西盟县佤族疟疾防治的医学人类学研究  

Medical anthropology study on malaria control among Wa Ethnic in Ximeng County, Yunnan Province

作　　者：许建卫[1] 夏敏[1] 

机构地区：[1]云南省寄生虫病防治所,思茅665000

出　　处：《中国血吸虫病防治杂志》2007年第2期131-135,共5页Chinese Journal of Schistosomiasis Control

基　　金：湄公河遏制疟疾IEC项目;云南省卫生厅科技教育处项目

摘　　要：目的探讨影响云南省西盟县佤族疟疾控制的医学人类学因素。方法采用人类学和流行病学相结合、定量和定性相结合、统计学分析和定性描述相结合的方法进行研究和探讨。结果佤族居民把疟疾列为当地3种主要疾病之一，佤语疟疾“Saihui”一词无发热之意，近1／3的人不把发热作为疟疾的症状，大多数居民只知道间日疟，不了解恶性疟；只有32．7％的人能把疟疾联系到蚊虫上，很少人能够肯定蚊虫是疟疾的惟一传播媒介；疟疾病因，预防和求医知识评定为好的比例均（25．0％；多因素logistic回归分析显示3类疟疾知识间密切相关，病因和预防知识间（调整后比值比即OR值为36．61，95％可信区间即95％CI：10．242～130．866，P〈0．01），较病因和求医知识间（调整后OR值为4．013，95％CI：1．020～15．787，P〈0．05）的联系程度强；佤族社区中蚊帐使用率极低，logistic回归分析肯定了蚊帐使用与疟疾预防知识相关；村民生病后的第一行动是使用草药或自己购买西药进行自诊自治，只有自诊自治无效后才到卫生机构求医；患疟求医行为不正确和蚊帐使用率低的主要原因为经济、地理、文化和信息方面的可及性差。结论可及性差是西盟佤族中疟疾流行和不能被有效遏制的原因之一；改进佤族居民卫生服务的可及性是保证佤族疟疾控制的有效策略。Objective To explore the factors of medical anthropology related to malaria control among Wa Ethnic minority in Ximeng County, Yunnan Province. Methods The study was conducted by the combination of anthropology and epidemiology, qualitative and quantitative, statistical analysis and description. Results Wa people considered malaria as one of three major diseases in the community. In Wa Ethnical language, the word of malaria, ＂Saihui＂ （Sai - illness and pain, Hui - being attacked quickly）, does not mean of fever. About one third of Wa people had not thought fever as one of malaria symptoms. Most of Wa people only knew vivax malaria, but not falciparum malaria. Only 32.7 % of people could connect malaria with mosquitoes, and a few of them could confirm mosquitoes as the only malaria vector. The proportions of sound knowledge of malaria causes, prevention and treatment seeking assessed were lower than 25.0%. As a result of multivariate logistic regression, 3 kinds of malaria knowledge were closely correlated each other, and the connection between causal knowledge and prevention （adjusted OR： 36. 610, 95% CI： 10. 242 ～ 130. 866, P〈0. 01） was stronger than that between treatment seeking and causes （adjusted OR： 4. 013, 95%CI： 1. 020～15. 787, P〈0.05）. The bednet coverage was extremely low in Wa communities. Multivariate logistic regression confirmed the relationship between bednet usage and knowledge of malaria prevention. Self-medication was villagers＇ first action for malaria treatment by using herbs or medicines from drug store, and villagers sought standard treatment only after selfmedication failure. Inappropriate treatment seeking and low bednet usage were attributed to poor accessibility in economics, geography, culture and information. Conclusions Poor accessibility is one of reasons that malaria can not be controlled effectively. Improving accessibility of health ser vice through both public and commercial means is one of the strategies of effective malaria control a mong Wa E

关 键 词：医学人类学 疟疾 佤族 可及性 

分 类 号：R531.3[医药卫生—内科学]