JOURNAL OF COMMUNITY MEOICINE
Y H O C
CONG E30NG 2015
NGHIEN curu TONG HOP SO MAC VA TUf VONG DO BENH SOT BENH XUAT HUYET TAI
CONG DONG 6 KHU VlTC NAM BO TRONG 10 NAM 2003-2013
Ta Ngoc Ha<, Nguyen Thj Thi Thcfi, Ltfu Phifdng Dung<, Phan Dang Thani, Le Thi PhUdng Mai', Nguyen Thi PhUdng Lieni, Nguyen Dieu Chi Mai^, Nguyen TU Quyet', Tran Ngoc PhUdng Mai^, Nguyen Thj Thanh ThOy\ Tran Van Dinhi.
TOM TAT
Do dac diflm dia ly, khi hiu nang ndng vi mua nhiflu thuyin Igi cho su sinh sin vi phit trifn cua muoi Aedes aegypti, sdt xuat huyft d mien Nam xuit hifln quanh nam, nhieu nhat vao cac thing 7, 8,9, 10 trong nam. Nghien ciiu hdi eiru sd Hfu mac/tii vong sdt xuat huyft Iheo thing vi dan sd tmh tu 2003-2013 nham tdng hgp va md ta chifu hudng va phan bo ciia bfnh sdt xuit huyft tai khu vuc Nam bd hong giai doan 2003-2013, kft qua eho thiy: Tai cic tinh phia Nam, bflnh sdt xuit huyft diing thii 4 trong sfl cic bfnh phd bien trong khu vuc vi chifm trfn 80% sd ca sdt xuat huyet loan qudc. Ty If mac sdt xuat huyet/100000 din 100-300 ca. Ty If mac sdt suit huyft cao dfu t|p trung vao cie thing Iii thing 6 (218.4 ca/100000 din) dfn thing 12 (182.4 ca/IOOOOO dan), dinh djch eao nhit hang nam vao cic thing 7 dfn thing 11 vdi khoing 300 ca/lOOOOO dan. Cic tinh cd ty If mic trfn 100000 din cao, bao gflm Binh Phudc (198.3), Ddng Nai (156.0), Bi Ria-Vung Tau (342.5), Binh Duang (246.3) vi Long An (140.4). Cic tinh cd ty if mic thap (dudi 50 ca/100000) din bao gdm Vinh
Long (51.2), Cin Tho (49.0), Tri Vmh (44.3), Bac Lieu (39.3) va Ca Mau (37.2).
Tir khda: Sdt xuat huyft, ty If mac bfnh, Nam bd.
SUMMARY:
Due to geographic features, hot and rainy weather which more conducive to reproduction and growth of Aedes aegypti. Dengue Haemorrhagie Fever (DHF) in the South of Vietnam occurs Ihroughout the year, especially in July, August, September and October. Retrospective study carried out to systhesize the number of cases and deaths of DHFo describe Ihe status of DHFin the South of Vietnam for this period 2003-2013. The results showed that in southem provinces, DHFranked fourth among the most common diseasesin in the region and accounts for over 80% of all DHF cases of country. The incidence of DHF/ 100,000 population was 100-300. The high incidence of the diseasewas from June (218.4 cases /100,000 population) to December (182.4 cases / 100,000 population). The peak of armual endemic wasfrom July to November with
. Vifn Vf sinh Djch te TW, Tic gii Tai Nggc Hi, DT: 0914.510.563, Email: [email protected]
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HEN Cl/U KHOA HOC
about 300 cases / 100000 populailon. Provinces with hight incidence were Bmh Phuoc (198.3), Dong Nai (156.0), Ba Ria-Vung Tau (342.5), Bmh Duong (246.3) and Long An (140.4). Provinces with low incidence O^ss than 50 cases / 100,000 polulation) were Vmh Long (51.2), Can Tho (49.0), Tra Vinh (44.3), Bac Lieu (39.3) and Ca Mau (37.2).
Keywords: Dengue fever, incidence of dengue haemorrhagie fever. South Region.
I. D4>T VAN DE
Sdt xuat huyflt Dengue (SXHD) lira hinh trfln 100 nude thugc cac khu v\rc cd khi hau nhift ddi va can nhift ddi vung Ddng Nam A vi Tay Thai Bmh Duang. Cd khoing 2,5 ty ngudi sdng trong viing nguy co. Dai dieh SXHD bat diu tii nhung nam cudi thf ky 20 vdi sd mac hang nam khoang 100 trifu trudng hgp raac Sdt Dengue (SD), 500.000 trudng hgp SXHD can nhap vien, trong dd, cd khoing 20.000 ca tii vong chi phi ude tinh cho mgt trudng hgp cip cim vi nhip vifn khoing 514- 1394 USD. SXHD li radi de dga ldn den siic khde, li ganh nang cho he thdng y te vi nfn kinh tf d hiu hft cac qudc gia nhiet ddi. So vdi tmh hinh each day 50 nim, ty lfl mic sdt xuit huyflt trfln loan thf gidi da tang 30 lin. Ngiy nay, SXHD dugc cho la quan trgng nhit trong cac bfnh do mudi truyfn vi nit trfln thf gidi [7] [8].
O Vift Nam bfnh di va dang trd thanh vin df y If nghiem trgng. Nhimg nam gan diy sd ca mac vi chft do SXHD cd xu hudng tang Ifn va Ii mgt trong 10 benh truyfn nhiem cd sd mac vi chft cao nhit trong 26 benh truyfn nhilm gay dich [1]. Chu ky cua dich diudng SXHD khoing tii 3-5 nam, thudng sau mgt sd vu dieh nhd vi vua li mgt vy d}ch ldn xiy ra. Ci Viet Nam, cac dinh dich SXHD Idn tfiudng rai vao cic nam 1987, 1998, 2007, trong khi dich nhd la nam 1991, 2004. Do dac difm dia ly, khi h|iu khac nhau, mifn Nam va Nara Trung Bg bfnh xuat hifn quanh nara, d mifn Bic benh thudng xiy ra tu thing 4 dfn thing 11, nhimg thing khac benh it xiy ra vi thdi tift lanh, it raua, khflng thich hgp cho sy sinh sin va ho?t dgng ciia mudi Aedes aegypti. Benh SXHD phat hifn nhifu nhit vio cac thing 7, 8, 9, 10 trong nim [6].
W«
Bflnh cd xu hudng lan truyen hi Ihanh phd ldn den Ihinh phd nhd, tdi cic ling mac, nhimg noi co vec ta, chu yfu li raudi Aedes aegypti [4][5]. Nghifln ciiu va Idng hgp si raic va tii vong do bfnh sot xuat huyflt tai khu vuc Nam bo trong giai doan 2003-2013 dinh gii tinh tuong quan giiia BDKH, mdi tnrdng sdng vi cac hinh vi cua con ngudi d^
ling trudc su thay ddi cua mdi tnrdng vi bfnh tat II. M y c TIEU NGHIEN CCtJ
Md ti ty If mac vi hi vong do bfnh sdt xuit huyet Idiu vuc Nam bg theo thdi gian trong giai doan tii 2003-2013.
Mo ta ty lfl mic va hi vong do benh sdt xuit huyft tbeo khflng gian giai doan 2003-2013.
m . DOI TirONG VA PHU'ONG PHAP NGHIEN CIJU 3.1. Doi tui^g nghien ciiu
Bio eio bflnh truyfln nhiflm ciia cic tinh trong khu vuc Nam bd: Bao cao ca bflnh sdt xuat huyet theo dudng din tai Quyft dinh Sd 371 l/QD- BYT ngay 19 thing 09 nam 2014 cua BdY tfl.
Sd lifu sdt xuat huyflt tai cic tinh va trong cac nioi giam thdng ke bfnh truyfln nhiem ciia Cyc YTDP giai doan 2003 - 2013 se dugc trich luc, tdng hgp iheo thai^
nam trfn bang excel.
Bio cao dan sd tai cic tinh thanh tii Tdng cpc T b ^ ke, giai doan 2003 - 2013.
3.2. Thdi gian va dia di^m Thdi gian hoi cuu sd heu: Nam 2015 Chudi thdi gian sd lieu: Tu 2003 dfln 2013 Dia difm nghifn eiiu: Khu vuc Nam bo 3 3 . Pbvong phap nghien cihi 3.3.1. Thiit ki nghien ciiu
Sir dung phuang phip dich tf hgc cd phan tich nhim tdng hgp vi md ta chieu hudng va phan bd ciia benh sol xuit huylt tai khu vuc Nara bg trong giai doan 2003-2013.
3.3.2. Phuffng phap thu thgp sd lieu
Hdi Cliu sd lieu tii bio cao cua he ihdng giam sat b ^ truyfln nhifm dinh ky tai Trung tam YTDP cac giii vf cac Vien Vfl sinh dich te/Vfn Pasteur bing van bin vi Cue YTDP - Bo Y tfl theo tiing thing vi hing nam (Tai Ueu Nien giam thdng ke cac bfnh truyen nhiem Hi nam 2003- 2013).
|S(!)25-TMngll/20I5 I Website: yhoccongdong.vi
JOURNAL OF COMMUNITY MEOICINE
Y H O C
CONGE)ONG2015
Hoi cuu sd liflu vfl dan sd tai cic tinh/thanh tir Nien giim thdng kf cua Tdng cyc Thdng kf giai doan 2003 - 2013.
3.3.3. Cdc nhdm bien sd chinh Ty If mic/100.000 din theo thdi gian Ty lfl raac/100.000 din theo dia diem Ty If tii vong/lOO.OOO din theo thdi gian Ty If hi vong/lOO.OOO dan theo dia difm 3.4. Qudn ly vdphdn tich sd lieu
Sd Ueu ciia cac bang sau khi dugc lira sach, se dugc nhap bing phin mfm Excel 2007. S6 lifu dugc phan tich Iheo phin mfm SPSS 18.0.
Sd Ueu phan tich dugc trinh bay theo cic bifu dd mo ti chifu hudng, sv phan bd ciia bfnh theo Ihdi gian.
IV. KET QUA NGHll&N CUtJ
4.1. SiJr phin bo theo thdi gian cua b^nh s6t xuit huylt tai cac tinh khu v^rc Nam bfl, giai doan 2003-2013 Bdng 1. Sd ca m&c do benh sdt xudt huyet tgi cdc tinh khu virc Nam bp, giai dogn 2003-2013
Thjri gian
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Tong s6
Namb$
So ca mac SXH (a)
40425 66045 45450 56857 87903 82296 73617 65301 60504 67681 33384 679463
Soca tir vong do SXH(b) 69 103 37 48 79 88 74 32 59 60 20 669
To&n quSc
Soca mac (c)
47808 73562 55398 65180 101096 92644 85980 101171 64047 82139 54407 823432
Tfr vong (d) 72 114 41 53 86 95 87 97 61 80 42 828
Ty If mac khu vuc Nam bd (a/c)
84.6%
89.8%
82.0%
87.2%
87.0%
88.8%
85.6%
64.5%
94.5%
82.4%
61.4%
82.5
Ty 1 j tfr vong khu vuc Nam b9
(b/d) 95.8%
90.4%
90.2%
90.6%
91.9%
92.6%
85.1%
33.0%
96.7%
75.0%
47.6%
80.8%
S625-Thdng 11/2015 I i r \ ' ^ - - ' Website yhoccongdong.vn I -»• --'
Q l l N curu KHOA HOC
Bilu dSl.Tfli mde sit xuat huyit trung binh hdng nam tgi khu virc Nam bg, giai dogn 2003-2013
Nam Nam Nam Nam Nam Nim Nam NSm Nam Nim Nam 2X3 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Bilu d6 tren cho thiy, ty le mic s6t xuit huylt/100000 dan tai khu vuc Nam bo cao a tit ca cac nam giai doan 2003- 2013, giao dong tu 100-300 ca/100000 dan moi nam. Cao nhit trong cac nam 2007 (271.2 ca/100000 dan) va 2008 (253.2 ca/100000 dan).
Biiu dd 2. Ty le Id' vong cua benh sot xudt huyit hdng ndm tgi khu vuc Nam bg, 2003-2013
Nam Nim Nam Nim Nam Nim Nim Nam Nam Nam Nim 2003 2004 2005 20O6 2007 2008 2009 2010 2011 2012 2013
7(\ I SOlS-Tlringll/MIS
JOURNAt OF COMMUNITY MEDICINE
Y H O C
OONG DONG 2015
.])lj Ty If hi vong do bfnh sdt xuit huyft Iao khu vuc Nam bd td 0,1 -0,4/100000 dan. Ty If niy eao d eic nam 2Q04 (0,4/100000 din)vi 2008 (0,3/100000 dan).
Bieu do3: So sdnh ty le mac sdt xuat huyit hdng ndm giira khu vuc Nam bp v&i todn qudc, giai dogn 2003-2013
300 250 5 200 o 0 150
1 ^°°
e S 500 1 3 9 ^
_93.fi 5 7 1 7
144
>a47.6
109.2 184.§/
127.2 ' 1 9 8
253.2
181.2 j g g j
• Nam B p 193.2
1 9 8 ^ 178.8
124.8 200.4
160.8 ^ 8 ^ 4 106.8 - • - T o a n Qu6c
Nam 2 0 0 3
N i m 2 0 0 4
N i m 2005
Nam 2006
Nam 2 0 0 7
N i m N i m 2008 2009
Nam 2 0 1 0
N i m 2011
N i m 2012
N i m 2 0 1 3
Kit qua tren cho thay, cac tinh trong khu virc Nam bo co ty le mic diu tren 100 ca benh/100000 dan. Nam 2013 co ty le thap hon la 98.4/100000 dan, tuy nhien truac do nam 2007 ty le nay la 271.2 ca/100000 dan. So vai ty le toan qu6c.
khu vuc Nam bp lu6n lu6n co ty 1$ mic cao han.
Bleu do 4. Ty le mde sol xudt huyet trung binh theo thdng tgi khu vuc Nam bg, giai dogn 2003-2013
350 300
'I 250 I 200
o S 150
•&
•^ ICO 50
—
88.8
i l
1
306
1
li.z
^"•<' 280.8
1 1
238.8 182.4
1 1 1
Thang Thsing Thdng Thang Thang Thang Thang Thcing Thang Thcing Thang Thang 1 2 3 4 5 6 7 8 9 10 11 12
^ Ketqui trfn cho thiy, tyle mac sot suit huyet eao deu tap trung vio cac thing tii thing 6 (218.4 ca/100000 dan) dfn
"j thing 12 (182.4 ca/100000 din), dinh dich cao nhit hang nam vao cic thing 7 dfn thing 11 hang nam vdi khoang ipO J ca/100000 din. Diy li nhimg thing mira nhifu, khi hiu nhiet ddi ndng am thuan lgi cho phit trifn vec to truyen ^ ^ 4 Nhimg thing il mua hem vi nhift dQ giim Id thing 12 den thing 6, ty If mac thap hon nhung d khu vuc niy van duy tn
t
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Q VJIAfll . t WW
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ty le mac 70-120 ca/100000 dan.tri ty le mac 70-120 ca/100000 dan.
Biiu dd S. So sdnh tylf mie sdt xudt huyit trung binh theo thdng tgi khu vife Nam bg vd cd niric, giai dogn 2003-2013
350 300
306-
—•—Nam b^ 7 1 8 4 /
—»-Toan Qudc jf ^B-s
121.2 1 2 8 J / ' ^ ^ Q c
^ v 75.6 78 8 8 . 8 ^ ^ ^ ^ /
313.2 297.6 280.8 238.8
^ 3 T \ 1 8 2 . 4
- ^ N » T R : 2
^ ^ ^ 'JJM "11 P ^ 6
Thang Thang Thang Thdng Thang Thang Thang Thdng Thang ThangThang Thang 1 2 3 4 5 6 7 8 9 10 11 12
Kft qua trfn cung phan anh tinh theo mua ciia khu vuc Nam bd va xu hudng chimg theo mua trfn loan qudc vf ty 1^
mic sdi xuat huyft. Nhm chung, ty If mac trung binh/100000 din theo thing cua khu v^c NB cao hon so vdi loan qii^c, ty If cao nhit ciia khu vuc hi thing 7 dfn diing 11 vm khoang 280-300 ca/100000 din.
Bieu dd 7: Xu hu&ng mde binh Igi khu vuc Nam bp giai dogn 2003-2013
1 - t o CO • * t D g j * 2 ( N i - - w j n m c 2 c o T - c D a ) - * a ) C N r - o i f i ^ ( o e o T - c D <
o o o o O O T - . - . -
Bieu do Iren cho thay, sot xuit huyit xay ra o tit ca cac thang trong nam voi cac miic do khac nhau o Nam bo. Thii diem thap nhat, khu vuc nay ciing co so mic 2000-3000 ca. Thoi ky cao diim, co diang Nam bo co 13 nghm-14 ngbin ca sot xuat huyet. Khong thiy diln bien giam hay tang ca benh trong giai doan nay. Biiu nay cho thiy, nguon miyin benh va nguy co bung phat dich ldn sSt xuit huyit la rit cao, khi cac dieu ki?n moi mrong, tap quan va thay dii kU hi"
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Bifu do trfn cho thiy, sdt xuit huyft say ra d tit ci cic thing trong nim vdi cie miic dg khie nhau d Nam bg. Thdi diem thip nhat, khu virc niy cimg cd so mSc 2000-3000 ca. Thdi ky cao difm, cd thing Nam bg cd 13 nghin-14 nghm ca sot xuat huyet. Khdng thay difn bifn giam hay tang ca benh trong giai doan nay. Dieu niy cho thay, ngudn truyen bfnh va nguy co bung phat dich ldn sdt xuit huyft li rat cao, khi cic dieu kifn mdi tnrdng, tap quan va Ihay ddi khi hati phd hgp cho sir phit trifn vec to truyin benh, cin phai tap trung cac bifn phap chu ddng phdng chdng sdt xuat huyet.
4.2. Su pbkn bo theo khdng gian cua benh sot xuat huylt tai khu VIJTC Nam bo, giai do^n 2003-2013 Bdng 2. Sd ea mac do sot xudt huyet tgi cdc tinh khu vuc Nam bp, ndm 2013
Tinh Binh Phuac Dong Nai Ba Ria-Vung Tau Binh Duong Tay Ninh TP Ha Chi Minh Long An Tiln Giang Ben Tre
Dong Thap VTnh Long Tra Vinh Can Tha An Giang Hau Giang Soc Trang Kien Giang Bac Lieu CaMau Khu vyc
Mac nam 2013 Sdlufmg
1S84 4018 4494 2587 750 6810 2185 1433 1169 1225 674 651 613 1515 365 1233 933 397 448 33384
Ty 16 mic/100000 dan 198.3 156.0 342.5 246.3 55.5 92.3 140.4 76.5 78.0 70.7 51.2 44.3 49.0 63.7 38.5 80.5 50.6 39.3 37.2 98.4
Tir vong nam 2013 Silirgmg
2 3 0 1 1 5 1 0 0 1 1 2 0 2 0 0 0 1 0 20
Ty]? TV/100000 dan 0.22 0.11 0 0.06 0.09 0.06 0.07 0 0 0.06 0.10 0.19 0 0.09
0 0 0 0.11
0 0.06
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lENCU
IEN CtfU KHOA HOC
Trong cac tinh Nam bd, cac tinh cd ty if m i c eao hon nam 2013 (tren 100 ca/100000 d i n ) bao g d m Binh Phudc (198.3), E)dng Nai (156.0), B i Ria-Viing T i u (342.5), Bmh Duong (246.3) v i Long An (140.4). Thanh phd Hd Chi Minh cd sd m i c 6810 ca, ty If 92.3 ca/1000000 dan. Nhung tmh cd ty le m i c thip, dudi 50 ca/100000 d i n n h u VTnh Long (51.2), c i n T h o (49.0), T r i Vinh (44.3), Bac Lifu (39.3) v i C i Mau (37.2) nam 2013.
Bieu do 8: Bdn do phdn ty Ip mac theo tinh khu vuc Nam bg vd todn quoc nam 2013
O 2S-UAMM»&
• n-KiaaJMAri
I
SO 25-Thang il/2015 V^bsttc. ylioccmgdoiig.viiJOURNAt OF COMMUKITY MEDICINE
Y H O C
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'''"Oil V. BAN LU^iN
'"''iili Moi nim khu vuc Nam bd (Binh Phudc, Dong Nai, Bi Ria-Vung Tau, Binh Duong, Tay Ninh, TP Ho Chi Minh, Long An,Tifn Giang, Bfn Tre, Ddng Thap, Vinh Long, Tra Vinh, Cin Tho, An Giang, Hiu Giang, Sdc Trang, Kien Giang, B^c Lifu, Ci Mau) cd hing eh\ic nghin ca mic sdt xuit huyft, l i khu vi^c trgng difm chifm hau het sd ca mic tren toin quoc. Nim 2007 cd 87903 ca chifm 87.0% sd mic toan qudc, nim 2011 khu vuc nay chifm 94.5% so mic loan qude (60504 ca). Nhin chung, khu viic Nam bg chifm Iren 80% sd ea sdt xuat huyet toin qudc.
Trong giai doan 2003-2013, khu vuc Nam bg cd 669 ca tir vong do sdt xuit huyft, chifm 80,8%i c i nude. Giai doan 2003-2008 Iy le Iii vong chifm trfn 90% so vdi toin qudc. Nhung nim sd ca SXH tu vong cao li 2004 (103 ca), cic nam 2007, 2008, 2009 cd sd ca tu vong 79, 88 vi 74 ca.
Ket qui giim sit nam 2014, e i nude ghi nhan 37.149 trudng hgp mac tai 49 tinh, Ihinh phd, chu yeu phia Nam, 20 trudng hgp tu vong lai cac tinh, Ihinh pho: Hd Chi Minh (05), Long An (03), Tifn Giang (02), Binh Phudc (02), An Giang (02), Ci Mau (02), Binh Duong (01), Dong Nai (01), Bfn Tre (01) vi tinh Phu Yfn (01). So vdi cung ky nam 2013 (72.239/40), so mic giam 48,6%, tu: vong giim 50,0% (giim 20 trudng hgp). Trong dd khu virc mien Bac giim 47,1%, mifn Trung giim 81,0%, mifn Nam giam 23,8%, Tiy Nguyen giam 89,6%. So vdi trung binh giai doan 2006-2010 sd mac nam 2014 ci nude giim 63,8%, tu vong giam 77,8%.
Theo kft qua giim sat toan qudc, cie tinh, thanh phd cd sd mac tich luy tang cao so vdi cung ky 2013:
Thinh phd Hd Chi Minh (7,2%), Tiy Ninh (27,1%).
10 tinh, thanh phd cd sd mic tich Iuy/100.000 dan cao nhat ca nude: Bi Ria - Viing Tiu (183,5), Binh Duong (173,5), Ddng Nai (123,2), TP. Hd Chi Minh (103,1), Long An (90,1), Khanh Hda (84,0), Binh Phudc (71,8), Tay Ninh (68,9), Phii Yfn (65,0), Sdc Tring (57,8). Ty If mic/100.000 din ciia ci nude la:
39,9.
Bfnh SD/SXHD it Vift Nam phit trifn theo mua v i Cling cd sir khac bift giira mien Bic v i mifn Nam.
Mifn Bac thudc vung khi hiu nhiet ddi, bfnh thudng xiy ra tir thing 4 den thing 11, nhiing thing khac benh it xiy ra vi Ihdi tift lanh, it mua, khdng thich hgrp cho su sinh san va hoat dgng ciia Ae.aegypti.
Benh phat trien nhifu hon tir thing 6 den thing 10 va sd mac nhieu tir thing 8 dfn thing 10, O mifn Nam va Nam Trung bd bfnh SD/SXHD xuit hifn trong suot nam vdi tan sd mac nhieu hon vao thing 4 den thing 11, dinh cao dich tir thing 7 dfn thing 11 hang nam.
VI. KET LUAN
Tai cac tinh phia Nam, benh sdt xuat huyft diing thir 4 trong sd cie bfnh phd bifn. Mdi nam khu v\rc Nam bd la khu vuc trgng difra, chiem tren 80% sd ca sdt xuit huyft toan qudc. Sd ca tu vong do sdt xuat huyft chifm 80,8% ca nude.
Ty If mac sdt xuit huyet/100000 dan tai khu vuc Nam bg cao d tit ca cic nam, giao ddng tir 100-300 ca/100000.
Ty If mac sdt suit huyft cao tap trung vao cic thing tir thing 6 (218.4 ca/100000 din) dfn thing 12 (182.4 ca/100000 dan), dinh dich cao nhit hing nam vao cac thing 7 den thing U vdi khoang 300 ca/100000 din.
Sdt xuit huyet xiy ra a tit c i cic thing Irong nira vdi cic muc do khie nhau. Thdi diem thip nhat, khu vuc nay cung cd sd mac 2000-3000 ca/thang. Thdi ky cao difm, cd thing len 13 nghin-14 nghin ca. Khdng thiy xu hudng giam sdt xuit huyet.
Cic tinh cd Iy If mac cao nam 2013 (trfn 100 ca/100000 dan) bao gdm Binh Phudc (198.3), Ddng Nai (156.0), Bi Ria-Vung Tiu (342.5), Binh Duong (246.3) vi Long An (140.4). Cae tinh cd ty If mic thip (dudi 50 ca/100000 dan) nhu Vinh Long (51.2), c i n Tho (49.0), Tra Vinh (44.3), Bac Lieu (39.3) va CaMau (37.2) nim 2013.
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Ql
1. WHO (2010), TDR Strategic Dhection, dengue, 2010. WHO dengue net, fact sheet NO 117, (http://www.
who.int/tdr/diseases/dengue/direction.htm, accessed 26 September 2006).
2. WHO (2012), DengueNet, (http://www.who-int/csr/disease/dengue/denguenet, accessed 25 September 2012).
3. Bg Y te (2009), Cim nang phdng chdng bfnh tmyen nhiem, Nha xuat ban Van hda thdng tin. Ha Ndi.
4. Trinh Quan Huan, Vu Sinh Nam, Nguyen Van Bifn, Sdt Dengue/sdt xuat huyft Dengue d mgt sd tinh mifn Nam-th\rc trang, nguyfn nhan va giii phap. Tap chi Y hgc Du phdng, 1998, t^p XHI, sd 2, tr 125.
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6. Td chiic Y te Thf gidi (200!), Tii lifu hudng dan phdng chdng sdt Dengue va sdt xuat huyft Dengue, Nhi xuat bin Y hgc.
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fyr I S6 25-Tiang 11/2015 I Website: yhoccongdong.vi
