Ꮧ
剕⇣㦠⮙ᰃҎ⬰݅ᙷ⮙ˈҎᕔᕔ䗮䖛Ⳉ䯈㾺ফᛳᶧⱘࡼ⠽ঞ݊ࠊકᛳᶧDŽ Ꮧ剕⇣㦠⮙Ϫ⬠Ϟ䆌ഄऎ䛑ᰃϔ⾡क ߚ䞡㽕ⱘҎ㉏⮒⮙ˈ⡍߿ᰃ⌆ⱘЈഄЁ⍋ᆊǃ࣫
䴲ǃϰ䴲ǃЁϰǃफѮǃЁѮǃЁ㕢⌆फ㕢⌆[1]DŽ Ꮧ剕⇣㦠⮙ᰃ⬅Ꮧ剕⇣㦠ሲⱘ㒚㦠ᇐ㟈DŽҎ㉏ 䗮䖛⸈ᤳⲂ㙸Ⳉ㾺㒘㒛ǃ㸔⎆ǃሓ⎆ǃ䰈䘧ߚ⊠
⠽ǃ⅏㚢㚢Ⲭৢᛳᶧ[2]DŽᏗ剕⇣㦠⮙᳔ᐌ㾕ⱘЈᑞ 㸼⦄ᰃথ⛁ǃᆦ乸ǃУǃܼ䑿⮐⮯ǃ݇㡖⮯ǃ㚠
⮯ǃ༈⮯ǃॠ亳ǃᆍᯧ⮆ࢇҹঞ㰮ᔅ[3]DŽ
㩭 স ⱘ Ҏ ᛳ ᶧ Ꮧ 剕 ⇣ 㦠 ⮙ থ ⮙ ⥛ ሙ ܼ ⧗ Ѡ ԡˈ25Ͼথ⮙⥛᳔催ⱘᆊЁ䖬ࣙᣀࠡ㢣㘨ⱘϾ݅
DŽḍ㩭সᆊ㒳䅵ሔⱘ᭄ˈᏗ剕⇣㦠⮙ਞথ
⮙⥛1990ᑈ–2000ᑈ䯈ᖿ䗳ϞछDŽ䖭ৃ㛑⬅Ѣ㩭স
䖭ϔᯊᳳ⬅⼒ӮЏН㒣⌢㞾⬅Ꮦഎ㒣⌢䕀ൟˈϡ ݡᇍ⬰⠻Ϯ䞛পϹḐⱘㅵ⧚[4]DŽ䖭ϔᯊᳳि⫳ᴎᵘথ
⫳ᬍবՓᏗ剕⇣㦠⮙᮴⊩ᕫࠄᮽᳳ䆞ᮁˈ㛑ᇍҎ
ࡼ⠽⭿ᚙⱘব࣪䞛পᑆ乘ᮑ[5]DŽ㩭সᏗ剕⇣㦠⮙ᕅ ડ㋴ࣙᣀӴ㒳ⱘ佂亳дᛃǃᷛޚि⫳ᮑǃ໘⧚⠯
ཊঞཊࠊકⱘᮍ⊩ҹঞ⡆⬰㕸ⱘᖿ䗳⿏ࡼ[3]DŽ
2011
ᑈᓔሩњܼᏗ剕⇣㦠⮙㸔⏙ᄺ䇗ᶹˈ݅Ң
21
Ͼⳕӑ337
Ͼऎⱘ11 528
Ͼ␌⠻⚍⬅2
Ͼ㟇4
Ͼ㩭সݰᴥҎ㕸Ꮧ剕⇣㦠⮙㸔⏙⌕㸠⮙ᄺ䇗ᶹ
Selenge Tsend
a, Zolzaya Baljinnyam
b, Bujinlkham Suuri
a, Enkhbayar Dashbal
a, Baatarkhuu Oidov
c, Felix Roth
d, Jakob Zinstag
d, Esther Schelling
dDavaalkham Dambadarjaa
c䗮䆃㗙˖Selenge Tsend (e-mail: tsendselenge2000@yahoo.com)DŽ
ҹϞⱘ⠻Ҏᆊᒁ݅ৠՓ⫼ৠϔ⠛㤝എ∈⑤ᵘ៤ˈ䞛 䲚њ168 027া⡆⬰ⱘᷛᴀ[6]DŽ᠔᳝21Ͼⳕǃ57.3%
ⱘऎҹঞ8%ⱘ␌⠻⚍Ẕߎњ㸔⏙Ꮧ剕⇣㦠䰇ᗻⱘ⡆
⬰ˈ⡆⬰ક⾡ࣙᣀ做偐ǃ⠯ǃ㓉㕞ቅ㕞DŽ݊Ё做偐 㸔⏙⌕㸠⥛Ў0.7%ǃ⠯Ў1.8%ǃ㓉㕞Ў0.7%ǃቅ㕞 Ў0.5%DŽ䞛⫼ⱘᮍ⊩ࣙᣀᑇ㸠ᓔሩ⥿⩄㑶⌟䆩Rose
Bengal TestsˈRBTǃ㸹ԧ㒧ড়䆩偠ҹঞ䝊㘨ܡ⭿䰘
䆩偠ELISA[6]DŽᴀ ⷨ お ᮼ Ԅ 䅵 㩭 স ݰ ᴥ Ҏ 㕸 Ё ⱘ Ꮧ 剕 ⇣ 㦠 㸔⏙⌕㸠⥛ঞᇐ㟈Ꮧ剕⇣㦠⮙㸔⏙ᄺ䰇ᗻⱘॅ䰽
㋴DŽ
ᮍ⊩
ⷨお䆒䅵ⳂᷛҎ㕸
ᴀ ⷨ お 䞛 প ῾ ᮁ 䴶 䇗 ᶹ ˈ ݅ 㒇 ܹ
8
Ͼ ⳕ ӑ DŽ2010ᑈ6᳜㟇9᳜ˈ佪ܜSukhbaatarⳕঞZavkhanⳕ
ᓔሩ䇗ᶹ[7]˗2011ᑈ11᳜㟇2012ᑈ1᳜ˈ䖯ϔℹArkhangaiǃKhuvsgulǃSelengeǃUvsǃUmnugoviҹঞ
Govi-Altaiㄝ6ϾⳕӑᓔሩⳌৠⱘ䇗ᶹ1DŽ䞛⫼Excel
䕃ӊҢ↣Ͼⳕӑ䱣ᴎᢑপ4ϾऎˈѢḋᴀ䞣䳔∖ݡ Ң↣Ͼऎ䱣ᴎᢑপ20Ͼ␌⠻⚍ˈ↣Ͼ␌⠻⚍䱣ᴎᢑপ4–5ҎDŽ
ދ䫒䖤䕧㟇ⳕ㑻ᅲ偠ᅸټᄬˈ᳔ৢ㒳ϔ䗕ᕔԡѢР݄
ᏈᠬⱘᆊӴᶧ⮙Ёᖗⱘᅲ偠ᅸ䖯㸠Ẕ⌟DŽ 㸔⏙ᄺẔ⌟
Փ⫼RBT⊩Ẕ⌟⌕ѻᏗ剕⇣㦠Brucella abortus㕞 Ꮧ剕⇣㦠Brucella melitensisᡫԧˈ䆩ࠖᴹ㞾ॄᑺ
Tulip Diagnostic݀ৌDŽ䰇ᗻ㸔⏙㒣1/2㟇1/32⿔䞞ৢ⫼
RBT⊩䖯㸠⌟
[9]ˈᑊ⫼䝊㘨ܡ⭿䰘䆩偠䖯㸠Ꮧ剕⇣㦠IgGᅮ䞣Ẕ⌟ˈ䆩ࠖᴹ㞾Nova Tec Immundiagnostica
GmbHᖋDietzenbach–63128݀ৌˈḍ䆩ࠖ⫳ѻ
ଚⱘ䇈ᯢк䖯㸠ELISAẔ⌟DŽ᭄ᔩܹঞ㒳䅵ߚᵤ
䞛⫼
Access 2007
䕃ӊ䖯㸠ঠᔩܹˈՓ⫼Epi Info™ 3.5
䕃ӊ䅶ℷᔩܹЁⱘ䫭䇃ˈՓ⫼STATA 10.1
䕃ӊ䖯㸠᭄ߚᵤDŽ㒣
ELISA
⊩RBT
⊩Ẕ⌟䰇ᗻⱘⷨおᇍ䈵㹿㒳 䅵ЎᏗ剕⇣㦠䰇ᗻDŽ䞛⫼
Pearson
[2]Fisher’s㊒⹂Ẕ偠⹂ᅮॅ䰽
㋴བҎষᄺ⡍ᕕǃ㸠ЎⳌ݇ॅ䰽㋴ҹঞਞⱘЈ ᑞ⮛⢊ҎᏗ剕⇣㦠㸔⏙䰇ᗻ䯈ⱘ݇㘨DŽՓ⫼ऩব 䞣Logisticಲᔦˈᑨব䞣ЎѠߚ㉏㸔⏙ᄺẔ⌟㒧ᵰˈ 䞛 ⫼
xtgeeੑ Ҹ ˈ ᑊ ᷵ ℷ њ ␌ ⠻ ⚍ ⱘ 䱣 ᴎ ᬜ ᑨ DŽ
ব䞣Logisticಲᔦ᷵ℷ␌⠻⚍ⱘ䱣ᴎᬜᑨՓ⫼ৢ䗔 䞛⫼᭛⤂䆄ᔩⱘᭈ㕸ᢑḋḋᴀ䞣䅵ㅫᮍ⊩[7]ˈ؛䆒㩭সݰᴥҎ㕸Ꮧ剕⇣㦠㸔⏙⌕㸠⥛Ў20%[8]DŽ
ˈᢑপⱘ㕸᭄↣Ͼ㕸ᢑপⱘҎ᭄ḍᔧഄⱘ乘ㅫ
ᅲ䰙ᚙމ䖯㸠њ᳔Ӭ䇗ᭈDŽ
ᴀⷨお䗮䖛㩭সए⾥ᄺएᄺӺ⧚ྨਬӮҹঞ⨲
ᏈาᇨӺ⧚ྨਬӮⱘᅵᡍDŽਞⶹ᠔᳝ⷨおᇍ䈵ᴀⷨ
お䆺ᚙҹঞ⮒⮙䆞ᮁǃਞ⊏⭫ⱘⳌֵ݇ᙃˈᑊㅒ 㕆њⶹᚙৠᛣкDŽᑈ啘ᇣѢ
16
ቕⱘⷨおᇍ䈵ⱘⶹᚙৠ ᛣк⬅݊⠊↡ㅒ㕆DŽ᭄ᬊ䲚 䇗ᶹ䯂ो
䆓䇜ⷨおᇍ䈵ˈ฿ݭ㒳ϔⱘ䯂ोˈ䯂ोݙᆍࣙᣀҎষ ᄺֵᙃǃॅ䰽㋴ҹঞᏗ剕⇣㦠⮙Јᑞ⮛⢊DŽᴀ䯂ो
Ѣ
2010
ᑈSukhbaatar
ǃZavkhan
ϸⳕ[7]ᓔሩњ乘䇗 ᶹˈℸৢⳕⱘ䇗ᶹЁՓ⫼њᬍ䖯⠜ᴀⱘ䯂ोˈᮄ⠜ᴀ䯂ोЁⱘ䯂乬ᯧ⧚㾷ᑊߴ䰸њϔѯ䖛ߚᬣᛳⱘ䯂 乬DŽ
㸔ᷛᴀ䞛䲚໘⧚
䞛⫼5ml Vacutainer®䆩ㅵ䞛䲚䴭㛝㸔DŽ㸔ᷛᴀ㒣䖛↣
ߚ䩳3000䕀⾏ᖗ5ߚ䩳DŽߚ⾏ᕫࠄⱘ1.5ml㸔⏙ᷛᴀ㒣
700 0 700 1400 㣅䞠
Bayan-Uigil ⳕ Uvs ⳕ
Khovd ⳕ
Govi-Aitai ⳕ Zavkhan ⳕ
Khuvsgul ⳕ
Arkhangal ⳕ
Selenge ⳕ
Sukhbaatarⳕ
Umnugovi ⳕ Bayankhongor ⳕ
Uvurkhangai ⳕ
Dundgovi ⳕ
Dornogovi ⳕ Tuv ⳕ
KhenƟ i ⳕ
Dornod ⳕ Darkhan-Uul ⳕ
Govisumber ⳕ Bulgan ⳕ
Orkhon ⳕ
Ulaanbaatar ⳕ
㒇ܹⱘⳕӑ
㒇ܹⱘⳕӑ
㩭সᓔሩⷨおᎹⱘⳕӑߚᏗ⼎ᛣ
ܡ䋷ໄᯢ˖Ёഄඳߦߚঞᷛ䆚ϡҷ㸼WHOᇍӏԩᆊǃഄऎǃජᏖǃ乚ഄ䖍⬠ԡ㕂ⱘᗕᑺDŽⱑ㒓ҷ㸼
㟈䖍๗ˈৃ㛑ᄬϔᅮѝ䆂DŽ
20
ৡݑए0.7%
ǃ18
ৡӕϮᆊ0.6%
ǃ16
ৡ᮴Ϯ㗙0.6%
ǃ13
ৡ6
ቕҹϟܓス0.5%
ҹঞ184
ৡ݊Ҫሙ⇥
6.4%
DŽ㸔⏙⌕㸠⥛
ⷨ お ᇍ 䈵 ⱘ Ꮧ 剕 ⇣ 㦠 㸔 ⏙ ⌕ 㸠 ⥛ Ў
11.1% 95%
CI:10.0%–12.1% ˈ 8ⳕ ⌕ 㸠 ⥛ 2.3%㟇 22.6%
П 䯈 㸼
1 ˈ 28Ͼ ऎ ⱘ ⌕ 㸠 ⥛ 㟇 43.8%П
䯈DŽ39.2%95% CI: 38.2%–41.0%ⱘ␌⠻⚍㟇ᇥ᳝1㟇4ৡ㸔⏙䰇ᗻ㗙㸼2DŽ䅵ㅫᕫࠄᑈ㸔⏙䕀࣪⥛Ў 1145/10ϛˈᑈথ⮙⥛Ў229/10ϛDŽ
ཇᗻⱘ㸔⏙⌕㸠⥛
11.2%
催Ѣ⬋ᗻ10.9%
p = 0.029
DŽቕঞҹϞᑈ啘㒘㸔⏙⌕㸠⥛᳔催ˈ Ў15.5% 95% CI: 13.9%–17.0%
˗4–10
ቕᑈ啘㒘᳔ԢˈЎ
2.6% 95% CI: 1.5%–20.4%
DŽϾ㘠ϮҎ㕸 ⱘ㸔⏙䰇ᗻ⥛2.8%
㟇30.0%
П䯈㸼3
DŽ⊩ㄯ䗝ব䞣ˈㄯ䗝ᷛޚЎ
P = 0.10
ˈㄯ䗝ॳ⧚ѢԐ✊↨⊩DŽऩব䞣ߚᵤЁ
p
ؐᇣѢ0.05
ⱘব䞣㒇ܹব䞣ൟDŽ
⫼ 㸔 ⏙ ⌕ 㸠 ⥛ 䰸 ҹ 㸔 ⏙ 䰇 ᗻ ᣕ 㓁 ਼ ᳳ ؛ 䆒 Ў
10.9
ᑈ[10]ˈҹ⹂ᅮᏗ剕⇣㦠ᲈ䴆ᇐ㟈ᘏҎ㕸ⱘᑈ㸔⏙䕀࣪⥛DŽҹ㸔⏙䕀࣪ⱘ
20%
ҷ㸼ⳳᅲЈᑞ⮙՟䖯㸠ֱᅜԄ䅵ᅲ䰙Ϟফ䆓䇜ᯊˈ᠔᳝㸔⏙䰇ᗻⷨおᇍ 䈵Ёˈ
58.5%
㟇ᇥߎ⦄ϸ⾡Јᑞ⮛⢊ˈ31.5%
㟇ᇥߎ⦄ϝ⾡Јᑞ⮛⢊ˈՓ⫼䆹↨՟Ьҹ
0.3
ˈᑊ䕀ᤶЎᘏ Ҏষⱘ10
ϛߚ⥛DŽ㒧ᵰ
݅ᢑপњ
8
Ͼⳕ31
Ͼऎ609
Ͼ␌⠻⚍ⱘ2856
ৡⷨおᇍ 䈵ˈᑈ啘4
ቕ–90
ቕЁԡᑈ啘Ў38
ቕˈࣙᣀ2260
ৡ⠻ ⇥
79.1%
ǃ142
ৡ ᄺ ⫳5.0%
ǃ96
ৡ ᭛ ਬ3.4%
ǃ70
ৡᎹҎ2.5%
ǃ7
ৡ䗔ӥ㗙1.3%
ǃ㸼1. 2010–2012ᑈ㩭সᏗ剕⇣㦠㸔⏙ᄺ䇗ᶹ䰇ᗻⷨおⳕӑߚᏗ
ⳕӑ 䇗ᶹऎ᭄ ⷨおᇍ䈵᭄ 㸔⏙䰇ᗻҎ᭄ 䰇ᗻ⥛*˄%˅ 95%ৃֵऎ䯈
˄%˅
Khuvsugul 4 400 46 11.5 8.72–14.2
Umnugovi 4 400 49 12.3 9.64–14.9
Govi-Altai 4 398 30 7.5 4.17–10.8
Selenge 4 391 60 15.3 12.9–17.6
Arkhangai 4 400 9 2.3 0.45–9.15
Uvs 3 293 17 5.8 1.27–10.3
Sukhbaatar 4 318 72 22.6 20.5–24.6
Zavkhan 4 256 33 12.9 9.7–16.1
ড়䅵 31 2856 316 11.1 10.0–12.1
* Ѣᑇ㸠ᓔሩⱘRBTঞELISAᅲ偠㒧ᵰDŽ
㸼
2. 2010–2012
ᑈ㩭সᏗ剕⇣㦠㸔⏙ᄺ䇗ᶹ䰇ᗻⷨおᇍ䈵᠔␌⠻⚍ⱘⳕӑߚᏗⳕӑ 䇗ᶹ␌⠻⚍᭄ 䰇ᗻⷨおᇍ䈵᠔␌
⠻⚍᭄ 䰇ᗻ⥛˄˅ ৃֵऎ䯈˄˅
Arkhangai 79 7 8.9 1.89–15.9
Govi-Altai 80 28 35.0 32.0–37.9
Khuvsgul 82 35 42.7 40.2–45.1
Umnugovi 80 33 41.3 38.1–44.5
Uvs 58 13 22.4 17.5–27.2
Selenge 78 40 51.3 49.1–53.4
Sukhbaatar 83 56 67.5 65.9–69.0
ҎᛳᶧᏗ剕⇣㦠⮙ঞЈᑞ⮛⢊
ⷨおᇍ䈵Ёˈ
2.7% n = 76
Ҏ᳒ফ䖛Ꮧ剕⇣㦠⮙⊏⭫˗䎱Ϟ⊏⭫ⱘЁԡᯊ䯈Ў
14
ᑈQ1 = 3.3
ᑈˈQ3 = 20
ᑈDŽ䰸এⵒЌ⮐⮯ˈ݊Ҫ⮛⢊Ͼᑈ啘㒘ߚᏗ᳝ᰒ㨫Ꮒᓖ˗
20–44
ቕᑈ啘㒘ҹঞ45
ቕঞҹϞᑈ 啘㒘ਞߎ⦄⾡Јᑞ⮛⢊DŽཇᗻ䕗⬋ᗻᐌߎ⦄༈⮯ǃ݇㡖⮯ǃ㚠⮯ǃ㙠㙝⮯ˈҹঞ㰮ᔅⴵ䱰
ㄝ⮛⢊㸼4DŽ
ᇍਞߎ⦄Ꮧ剕⇣㦠⮙ⱘⷨおᇍ䈵Ϣ㸔⏙䰇ᗻ
ⷨおᇍ䈵䖯㸠↨䕗ৢথ⦄ˈ316ৡ㸔⏙䰇ᗻⷨおᇍ 䈵Ё᳝165ৡ52.2%ߎ⦄Јᑞ⮛⢊ˈ2540ৡ㸔⏙
䰈ᗻⱘⷨおᇍ䈵㗙Ё᳝1186ৡ46.7%ߎ⦄Јᑞ⮛
ᛳᶧᏗ剕⇣㦠ⱘॅ䰽㋴ߚᵤ
ऩ㋴ߚᵤᰒ⼎ˈ㸔⏙Ꮧ剕⇣㦠䰇ᗻⱘॅ䰽㋴ࣙᣀ ᑈ啘
≥45
ቕ↨ؐ↨[OR] = 6.6
ˈP = 0.046
ǃ㘠ϮЎ ݑएOR = 3.5
ˈP = 0.016
ǃ㾺ࡼ⠽⅏㚢㚢ⲬOR = 1.35
ˈP = 0.016
ҹঞ亳⫼ᅠܼ❂❳ⱘ㙱㛣OR = 1.51
ˈP=0.001
㸼3DŽ ব 䞣 ߚ ᵤ ᰒ ⼎ ˈ ҙ ᳝ ϸ Ͼ ব 䞣 Ϣ 㸔 ⏙ 䰇 ᗻⳌ݇˖ᑈ啘≥45ቕ䇗ᭈৢⱘ↨ؐ↨[AOR] = 6.9ˈ
95%CI: 5.1–8.7ҹঞ㘠ϮЎݑएAOR = 2.8ˈ95%
CI:1.5–5.0DŽখࡴ䇗ᶹⱘݑएЁˈ72.7%খϢ⡆⬰ߚ
ࡽѻᎹˈ50%᳒Ⳉ㾺ࡼ⠽⅏㚢ঞ㚢ⲬDŽݑए ᛳᶧᏗ剕⇣㦠ⱘॅ䰽ᰒ㨫催Ѣ݊Ҫ㘠ϮP < 0.001DŽ
㸼
3. 2010–2012
ᑈ㩭সᏗ剕⇣㦠⮙㸔⏙䰇ᗻॅ䰽㋴ऩব䞣ߚᵤ㒧ᵰ⡍ᕕ ⷨおᇍ䈵᭄ 㸔⏙䰇ᗻҎ᭄ OR (95% CI) Pؐ
ᑈ啘㒘ቕ
4–9ቕ 39 1 (2.6) 1.0 –
10–14ቕ 69 4 (5.8) 2.3 (1.2–4.1) 0.440
15–19ቕ 96 3 (3.1) 1.2 (0.6–2.7) 0.864
20–44ቕ 1769 171 (9.7) 3.9 (1.2–7.6) 0.151
45ቕঞҹϞ 883 137 (15.5) 6.6 (4.5–10.2) 0.046
ᗻ߿
⬋ 1181 132 (11.2) 1.0 –
ཇ 1675 184 (10.9) 1.0 (0.9–1.2) 0.968
㘠Ϯ
⠻⇥ 2260 263 (11.6) 1.3 (0.9–2.5) 0.087
ᄺ⫳ 142 4 (3.0) 0.9 (0.3–2.5) 0.345
᭛ਬ 96 7 (7.3) 0.7 (0.2–1.6) 0.267
ᎹҎ 70 7 (10.0) 0.9 (0.5–2.0) 0.733
䗔ӥҎਬ 37 7 (18.9) 2.0 (0.8–4.2) 0.112
ݑए 20 6 (30.0) 3.5 (1.6–7.9) 0.016
ӕϮᆊ 18 4 (22.2) 2.3 (1.0–4.6) 0.119
᮴Ϯ㗙 16 1 (6.3) 0.5 (0.3–1.3) 0.521
6ቕҹϟܓス 13 1 (7.7) 0.7 (0.3–1.6) 0.708
݊Ҫ 184 16 (8.7) 0.8 (0.4–1.7) 0.328
ॅ䰽㋴
খϢࡼ⠽⫳ 778 93 (11.9) 1.5 (0.9–2.5) 0.121
㾺ࡼ⠽⅏㚢ঞ㚢Ⲭ 769 104 (13.5) 1.4 (1.0–2.1) 0.016 亳⫼⫳⠯ཊ 295 32 (10.8) 1.2 (0.7–1.8) 0.546 亳⫼⫳㙱㛣 38 11 (28.9) 0.8 (0.5–1.2) 0.612 亳⫼❂❳ⱘ㙱㛣 1067 146 (13.7) 1.5 (0.9–4.3) 0.001 亳⫼ࡼ⠽ᮄ剰㸔⎆ 143 12 (8.4) 1.5 (1.0–1.7) 0.332
ORˈ↨ؐ↨˗CIˈৃֵऎ䯈DŽ
* Ѣᑇ㸠ᓔሩⱘRBTঞELISAᅲ偠㒧ᵰDŽ
ᴀⷨおৃЎᓔሩܼ⡆⬰ܡ⭿乍ⳂᦤկݰᴥҎ㕸 Ꮧ剕⇣㦠㸔⏙⌕㸠⥛㒓᭄˗гৃЎᣕ㓁ⱘᏗ剕⇣
㦠⮙ⲥ⌟ᦤկখ㗗DŽҎᏗ剕⇣㦠থ⮙⥛ϟ䰡ҹঞҎ 㕸Ё䞡ᓔሩ㸔⏙ᄺ䇗ᶹৃҹ䯈䆘Ӌ⡆⬰Ёᓔሩ
⭿㢫ܡ⭿乍Ⳃⱘᬜᵰ[23]DŽ
ᴀ ⷨ お ᄬ ϔ ѯ ϡ 䎇 DŽ 佪 ܜ ˈ 䰸
Zavkhan
ঞSukhbaatar
ϸⳕ[7]ˈ݊ԭⳕ㛑䖯㸠Ҏ⡆⬰㸔⏙ᄺ䰇ᗻ⥛݇㘨䆘ԄDŽ݊ˈܓスᏗ剕⇣㦠⮙ॅ䰽㋴
ৃ㛑ᄬᯊ䯈ব࣪ˈℸՓ⫼῾ᮁ䴶ⷨおৃ㛑䲒ҹ㦋 ᕫ݊㸔⏙䰇ᗻ⥛⮙ॳᲈ䴆ϢᏗ剕⇣㦠⮙Јᑞ⮛⢊П 䯈ⱘ݇㋏DŽ
㒧䆎
ᴀⷨおথ⦄ˈ㩭সݰᴥҎ㕸Ꮧ剕⇣㦠⮙㸔⏙⌕㸠⥛
催 ˈ Ԅ ㅫ থ ⮙ ⥛ ᯢ ᰒ 催 Ѣ ਞ থ ⮙ ⥛ DŽ ℷ བ 㘨 ড়
㊂ݰ㒘㒛ǃϪ⬠ࡼ⠽ि⫳㒘㒛ҹঞϪ⬠ि⫳㒘㒛᠔ ᓎ䆂ⱘˈᑨ䆹㩭স⿏ࡼ⠻㕸Ёᓔሩ㾘⡆⬰ܡ
⭿DŽ
䙓ܡᛳᶧᏗ剕⇣㦠⮙ⱘᅝܼᮑࣙᣀ˖こ᠈䰆ᡸ
᳡㺙Խ᠈༫ˈՓ⫼䞥ሲ䩽ᄤᬊ䲚ࡼ⠽⅏㚢ঞ㚢Ⲭ ᑊඟ☿࣪ˈϢ⡆⬰㾺ৢ⋫ˈᇣൟডߡ㉏ࡼ⠽
ⱘ㙱㛣ᑨᅠܼ❂❳DŽᑨሑৃ㛑ᇚ䖭ѯֵᙃࣙᣀعᒋ ᅷӴᴤ᭭Ёˈҹሑৃ㛑乘䰆ᮄ⮙՟ⱘߎ⦄ˈ⡍߿ᰃ
ᓔሩ㾘ܡ⭿乍ⳂПࠡˈЎ䙷ᯊ⮙㦠ҡᕾ⦃DŽ ៥ӀᏆࠊЏ㽕䩜ᇍܓスⱘк䴶⠛ᅷӴᴤ᭭DŽ
⢊DŽ
36.7%
ⱘ㸔⏙䰇ᗻⷨおᇍ䈵ਞ3
⾡ҹϞⱘЈᑞ⮛⢊˗
23.1%
ⱘ㸔⏙䰈ᗻⷨおᇍ䈵ਞ3
⾡ҹϞⱘЈᑞ⮛⢊
P < 0.001
DŽ༈⮯ǃ݇㡖⮯ǃ㚠⮯ǃ㙠㙝⮯ǃ ⲫ∫ঞⴵ䱰ㄝ⮛⢊Ϣ㸔⏙Ꮧ剕⇣㦠䰇ᗻᰒ㨫Ⳍ݇㸼
5
DŽ䅼䆎
ᴀⷨおথ⦄ˈݰᴥҎ㕸Ꮧ剕⇣㦠㸔⏙⌕㸠⥛Ў
11.1%
ⳕⱘ⌕㸠⥛
2.3%
㟇22.6%
П䯈ˈᑈথ⮙⥛Ў229/10
ϛDŽ催থ⮙⥛ৃ㛑ডњ㩭স⬅⼒ӮЏН㒣⌢Ꮦഎ㒣⌢䕀ൟ䰊↉⡆⬰⾕᳝࣪ҹঞ䲚ԧᬒ⠻ᔶᓣⱘ
⍜༅[4]᠔ᇐ㟈ⱘҎᛳᶧᏗ剕⇣㦠⮙থ⮙⥛ϞछDŽ Ꮖ᳝ⷨおᇍ㩭স催ॅҎ㕸བ⠻⇥ǃݑएǃࡼ⠽ࠊ ક⫳ѻ㗙䖯㸠њ㸔⏙Ꮧ剕⇣㦠⌕㸠⥛ⱘԄ䅵[11–14]ˈ ԚϢᴀⷨおᓔሩⱘᯊ䯈ҹঞⷨお䆒䅵ᮍ⊩ㄝᮍ䴶
᳝䇌ϡৠˈ㗠᮴⊩䖯㸠↨䕗DŽᴀⷨお䇗ᶹᕫࠄⱘ 㸔⏙⌕㸠⥛↨݊Ҫᆊ催ॅҎ㕸䇗ᶹ[10,15–21]ᕫࠄⱘ
0.1%㟇10.1%㒧ᵰЎ催ˈ⬅Ѣ㩭সᰃሙܼ⧗Ꮧ剕⇣
㦠⮙থ⮙⥛Ѡԡⱘᆊ[5]ˈᬙᕫࠄ䖭ϔ㒧ᵰᑊϡᛣ
DŽሑㅵ៥ӀᏆ㒣ᣝ✻ҙ᳝20%ⱘ㸔⏙䰇ᗻ㗙ЎᏗ剕
⇣㦠⮙Јᑞ⮙՟䖯㸠ֱᅜԄ䅵ˈԚᴀⷨお䅵ㅫᕫࠄⱘ থ⮙⥛ҡ䖰催Ѣਞথ⮙⥛[22]DŽ
ḍব䞣ߚᵤ㒧ᵰˈᑈ啘≥45ቕݑएᛳᶧᏗ 剕⇣㦠ⱘ亢䰽催DŽ45ቕঞҹϞᑈ啘㒘Ҏ㕸ᰃҢџᬒ
⠻Ў⡆⬰⫳ⱘЏ㽕Ҏ㕸ˈݑए䖯㸠ݑ㉏Ẕᶹᯊ
㸼
4. 2010–2012
ᑈ㩭সᏗ剕⇣㦠㸔⏙ᄺ䇗ᶹ᳝Јᑞ⮛⢊㗙ⱘᑈ啘ᗻ߿ߚᏗ˄N = 2856
Ҏ˅⮛⢊ Ҏ᭄
ᑈ啘㒘˄ቕ˅ ᗻ߿
0–9 10–14 15–19 20–44 ı45 Pؐ*
Pؐ* ⬋ ཇ
% % % % % % %
থ⛁ 135 0.7 1.6 0.7 52.6 44.4 0.009 3.8 5.4 0.053
༈⮯ 1268 0.3 0.7 2.0 57.9 39.1 < 0.001 34.3 51.8 < 0.001
݇㡖⮯ 1287 0.4 0.5 1.5 50.7 46.9 < 0.001 38.7 49.5 < 0.001
㚠⮯ 1351 0.1 0.4 1.4 57.6 40.5 < 0.001 43.6 49.8 0.001
㙠㙝⮯ 590 0.5 1.0 1.0 46.4 51.1 < 0.001 14.9 24.7 < 0.001
㰮ᔅ 964 0.3 0.3 0.4 50.7 48.3 < 0.001 26.9 38.6 < 0.001
ⲫ∫ 336 0.9 0.6 0.6 45.8 52.1 < 0.001 11.4 12.0 0.812
ⴵ䱰 530 0.2 – 0.4 42.3 57.1 < 0.001 14.5 21.4 < 0.001
ԧ䞡ޣ䕏 233 1.3 1.3 1.3 40.7 55.4 < 0.001 7.2 8.8 0.115
⌕ѻ 31 – – – 90.3 9.7 0.015 – 100.0 < 0.001
ⵒЌ⮯ 10 – – – 50.0 50.0 0.749 100.0 – < 0.001
* 䞛পχẔ偠Fisher’s㊒⹂Ẕ偠DŽ
খ㗗᭛⤂
1. Corbel MJ. Brucellosis in Humans and Animals. Geneva, Food and Agriculture Organization of the United Nations, World Organization of Animal Health, World Health Organization, 2006.
2. Dean AS et al. Clinical manifestation of Human brucellosis:
A systematic review and meta-analysis. PLoS Neglected Tropical Diseases, 2012, 6(12):e1929. doi:10.1371/journal.
pntd.0001929 pmcid:3516581
3. Madkour MM. Madkour’s brucellosis. 2nd edition. New York, Springer-Verlag, 2001,1–32.
4. Roth F et al. Human health benefits from livestock vaccination for brucellosis: case study. Bulletin of the World Health Organization, 2003, 81:867–876. pmid:14997239
5. Pappas G et al. The new global map of human brucellosis. Lancet Infectious Diseases, 2006, 6:91–99. doi:10.1016/S1473- 3099(06)70382-6 pmid:16439329
6. Nansalmaa M et al. Result of seroprevalence study on brucellosis and other infectious diseases. Ulaanbaatar, Report of State Central Veterinary and Hygiene Laboratory, 2012, 46–57.
7. Zolzaya B et al. Representative seroprevalences of human and livestock brucellosis in two Mongolian provinces.
EcoHealth, 2014, 11:356–371. doi:10.1007/s10393-014- 0962-7 pmid:25012215
8. Annual report of communicable diseases. Ulaanbaatar, National Center for Communicable Diseases, 2009, 17–18.
9. Díaz R et al. The Rose Bengal Test in human brucellosis: a neglected test for the diagnosis of a neglected disease. PLoS Neglected Tropical Diseases, 2011, 5:e950. doi:10.1371/
journal.pntd.0000950 pmid:21526218
߽Ⲟކさ
⬇DŽ
䞥
2010
ᑈSukhbaatar
ঞZavkhan
ⳕᓔሩⱘ䇗ᶹ⬅⨲থሩড়㒘㒛䌘ࡽDŽ
2011–2012
ᑈⱘⷨお⬅㩭সि⫳䚼ǃ㩭সعᒋ֗䖯䞥Ӯҹঞݑएⷨお᠔䌘ࡽDŽ ৠᯊᛳ䇶Ϟ䗄ᴎᵘⱘҎਬᇍᴀⷨおᦤկⱘᐂࡽDŽ 㟈䇶
ᛳ 䇶
A r k h a n g a i
ǃK h u v s g u l
ǃS e l e n g e
ǃU v s
ǃUmnugoviǃGovi-AltaiǃZavkhanঞSukhbaatarܿⳕ
ⱘⳕ㑻ि⫳䚼䮼ঞ᠔䕪ऎ㑻ि⫳䚼䮼ǃЈᑞए⫳ঞ ᅲ偠ᅸҎਬणࡽᬊ䲚᭄DŽᓩ⫼ᴀ᭛ഄഔ˖
Tsend S et al. Seroprevalence survey of brucellosis among rural people in Mongolia. Western Pacific Surveillance and Response Journal, 2014, 5(4):13–
20. doi:10.5365/wpsar.2014.5.1.002
㸼5. 2010-2012ᑈ㩭সϡৠ㸔⏙⢊މⱘⷨおখϢ㗙Јᑞ㸼⦄ᚙމ
Јᑞ⮛⢊ খࡴҎ᭄ 䰇ᗻ᭄˄ˁ˅ Pؐ
থ⛁ ≵᳝ 2721 301 (11.1)
᳝ 135 15 (11.1) 0.561
༈⮯ ≵᳝ 1588 167 (10.5)
᳝ 1268 149 (11.8) < 0.001
݇㡖⮯ ≵᳝ 1569 155 (9.9)
᳝ 1287 161 (12.5) 0.014
㚠⮯ ≵᳝ 1505 151 (10.0)
᳝ 1351 165 (12.2) 0.038
㙠㙝⮯ ≵᳝ 2266 234 (10.3)
᳝ 590 82 (13.9) 0.009
㰮ᔅ ≵᳝ 2623 287 (10.9)
᳝ 233 29 (12.4) 0.379
ⲫ∫ ≵᳝ 1892 194 (10.3)
᳝ 964 122 (12.7) 0.058
ⴵ䱰 ≵᳝ 2520 266 (10.6)
᳝ 336 50 (14.9) 0.013
ԧ䞡ޣ䕏 ≵᳝ 2326 242 (10.4)
᳝ 530 74 (14.0) 0.010
⌕ѻ ≵᳝ 1644 182 (11.1)
᳝ 31 2 (6.4) 0.713
ⵒЌ⮯ ≵᳝ 1171 131 (11.2)
᳝ 10 1 (10.0) 0.620
(KAPs). BMC Public Health, 2011, 11:341. doi:10.1186/1471- 2458-11-341 pmid:21595871
18. Rahman AK et al. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh. Foodborne Pathogens and Disease, 2012, 9:190–197. doi:10.1089/
fpd.2011.1029 pmid:22300225
19. Ali S et al. Seroprevalence and risk factors associated with brucellosis as a professional hazard in Pakistan. Foodborne Pathogens and Disease, 2013, 10:500–505. doi:10.1089/
fpd.2012.1360 pmid:23560424
20. Dean AS et al. Epidemiology of brucellosis and Q Fever in linked human and animal populations in northern Togo. PLoS ONE, 2013, 8:e71501. doi:10.1371/journal.pone.0071501 pmid:23951177
21. Ron-Román J et al. Human brucellosis in northwest Ecuador:
typifying Brucella spp., seroprevalence, and associated risk factors. Vector Borne and Zoonotic Diseases, 2014, 14:124–
133. doi:10.1089/vbz.2012.1191 pmid:24410144
22. Ebright JR, Altantsetseg T, Oyungerel R. Emerging infectious diseases in Mongolia. Emerging Infectious Diseases, 2003, 9:1509–1515. doi:10.3201/eid0912.020520 pmid :14720388
23. Roth F et al. Guidebook for the control of brucellosis in the Mongolian nomadic husbandry system. Ulaanbaatar, Health Project of Swiss Development Agency in Mongolia, 2012, 27.
10. Bonfoh B et al. Representative seroprevalences of brucellosis in humans and livestock in Kyrgyzstan. EcoHealth, 2012, 9:132–
138. doi:10.1007/s10393-011-0722-x pmid:22143553 11. Dashdavaa J. Clinical and epidemiological situation of brucellosis
in Republic of Mongolia [dissertation]. Ulaanbaatar, 1969, 55–91.
12. Baldandorj TS. Epidemiology and prevention of brucellosis in Republic of Mongolia [dissertation]. Ulaanbaatar, 1972, 50–71.
13. Gombosuren T. Epidemiological situation of brucellosis in Republic of Mongolia [dissertation]. Ulaanbaatar, 1982, 48–
69.
14. Dagvadorj YA et al. Human brucellosis prevalence in Mongolia.
Journal of Mongolian Medicine, 2003, 1:21–22.
15. Omer MK et al. Prevalence of antibodies to Brucella spp. and risk factors related to high-risk occupational groups in Eritrea.
Epidemiology and Infection, 2002, 129:85–91. doi:10.1017/
S0950268802007215 pmid:12211600
16. Cetinkaya Z et al. Seroprevalence of human brucellosis in a rural area of Western Anatolia, Turkey. Journal of Health, Population, and Nutrition, 2005, 23:137–141. pmid:16117365
17. Holt HR et al. Brucella spp. infection in large ruminants an endemic area of Egypt: cross-sectional study investigating seroprevlance, risk factors and livestock owner’s knowledge. attitudes and practices
