湖南省四县农村人群狂犬病暴露情况及疫苗接种影响因素分析  

Analysis of exposure situation and influence factors of vaccination of rabies among the rural people who come from four counties in Hunan province

作　　者：李亮[1] 刘富强[2] 陈立章[1] 郭亚伟[1] 

机构地区：[1]中南大学公共卫生学院流行病学教研室,湖南长沙410078 [2]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《中国现代医学杂志》2011年第32期4049-4053,共5页China Journal of Modern Medicine

基　　金：湖南省科技厅科技计划项目(No:2011SK3249);中南大学研究生教育创新工程项目(No:2011ssxt067)

摘　　要：目的了解湖南省农村人群狂犬病的暴露现状,探讨人群狂犬病暴露后疫苗接种的影响因素。方法采取多阶段抽样的方法,在湖南省选取4个县、20个乡镇、40个村,每个村选取部分村民参与狂犬病暴露及暴露后处置情况的问卷调查,采用SPSS 17.0进行描述性统计分析和多因素非条件Logistic回归分析。结果共调查40个村979户3 538名村民,自2009年1月～2010年10月共发现狂犬病暴露150人次,合计暴露率4.24%,年均暴露率为2.32%。其中0～9岁组暴露率最高(7.59%),20～29岁组暴露率最低(1.74%)。受伤部位为下肢膝及以下者最多(40.67%),致伤动物免疫接种过的仅占16.67%。72.00%的暴露者去医疗机构/诊所就诊,仅69.33%进行疫苗接种,8.43%注射抗狂犬病免疫血清或免疫球蛋白。Logistic回归分析结果显示,狂犬病防治知识得分、是否加入新型农村合作医疗及伤口深浅对狂犬病疫苗接种率有显著影响。结论狂犬病暴露后应该进行规范化的预防处置,将处置费用纳入新型农村合作医疗项目予以报销,采用综合防治措施,能够有效控制狂犬病的发病率。[Objective] To understand the current situation of potential rabies exposure to the rural people in Hunan province, and to explore the influence factors of rabies vaccination among the crowd. [Methods] Taking the multistage sampling method, questionnaire survey was conducted in forty villages which belonged to four counties twenty towns in Hunan province. Samples of these villagers were selected from 6aeh village for their rabies exposure and post-exposure disposal information. SPSS 17.0 software was used for descriptive sta- tistical analysis and multivariate non-conditional logistic regression analysis. [Results] Among 3 538 villagers, whom came from these 40 villages＂ 979 households, being interviewed, 150 person-times exposure were found during January 1, 2009 to October of 2010. The total exposure rate in the observed villagers was 4.24%, the years average exposure rate was 2.32%. Among the observed villagers, the exposure rate was highest from 0 to 9 age group （7.59%） and lowest in 20 to 29 age group （1.74%）. The lower limb and below the knees were the most injured areas of body （40.67%）. Only 16.67% animals which causing injures had received vaccination. Among the exposed persons, 72.00% received treatment from medical institutions or clinics, 69.33% were immunized, and 8.43% received antiserum or immunoglobulin of rabies. Logistic regression analysis showed that： the score of rabies prevention knowledge, whether or not to take part in the new rural cooperative medi- cal treatment and wound depth had a remarkable influence on the rate of rabies vaccination. [Conclusion] The post exposure preventive disposal to rabies should be standardized, and the disposal expenses should be add to the new rural cooperative medical treatment project to submit an expense account, the comprehensive prevention measures should be adapted to control the incidence of rabies effectively.

关 键 词：狂犬病 暴露 疫苗接种 影响因素 

分 类 号：R512.99[医药卫生—内科学]