湖南省农村居民狂犬病暴露处置现况调查  

Survey on rabies post-exposure treatment in rural residents of Hunan

作　　者：王世清[1] 张斯钰[1] 肖军叶[2] 杨浩[1] 曾舸[1] 胡世雄[1] 刘富强[1] 高立冬[1] 

机构地区：[1]湖南省疾病预防控制中心流行病防治科,湖南长沙410005 [2]中南大学公共卫生学院

出　　处：《中国媒介生物学及控制杂志》2011年第6期564-566,569,共4页Chinese Journal of Vector Biology and Control

基　　金：湖南省卫生厅资助课题(B2009-088)~~

摘　　要：目的了解农村居民狂犬病暴露处置现况,探讨狂犬病高发影响因素,为制定有针对性的干预措施提供依据。方法采用多阶段抽样方法,对4个县40个村的部分居民户进行人户调查,对调查结果进行描述性流行病学分析。结果农村居民户犬、猫饲养率为38.68%,均以放养为主,犬密度为8.97只/100人,其兽用狂犬病疫苗免疫率为31.87%;农村居民年平均暴露率为2.22%,以家养犬、猫,年龄<15岁,学生的暴露率较高,暴露特征以到有犬、猫居民家中串门、被犬伤下肢、Ⅲ级暴露为多;暴露后仅28.23%立即自行处理伤口,部分还采用自敷草药等错误的处理方式,暴露对象有3/4就医,人平均处置费用416.68元,就诊对象中有4.30%拒绝使用狂犬病疫苗,Ⅲ级暴露者中有93.55%未使用狂犬病被动免疫制剂。结论农村居民为狂犬病暴露的高危人群,暴露主要来源于家犬;居民对狂犬病缺乏科学认识、经济条件有限是导致狂犬病暴露后处置不合规范要求的主要原因。Objective To determine the current post- exposure treatment for rabies and analyze the risk factors for development of targeted intervention strategies. Methods Household survey based on multi- stage sampling method was adopted, and 40 villages from 4 counties was conducted followed by descriptive epidemiological analysis. Results A total of 38.68% households had cats or dogs at home with a dog density of 8.97/100 people. The coverage rate of rabies vaccine was 31.87%. The average annual exposure rate among the residents was 2.22%, and higher exposure rate was found in those having dogs or cats at home or aged less than 15 years old and students. Many exposures were related to visiting dog-keeping families. Injuries were mostly lower limb injury and grade m exposure. However, only 28.23% of the patients self-treated immediately after exposure, and some used herbs or other improper approaches. Three quarters of the patients visited a doctor after exposure with an average cost of 416.68 RMB, but 4.30% of them refused to inoculate rabies vaccine. Moreover, 93.55% of those with ]]I level exposure had not obtained passive immunization. Conclusion Rural residents were at high risk of rabies exposure, most of which were caused by house dogs. Inadequate knowledge and economic support were the key factors which contributed to improper post-exposure treatment.

关 键 词：狂犬病 农村居民 犬猫饲养率 暴露率 暴露处置 

分 类 号：R373.9[医药卫生—病原生物学]