目的 了解湖南省不同经济水平地区居民华支睾吸虫病知晓情况及其可能的影响因素,为湖南省华支睾吸虫病防治策略制定提供参考依据。方法 采用多阶段整群抽样方法抽取湖南省不同经济水平地区的有效调查对象共1 490人,运用SPSS 16.0、MLwiN 2.02软件整理分析资料,采用多水平Logistic回归对知晓率的影响因素进行分析。结果 湖南省经济发达地区、经济较发达地区和经济欠发达地区评分优的人数构成比分别为10.71%、7.24%和7.17%,评分差的人数构成比分别为22.03%、24.79%和12.95%,不同经济水平地区间居民华支睾吸虫病知晓率差异有统计学意义(χ2=33.964,P < 0.001),经济发达地区和经济欠发达地区居民知晓率呈现两极化趋势,而欠发达和较发达地区的大部分居民知晓情况处于中等水平;病原学特征、临床表现、流行病学特征和个人预防常识评分优的人数构成比分别为5.32%、11.27%、16.35%和4.14%,评分差的人数构成比分别为32.14%、24.59%、19.70%和28.77%,不同疾病知识方面居民知晓率差异有统计学意义(χ2=48.823,P < 0.001);影响知晓率的社会因素为疾病预防信息获取渠道(95%CI:0.141~0.706)、民族(95%CI:2.418~7.222);影响知晓率的临床因素为腹泻频次(95%CI:0.113~0.860)、食物中毒史(95%CI:0.121~0.687)及寄生虫病史(95%CI:0.134~0.849)。结论 湖南省应对经济发达地区重点区域进行华支睾吸虫病卫生宣传教育,侧重点为病原学知识及个人日常预防常识,同时结合影响华支睾吸虫病知晓率的社会及临床因素开展特殊人群的健康教育。
Objective To investigate the awareness and possible influencing factors of clonorchiasis among residents at different economic levels in Hunan province. Methods Multi-stage cluster sampling were used to extract 1 490 effective subjects, SPSS 16.0 and MLwiN 2.02 softwares were used to analyze the data, and the influencing factors of the awareness were analyzed by multi-level Logistic regression. Results The awareness were different among different economic level regions(according to the order of developed areas/more developed areas/less developed areas, the superior proportion were 10.71%, 7.24%, 7.17%, the poor proportion were 22.03%, 24.79%, 12.95%)(χ2=33.964, P < 0.001), the rate of awareness in economically developed areas and economically underdeveloped areas showed a trend of polarization. The awareness of different diseases was different(according to the order of pathogenic characteristics, clinical manifestations, epidemiological features, the order of personal precautions, the superior proportion were 5.32%, 11.27%, 16.35%, 4.14%, the poor proportion were 32.14%, 24.59%, 19.70%, 28.77%)(χ2=48.823, P < 0.001). The social factors that affect the rate of awareness were disease prevention information acquisition channels(95%CI:0.141-0.706) and ethnic groups (95%CI:2.418-7.222), the clinical factors affecting the awareness were frequency of diarrhea(95%CI:0.113-0.860), history of food poisoning(95%CI:0.121-0.687) and history of parasitic diseases(95%CI:0.134-0.849). Conclusion The key areas for health education of clonorchiasis in Hunan province should be the developed areas, the emphasis of health education are etiological knowledge and personal daily prevention knowledge. At the same time we can also combine the social and clinical factors to carry out the health education for the special population.
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