hd xi d xa An f-ida cung cdn thap
(60%), viec phdng ue ra dat, dong rupng cung
cdn nhieu se tao dieu kien tdt cho viec khep kin
chu ky SLG nhd
Ket qua nghien cffu cho thay giffa kien thffc,
thai dd va thffc hanh deu cd moi lien quan tdi
tinh trang nhiem SLG nhd vdi p < 0,01 Theo ket
qua d bang 2 nhffnq ngffdi cd kien thffc khdng
dat thi nguy cd nhiem SLG nhd cao gap 2,4 lan
ngffdi cd kien thffc dat Nhffng ngffdi cd thai dp
2,2 lan so vdi ngffdi cd thai dp dat (bang 3)
Vdi nhffng ngffdi cd thffc hanh chung dat thi
98,68% khdng bi nhiem benh SLG nhd, chi cd
nhiem san la gan nhd (Bang 6) Ket qua nghien
va thffc hanh vdi tinh trang nhiem SLG nhd tai
Nga An ciia Oo Thai Hda cho thay deu cd mdi lien
quan gidng nhff nghien cffu ciia chiing tdi (p <
0,001) [ 7 ] , nhffng nguy cd giffa nhdm khdng dat
va nhdm dat khac so vdi nghien cffu ciia chiing
tdi, nhffng ngffdi cd kien thffc khdng dat thi nguy
va ngffdi co thai dp khdng dat
V Kfr LUAN
- Cd moi lien quan giffa gidi tinh, kien thffc, thai
dp, hanh vi an gdi ca va^thffc hanh chung ciia ddi
tffdng vdi tinh trang nhiern^ SLG nhd (p < 0,01)._
- Nam gidi cd nguy cd nhiem gap 3,3 lan nff gidi,^
- Nhdm cd kien thffc, thai dp, thffc hanh dat co
nguy cd nhiem thap hdn nhdm khdng dat
V I KIEN N G H ! Day manh cdng tac tuyen truyen giao due nang cao kien thffc phdng chdng benh SLG nhd cho cdng ddng tai xa An Hda Van dpng ngffdi dan tff bd tap quan an gdi ca, nang cao ty le hd
cd hd XI hdp ve sinh
T A I L I E U T H A M KHAO
1, E>ang Thj Cam Thach, Pham V3n ThSn,
Nguyen Thj Ha va CTV (2005), "Tinh hinh nhiem
va SLf phan bo ciia Cionorchis sinensis \.tkn the gidi
va Viet Nam" Tap chi phong chong benh Sdt ret
Trung i/dng, (1), tr 69 - 77
z Le Oinh Cong (1998), Tinh hinh benh giun san hien nay d Viet Nam, phWdng hu'dng ke hoach phong chong cac benh giun san 1998-2000 va den nam 2005 Hoi thao QuiSc gia phong chong cac
benh giun san 1998-2000 va den 2005, Bo Y^te • DiT an phong ciiong cac benh giun san, Ha Noi, tr 01-07
3 Nguyen Van Chu'dng (2007), "Ket qua nghien cii'u cac benh giun san tai khu vUc mien Trung-Tay Nguyen glai doan 1989-2006, dmh hydng chien
lu'dc phong chong giun san 2007-2010" Ky yeu cdng trinh nghien c&u k/ioa hoc 2001-2006 Vien
Sot ret-KST-CT Quy Nhdn, NXB Y hoc, nam 2007,
tr 402-409
<* Nguyin Van Be, Le Thanh Hoa va CTV (2007),
"Tinh hinh nhiem san la gan d ngu'di va thanh phan
loai san la gan 6 Viet Nam" Ky yeu cdng trinh nghien cuV /<iioa hoc 2001-2006 Vien Sdt
ret-KST-CT Quy Nhan, NXB V hoc, Ha Npi, tr 474 - 482
a Nguyen Van Chu'dng,^ Biii Van Tuan (1998),
Bien dong cua ty le nhiem san la gan nhd tai mgt
so xa ven bien mien Trung Viet Nam Hgi thao
Qudc gia phong chong cac benh giun san 1998
-2000 va den 2005 Bo Y te - DU an phong chong cac benh giun san, Ha Ngi, nam 1998, tr 51 - 56
6 Nguyen Van De (2007),"Dich te, chan doan, dieu tri va phong chong san la gan d Viet Nam" Tap
chi Thay thudc Viet Nam, Dac san cua Td'ng hgi Y hoc Viet Nam, (S), NXB Cong ty c6 phan xuat ban
tre, Ha Noi, trang 8 - 1 1
/, Do Thai Hoa (2005), Mot sd yiu td lien quan tdi thuc trang nhiem san la gan nho tai xa Nga An, huyen Nga Sdn, Thanh Hoa Luan vSn Thac sy Y
te cong cpng, Dai hpc Y te cdng cgng