2012年菲律宾甘马苏尔省纳布亚地区霍乱暴发的原因

ᲈথ䇗ᶹ᡹ਞ

WPSAR Vol 6, No 3, 2015 | doi: 10.5365/wpsar.2015.6.1.005

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1

a ⦄എ⌕㸠⮙ᄺ෍䆁乍Ⳃˈ⌕㸠⮙ᄺ໘ˈि⫳㕆ˈ೷ศܟ剕ݍऎˈ偀ሐᢝˈ㧆ᕟᆒDŽ

b ि⫳㕆ˈ೷ศܟ剕ݍऎˈ偀ሐᢝˈ㧆ᕟᆒDŽ

ᡩ〓᮹ᳳ˖2015ᑈ1᳜21᮹˗থ㸼᮹ᳳ˖2015ᑈ8᳜27᮹ doi: 10.5365/wpsar.2015.6.1.005

䳡

хᰃ⬅Ѣᨘܹফࠄ䳡хᓻ㦠∵ᶧⱘ∈៪亳

⠽㗠ᓩ䍋ⱘϔ⾡ᗹᗻ㚗㙴䘧ᛳᶧᗻ⮒⮙ˈ Јᑞ㸼⦄ЎϹ䞡∈ḋ֓ˈབ᳾ঞᯊ㒭ќ⊏

⭫ৃᓩ䍋㜅∈੠⅏ѵ^[1]DŽ䗮ᐌ䳡х⭿ᚙ᥻ࠊⱘ佪㽕᥾

ᮑЎ⹂ֱ᳝ܙ䎇ⱘᅝܼ∈կ㒭DŽ

㒇ᏗѮሲѢ㧆ᕟᆒ↨ܟᇨቯഄऎⱘ⫬偀㢣ᇨⳕˈ

᳝

42

ϾᴥˈҎষ᭄Ў

82 614

Ҏ^[2]ˈ᳝

2

ϾЏ㽕ⱘि⫳Ё ᖗDŽᔧഄⱘⲥ⌟᭄᥂ᰒ⼎ˈ䆹ഄऎ

2008–2012

ᑈᳳ䯈

᳾থ⫳䖛䳡хᲈথ⭿ᚙ^[3]DŽ

2012

ᑈ

5

᳜ˈ෎Ѣџӊⱘⲥ⌟㋏㒳᡹ਞ㒇ᏗѮഄ

ऎⱘ㝍⋏⮙՟᭄੠⅏ѵ᭄๲ࡴDŽЎᶹᯢᴀ⃵ᲈথⱘॅ

䰽಴㋴ˈᑊ᳈དഄњ㾷ᲈথⱘӴ᪁䗨ᕘˈ㧆ᕟᆒ⦄എ

⌕㸠⮙ᄺ෍䆁乍Ⳃ㘨ড়ᔧഄि⫳䚼䮼㒘៤䇗ᶹ䯳ӡࠡ

ᕔ⦄എᓔሩ䇗ᶹDŽ

ᮍ⊩

ᦣ䗄ᗻⷨお

䗮䖛ᶹ䯙

2

ᆊЏ㽕ⱘि⫳Ёᖗঞ㒇ᏗѮ਼䖍

2

ᆊए䰶 ⱘए⭫䆄ᔩֵᙃˈᓔሩᦣ䗄ᗻⷨおDŽ⭥Ԑ⮙՟ᅮНЎ

2012

ᑈ

3

᳜

16

᮹㟇

6

᳜

22

᮹ᳳ䯈ˈ⫬偀㢣ᇨⳕ㒇ᏗѮ

ᅝܼ佂⫼∈ⱘৃ㦋ᕫᗻ˖ 2012 ᑈ㧆ᕟᆒ⫬偀 㢣ᇨⳕ㒇ᏗѮഄऎ䳡хᲈথⱘॳ಴

Alethea De Guzman

^ab

ˈVikki Carr de los Reyes

^b

ˈMa Nemia Sucaldito

^b

੠Enrique Tayag

^b

䗮䆃԰㗙˖Alethea De Guzman (⬉ᄤ䚂ӊ: aletheardeguzman@gmail.com)DŽ

ഄऎعᒋሙ⇥Ёߎ⦄∈ḋ֓⃵᭄ı3⃵໽㗙ˈ⭥Ԑ⮙

՟㉾֓㒣㒚㦠෍ݏ䳡хᓻ㦠䰇ᗻ㗙Ў⹂䆞⮙՟DŽ

⮙՟ᇍ✻ⷨお

೼㕍ᙷ⥛᳔催ⱘᴥᑘᓔሩ

1 2

Ͼԧऍ䜡ⱘ⮙՟ᇍ✻ⷨ

おˈऍ䜡಴㋴Ўᑈ啘੠ᗻ߿DŽ㗗㰥ࠄᯊ䯈䰤ࠊˈᇚ䚼 ߚ⭥Ԑ⮙՟㒇ܹⷨおDŽᇍ✻䗝ᢽ㒇ᏗѮഄऎⱘعᒋ ሙ⇥ˈϨᅲ偠ᅸẔ⌟䳡хᓻ㦠䰈ᗻ㗙DŽ៥ӀՓ⫼Ⳃ ⱘᢑḋᮍ⊩೼⮙՟ϔ㾜㸼Ё䗝ᢽ⮙՟ˈ೼ܹ䗝ⱘ↣

ৡ⮙՟ⱘᆊᒁݙ៪˄੠˅䚏ሙᆊᒁݙ䗝ᢽ

2

ৡᇍ✻DŽ 䞛⫼㒳ϔⱘ䇗ᶹ㸼ᇍ⮙՟੠ᇍ✻ᓔሩ䴶ᇍ䴶䯂ो䇗 ᶹˈЏ㽕ݙᆍࣙᣀ∈⑤㉏ൟǃϾҎि⫳੠ि⫳䆒ᮑঞ

݊Ҫ⦃๗಴㋴DŽ䗮䖛⅏಴᥼ᮁᮍ⊩Ḍᅲ⅏ѵॳ಴^[4]DŽ 䞛⫼

Epi Info 3.5.4

㒳䅵䕃ӊ䖯㸠᭄᥂ᔩܹǃऩ಴㋴੠

໮಴㋴ߚᵤDŽ

᠔᳝⮙՟੠ᇍ✻೼䯂ो䇗ᶹ੠ᷛᴀ䞛䲚ᯊഛㅒ㕆 њⶹᚙৠᛣкDŽ

ᅲ偠ᅸẔ⌟

೼ᓔྟ䇗ᶹҹঞ⮙՟᧰㋶ᯊˈ䞛䲚⮙՟㙯ᣁᄤᷛᴀDŽ

⮙՟ᷛᴀ䞛䲚Ϣথ⮙ᯊ䯈䯈䱨Ң޴໽ࠄϔϾ᳜ϡㄝDŽ

WPSAR Vol 6, No 3, 2015 | doi: 10.5365/wpsar.2015.6.1.005 www.wpro.who.int/wpsar

2

De Guzmanㄝ 2012ᑈ㧆ᕟᆒ⫬偀㢣ᇨⳕ䳡хᲈথ

158

՟Ў⬋ᗻ⮙՟˄ऴ

51%

˅ˈ݊ᑈ啘㣗ೈЎ

3

᳜啘ࠄ

92

ቕ˄ᑈ啘Ёԡ᭄Ўቕ˗

140

՟ᑈ啘ᇣѢ

5

ቕ

˄ऴ

45%

˅DŽᴀ䍋⭿ᚙ⊶ঞϾᴥᑘˈ㕍ᙷ⥛᳔催ⱘ ᴥᑘЎ

3.9%

DŽ

⮙՟ᇍ✻

ᴀ⃵݅䇗ᶹ

55

ৡ⮙՟੠

110

ৡᇍ✻DŽऩ಴㋴ߚᵤᰒ

⼎ ˈ ⮙ ՟ 㒘 佂 ⫼ ᮴ य़ ⌙ ѩ ∈ ˄

OR=3.6

˗

95%CI

˖

1 . 6 – 8 . 5

˅ ੠ ᳾ ᇕ 䯁 ⱘ ⏅ ѩ ∈ ˄

O R = 2 . 8

˗

95%CI

˖

0.97-8.2

˅ ⱘ ↨ ՟ ᰃ ᇍ ✻ 㒘 ⱘ

3

ס ˈ ⮙ ՟ 㒘∈⑤ѩϢ३᠔䎱⾏೼㉇ݙⱘ↨՟㑺Ўᇍ✻㒘ⱘ

3

ס˄

OR=2.7

˗

95%CI

˖

1.35–5.32

˅˄㸼1˅DŽ⮙

՟㒘佂⫼㞾ᴹ∈ⱘ↨՟ᰃᇍ✻㒘ⱘ

0.22

סDŽ໮಴㋴

ߚᵤ㒧ᵰᰒ⼎ˈ佂⫼㞾ᴹ∈ᰃଃϔ᳝㒳䅵ᄺᛣНⱘ

಴㋴ˈ䆹಴㋴ᰃֱᡸᗻ಴㋴˄

OR=0.21

˗

95%CI

˖

0.09–0.49

˅DŽ

ሙ⇥ϡՓ⫼ᓔ∈៪ࡴ∃⍜↦∈ⱘЏ㽕ॳ಴ࣙᣀ˖

ϡ୰⃶ᓔ∈៪ࡴ∃⍜↦∈ⱘੇ䘧៪⇨ੇˈ⚻ᓔ∈੠ᇍ

∈䖯㸠ࡴ∃⍜↦໾㗫䌍ᯊ䯈ˈ䌍⫼г催DŽ ᅲ偠ᅸẔ⌟

݅䞛䲚

222

ӑ㙯ᣁᄤˈ݊Ёӑ˄

4%

˅Ẕ⌟䳡хᓻ㦠 䰇ᗻˈЎᇣᎱ඗ᇨᠬൟˈ

1

ӑ˄

0.5%

˅Ў䴲

O1

㕸DŽ

102

՟⮙՟䞛ḋࠡഛ᳡⫼њᡫ⫳㋴ˈ݊ᅗ㒚㦠෍ݏẔ

⌟㒧ᵰഛЎ䰈ᗻDŽᇍ✻㒘ⱘ䳡хᓻ㦠ঞ݊ᅗ㒚㦠෍ݏ Ẕ⌟㒧ᵰഛЎ䰈ᗻDŽ

㙯ᣁᄤᷛᴀᬒ㕂Ѣ

Cary-Blair

䖤䕧෍ݏ෎Ё䖯㸠ᅸ⏽ֱ

ᄬˈᑊѢ䞛䲚ৢ

2

໽ݙ䗕ᅲ偠ᅸẔ⌟DŽ䗮䖛᮴㦠ᡔᴃ䞛 䲚∈ḋˈᑊᬒ㕂೼ᆍ䞣Ў

1

छⱘ᮴㦠䞛ḋ⫊Ёˈᇍḋક 䖯㸠㒚㦠ߚ⾏Ẕ⌟ˈৠᯊˈ⬅೑ᆊখ↨ᅲ偠ᅸᓔሩᬣ ᛳᗻẔ⌟DŽ

⦃๗䇗ᶹ

䆓䇜ि⫳ЁᖗᎹ԰Ҏਬњ㾷ⲥ⌟᭄᥂ǃ䳡х⮙՟䆞ᮁ

੠ㅵ⧚ǃ佂∈ঞि⫳⢊މㄝֵᙃ˗ᓔሩ⦃๗䇗ᶹᇍϞ 䗄ֵᙃ䖯㸠䆘ԄDŽৠᯊˈ䆓䇜ϝ㑻կ∈㋏㒳ⱘㅵ⧚

㗙ˈњ㾷ᴥᑘՓ⫼∈⑤ⱘᚙމঞ∈䋼ⲥ⌟䯂乬DŽ ᇍ䳡хᕅડ᳔Ϲ䞡ᴥᑘⱘ∈⑤੠ϝ㑻կ∈㋏㒳䖯 㸠њ䆘Ԅˈৠᯊᇍ⏫ⓣǃৃ㛑ⱘ∵ᶧᴹ⑤ঞ∈⑤ഄ਼

䖍ⱘि⫳⢊މ䖯㸠њ䇗ᶹDŽ

㒧ᵰ

ᦣ䗄ᗻⷨお

݅᧰㋶ࠄ

309՟⭥Ԑ䳡х⮙՟DŽ佪থ⮙՟থ⮙᮹ᳳ

Ў3᳜16᮹ˈ㟇5᳜21᮹থ⮙Ҏ᭄䖒催ዄ˄೒

1˅DŽ 309՟⮙՟Ёˈ37՟ԣ䰶⊏⭫˄ऴ12%˅ˈ2՟⅏ѵ

˄⮙⅏⥛Ў0.6%˅DŽ2՟⅏ѵ⮙՟ഛ᳝Ϲ䞡㝍⋏ˈ݊

Ё՟Ў㗕ᑈ⬋ᗻˈ2՟⮙՟ഛ᳾ࠡᕔए⭫ᴎᵘህ䆞DŽ 䰸ᗹᗻ∈ḋ㝍⋏໪ˈ⮙՟ⱘ݊ᅗ⮛⢊੠ԧᕕࣙᣀ㝍

⮯˄26%˅ǃ䕏ᑺ㜅∈˄22%˅੠਩৤˄21%˅ˈ ҙ2՟⅏ѵ⮙՟ߎ⦄Ϲ䞡㜅∈˄0.6%˅DŽ

0 10 20 30 40 50 60 70

3᦬10–12ᣣ 3᦬13–15ᣣ 3᦬16–18ᣣ 3᦬19–21ᣣ 3᦬22–24ᣣ 3᦬25–27ᣣ 3᦬28–30ᣣ 3᦬31ᣣ–4᦬2ᣣ 4᦬3–5ᣣ 4᦬6–8ᣣ 4᦬9–11ᣣ 4᦬12–14ᣣ 4᦬15–17ᣣ 4᦬18–20ᣣ 4᦬21–23ᣣ 4᦬24–26ᣣ 4᦬27–29ᣣ 4᦬30ᣣ–5᦬2ᣣ 5᦬3–5ᣣ 5᦬6–8ᣣ 5᦬9–11ᣣ 5᦬12–14ᣣ 5᦬15–17ᣣ 5᦬18–20ᣣ 5᦬21–23ᣣ 5᦬24–26ᣣ 5᦬27–29ᣣ 5᦬30ᣣ–6᦬1ᣣ 6᦬2–4ᣣ 6᦬5–7ᣣ 6᦬8–10ᣣ 6᦬11–13ᣣ 6᦬14–16ᣣ 6᦬17–19ᣣ 6᦬20–22ᣣ 6᦬23–25ᣣ 6᦬26–28ᣣ

থ∛

ᱫ੢

ᱫ੢

⮙՟᭄⮙՟᭄

থ⮙᮹ᳳ

থ⮙᮹ᳳ

䰡䲼ᓔྟᯊ䯈

೒1. 2012ᑈ3᳜10᮹㟇6᳜28᮹㧆ᕟᆒ⫬偀㢣ᇨ㒇ᏗѮ䳡х⮙՟থ⮙ᯊ䯈ߚᏗ೒˄n = 309˅

WPSAR Vol 6, No 3, 2015 | doi: 10.5365/wpsar.2015.6.1.005

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3

2012ᑈ㧆ᕟᆒ⫬偀㢣ᇨⳕ䳡хᲈথ De Guzmanㄝ

佂⫼DŽि⫳䚼䮼ᇍ᠔᳝ⱘ∈⑤ഄ䖯㸠њẔᶹˈ݇䯁њ ফ∵ᶧⱘ∈ѩˈᑊᇍ݊Ҫ∈⑤∈䖯㸠ᅮᳳࡴ∃⍜↦Ꮉ

԰DŽৠᯊˈि⫳䚼䮼ᇚϝ㑻ࡴ∃⍜↦ⱘ㞾ᴹ∈կ∈㋏

㒳ᓊԌࠄܜࠡ᳾㽚Ⲫࠄⱘᴥᑘˈᑊ೼ᔧഄᓎゟњ∈䋼 ⲥ⌟ྨਬӮҹֱ䱰ᔧഄሙ⇥ⱘ佂∈ᅝܼDŽ

䅼䆎

ᴀ⃵䳡хᲈথ⭿ᚙЁˈ៥Ӏথ⦄佂⫼᳾ࡴ∃⍜↦ⱘ ѩ∈ᰃϔϾ䞡㽕ⱘॅ䰽಴㋴ˈ㗠佂⫼㞾ᴹ∈Ϣথ⮙

П䯈ਜ䋳Ⳍ݇ˈᰃֱᡸ಴㋴DŽ⦃๗䇗ᶹЁ䞛䲚ѩ∈∈

ḋⱘẔ⌟㒧ᵰᦤ⼎ѩ∈ফࠄ㉾֓∵ᶧDŽ䞛পᇍ∈⑤ࡴ

∃⍜↦੠ሙ⇥佂⫼ᓔ∈៪ࡴ∃⍜↦∈ৢˈᲈথ⭿ᚙ㒜 ℶDŽ

䳡хᛳᶧ䗮ᐌᰃ⬅Ѣ∈੠亳⠽ফࠄ∵ᶧDŽᴀ⃵ᲈ থⱘৃ㛑ॳ಴Ў∈⑤ѩ䎱⾏३᠔੠ൗഒ䕗䖥ˈϨᲈ䲼

⏍≵њ䖭ѯ∈ѩˈҢ㗠ᇐ㟈∈ѩ∵ᶧDŽ⬅Ѣ⊇⌕ᰃᆠ

᳝㧹ݏⱘ⦃๗ˈ⊇∈Ё㒚㦠㦠㕸ⱘᬍবৃ㛑Ӯᓩ䍋Ϣ 䳡хᲈথⳌ݇ⱘ⍂␌⫳⠽ⱘ໻䞣㐕Ⅺ^[6]DŽৠᯊ⋾∈г

ৃ㛑ӮϢ਼䖍࣪㉾∴ⱘ⑶ߎ⠽⏋ড়೼ϔ䍋DŽഄϟ∈г

ৃ㛑ফࠄњ∵ᶧˈ಴Ў䖭ѯ∈ѩ≵᳝䖯㸠䗖ᔧⱘ㓈ᡸ

੠ⲥ⌟ˈ䖭ৃҹ㾷䞞᳾㹿⋾∈∵ᶧⱘ∈ѩгᓩ䍋њ⮒

⮙Ӵ᪁DŽ

ᴀ⃵ᲈথЁˈ77%ⱘᴥ⇥ᆊᒁ᳝ࡴ∃⍜↦∈Ԛ ҡ佂⫼᳾㒣໘⧚ⱘѩ∈ˈ㗠ᛳᶧњ䳡хDŽሑㅵ㝍⋏⮙

՟੠⅏ѵ⮙՟ϡᮁ๲ࡴˈሙ⇥ҡϡᇍҪӀⱘ佂⫼∈䖯 㸠໘⧚DŽⳈࠄ䇗ᶹҎਬᓎ䆂ᔎ࣪عᒋᬭ㚆⌏ࡼˈᔎ䇗 ᇍ佂⫼∈⑤໘⧚ⱘ䞡㽕ᗻৢˈሙ⇥ᠡᓔྟᇍ佂⫼∈䖯 㸠໘⧚DŽ᳔ৢˈ݀݅३᠔гৃ㛑ᰃ∈ѩফࠄ∵ᶧⱘᴹ

⑤DŽ

ᴀ⃵ᲈথЁ៥Ӏߚ⾏ࠄ

O1

㕸ᇣᎱ඗ᇨᠬൟ䳡х ᓻ㦠੠䴲

O1

㕸䳡хDŽϢস݌ൟ䳡хⳌ↨ˈ䖭ϸ⾡ൟ߿

∈ḋẔ⌟㒧ᵰᰒ⼎ˈ4ӑ㉾໻㙴㦠㕸䰇ᗻˈ2ӑ

˄20%˅ர∈⇨ऩ㚲㦠䰇ᗻ˗㗠䳡хᓻ㦠Ẕ⌟ഛЎ䰈 ᗻDŽ

⦃๗䇗ᶹ

㒇ᏗѮկ∈ഄऎ⬅ᔧഄᬓᑰ䋳䋷ㅵ⧚ˈ䗮䖛㞾ᴹ∈ㅵ 㔥㋏㒳৥36Ͼᴥᑘ˄86%˅կᑨࡴ∃⍜↦ⱘ㞾ᴹ∈DŽ 㒇ᏗѮկ∈ഄऎⱘⱏ䆄䆄ᔩᰒ⼎ˈ↣᳜䗕ᕔഄऎि⫳

ࡲ݀ᅸ䖯㸠㒚㦠Ẕ⌟ⱘ∈ḋˈ݊㉾֓∵ᶧᣛᷛⱘẔ⌟

㒧ᵰഛЎ䰈ᗻDŽ↣ᑈ䞛䲚㞾ᴹ∈ߎॖ∈ⱘ⧚࣪Ẕ⌟㒧 ᵰгヺড়೑ᆊᷛޚ^[5]DŽ

㒇ᏗѮկ∈ഄऎ᳾㽚Ⲫⱘᴥᑘˈ䗮ᐌՓ⫼᳾ࡴ∃

⍜↦ⱘ⌙∈ѩ៪᳾ᇕ䯁ⱘ⏅ѩ∈԰Ў佂⫼∈੠ᔧഄⱘ

∈⑤DŽᴀ⃵䇗ᶹⱘ

165

ৡሙ⇥ᆊᒁܼ䚼᥹䗮њ㒇ᏗѮ կ∈ഄऎⱘ㞾ᴹ∈ˈԚҙ᳝

38

ৡሙ⇥˄

23%

˅Փ⫼

㞾ᴹ∈DŽ㒣䇗ᶹˈሙ⇥ϡՓ⫼㞾ᴹ∈ⱘϸϾЏ㽕ॳ಴

ᰃ˖˄

1

˅⬅Ѣܜࠡ᳾থ⫳䖛䳡хˈሙ⇥≵᳝ᛣ䆚ࠄՓ

⫼ࡴ∃⍜↦㞾ᴹ∈ⱘད໘ˈ˄

2

˅ᅝ㺙ϝ㑻ࡴ∃⍜↦㋏

㒳䳔㽕ሙ⇥ᡓᢙ乱໪ⱘ䌍⫼DŽ⬅Ѣᔧഄ≵᳝∈䋼ⲥ⌟

ྨਬӮˈ᳔䖥ϔ⃵ᇍ∈ѩ䖯㸠∈䋼ߚᵤⱘᯊ䯈䖬ᰃ

5

ᑈ

ࠡ䖯㸠ⱘDŽ

ि⫳ЁᖗᎹ԰Ҏਬ⿄ˈᴀ⃵䳡х⭿ᚙᲈথࠡⱘ޴

਼ᔧഄϟ䖛ᲈ䲼ˈ↨⾥ᇨ⊇⊓ኌⱘᴥᑘ೼ᲈ䲼ᳳ䯈㹿

⊇∈⏍≵䖛ˈ㗠䳡х㕍ᙷ⥛᳔催ⱘ5Ͼᴥᑘഛ໘Ѣ䖭Ͼ 㹿⊇∈⏍≵䖛ⱘऎඳDŽ䇗ᶹЁˈ៥Ӏথ⦄∈ѩ䎱⾏࣪

㉾∴੠݀݅३᠔ⱘ䎱⾏೼20㉇ҹݙˈ10Ͼ㹿䇗ᶹⱘ∈

ѩЁ᳝2Ͼ∈ѩⱘㅵ䘧থ⫳⏫ⓣ˄20%˅DŽ 乘䰆੠᥻ࠊ᥾ᮑ

䇗ᶹৢˈᔧഄि⫳䚼䮼ᇍሙ⇥ᆊᒁᓔሩњعᒋᬭ㚆Ꮉ

԰ˈ䞡⚍ᔎ䇗೼ᆊᒁЁᑨᇍ佂∈ࡴ∃⍜↦੠⚻ᓔৢ

㸼

1. 2012

ᑈ

3

᳜

10

᮹

–6

᳜

28

᮹㧆ᕟᆒ⫬偀㢣ᇨⳕ㒇ᏗѮഄऎ䳡х⭿ᚙ᳝݇ⱘ∈੠⦃๗಴㋴

಴㋴ ⮙՟ (n = 55) ᇍ✻ (n = 110) ↨ؐ↨OR P ؐ 佂⫼᮴य़⌙ѩ∈ 20 (37%) 16 (15%) 3.62 0.001 佂⫼᳾ᇕ䯁⏅ѩ∈ 25 (45%) 43 (39%) 2.81 0.028 ३᠔ԡѢ∈⑤ഄ20㉇ҹݙ 38 (69%) 50 (45%) 2.68 0.002 佂⫼㞾ᴹ∈ 8 (14%) 48 (44%) 0.22 < 0.001 ཇᗻ˄ᗻ߿˅ 32 (58%) 63 (57%) 1.04 0.960

⚻ᓔ∈ 16 (29%) 35 (32%) 0.88 0.860

ᆊ᳝३᠔ 41 (74%) 94 (86%) 0.50 0.140

೼佂⫼∈Ёࡴބ 40 (77%) 78 (71%) 1.09 0.950 Ϟ३᠔ৢ⋫᠟ 54 (98%) 110 (100%) 0.00 0.720

WPSAR Vol 6, No 3, 2015 | doi: 10.5365/wpsar.2015.6.1.005 www.wpro.who.int/wpsar

4

De Guzmanㄝ 2012ᑈ㧆ᕟᆒ⫬偀㢣ᇨⳕ䳡хᲈথ

ᓩ⫼ᴀ᭛ഄഔ˖

De Guzman A et al. Availability of safe drinking-water:

the answer to cholera outbreak? Nabua, Camarines Sur, Philipines, 2012. Western Pacific Surveillance and Response Journal, 2015, 6(3):12–16. doi:10.5365/

wpsar.2015.6.1.005

খ㗗᭛⤂

1. Heymann D. Control of Communicable Diseases Manual 19th Edition. Washington, DC, American Public Health Association, 2008.

2. Field Health Services Information System Annual Report: 2012.

Camarines Sur, Nabua Municipal Health Office, 2012.

3. Philippine Integrated Disease Surveillance and Response Annual Report: 2008–2012. Albay, Department of Health Region V, 2012.

4. Verbal autopsy standards: the 2012 WHO verbal autopsy instrument. Geneva, World Health Organization, 2012 (http://

www.who.int/healthinfo/statistics/WHO_VA_2012_RC1_

Instrument.pdf, accessed 30 July 2015).

5. Administrative Order No. 2007–0012: Philippine national standards for drinking-water, 9 March 2007. Manila, Department of Health, 2007.

6. Jutla AS et al. Warming oceans, phytoplankton, and river discharge: implications for cholera outbreaks. The American Journal of Tropical Medicine and Hygiene, 2011, 85:303–308.

doi:10.4269/ajtmh.2011.11-0181 pmid:21813852

7. Ghosh-Banerjee J et al. Cholera toxin production by the El Tor variant of Vibrio cholerae O1 compared to prototype El Tor and classical biotypes. Journal of Clinical Microbiology, 2010, 48:4283–4286.

doi:10.1128/JCM.00799-10 pmid:20810767

᠔ᓩ䍋ⱘ⮒⮙䗮ᐌϡ໾Ϲ䞡^[7]DŽ䖭Ϣ៥Ӏ䇗ᶹЁথ⦄

ⱘ⮙՟⮛⢊੠ԧᕕ䕗䕏ˈᙷ㗙⮙⅏⥛䕗Ԣⱘ㒧ᵰⳌϔ 㟈DŽ

ᴀ䇗ᶹⱘϔϾሔ䰤ᗻᰃᔧ៥Ӏᓔྟ䇗ᶹᯊˈ⮙

՟ഛᏆՓ⫼ᡫ⫳㋴⊏⭫ˈৠᯊ∈⑤гᓔྟ䖯㸠ࡴ∃⍜

↦DŽ䖭ৃ㛑гᰃ៥Ӏ䞛䲚ⱘЈᑞᷛᴀ੠⦃๗ḋᴀ䰇ᗻ

⥛䕗Ԣⱘॳ಴DŽ⬅Ѣ䇗ᶹ೼ᲈথᓔྟ໻㑺ϸϾ᳜ৢ䖯 㸠ˈᇍⷨおᇍ䈵ⱘ䯂ो䇗ᶹৃ㛑ᄬ೼ಲᖚأ׮DŽ

೼䳡хᲈথ⭿ᚙЁˈᦤկᅝܼǃࡴ∃⍜↦ⱘ佂⫼

∈ᰃᐌ㾘ⱘ᥻ࠊ᥾ᮑᓎ䆂DŽᴀ⃵ᲈথЁˈᦤկࡴ∃⍜

↦∈ᑊ≵᳝䰏ᮁ⭿ᚙⱘӴ᪁ˈ㗠佂∈㸠Ў಴㋴ᰃ⭿ᚙ ᣕ㓁Ӵ᪁ⱘЏ㽕ॳ಴DŽᇚᴹ೼䳡х⭿ᚙ᥻ࠊЁˈᑨ䞡

⚍ࣙᣀᓔሩᬍব㸠Ўⱘ݀݅عᒋ乍ⳂDŽ

߽Ⲟކさ

᮴DŽ

䌘䞥䌘ࡽ

᮴DŽ

㟈䇶

ᛳ䇶↨⾥ᇨቯعᒋ੠থሩЁᖗǃ⛁ᏺएᄺⷨお᠔ǃ⫬

偀㢣ᇨⳕि⫳ࡲ݀ᅸˈ㒇ᏗѮᔧഄᬓᑰঞᔧഄሙ⇥೼

⦄എ䇗ᶹЁ㒭ќⱘড়԰੠ᬃᣕDŽ