CONG TAC QUAN LY NGO DOC THUC PHAM TAI TINH ViNH PHUC TUT NAM 2007 DEN NAM 2010
PHAM PHUONG LIEN, PHUNG THANH HUNG Giang vien TrUdmg Bai hgc Y ti cong cgng LE MANH HUNG - Hpc viin chuyen khoa I • K30 TrUdng BH Y ticdng cgng DAT VAN DE
An loan thflc pham d mdt tam quan trpng ddc biet khong chi vdi sflc khoe mdi d nhan, d ^ Q ddng, sfl phdt trien moi gidng ndi ma cdn lien quan den sfl phat trien kmh te, vdn hoa, xa hpi va an ninh chinh tri mdi dja phuang, mdi qudc gia. Sfl dyng thuc pham khdng dam bao ve sinh trfldc mdt cd the bj ngd dpc d p tinh vdi cac tridu chflng d at dd nhdn thay, nhflng van de nguy hiem hfln nfla la sfl tich luy d c chal dpc d mdt sd bd phdn trong cfl the sau mpl thdi gian se phdt benh nhfl ung thfl hodc d the gay di tat, dj dang cho cac t h l he mai sau [1]. Nham han che tdi da sd Iflflng va mflc dp nghiem trong cua cac vu ngd ddc thflc pham, d n g tac quan ly ngd doc Ihflc pham tai cac dja phflong can dflpc day manh, Chung tdi tien hdnh nghien cflu de tai vdi myc tieu danh gia thflc trang cdng lac quan ly ngp ddc tiiflc pham cua linh VTnii Phuc tfl ndm 2007 den ndm 2010. Cac phat hien chinh cua de tai se giup cac nha quan ly y te nhan thflc rd dflpc hieu qua cua d n g tac quan ly ve sinh an toan thflc pham tai VTnh phuc nham dfla ra cdc giai phap cai tiiien phCi hpp,
DOI TUONG VA PHUONG P H A P NGHIEN CLRJ 1. Doi tuflng nghien cuU
Can t)p y te IRTC liep phu trach cdng tac Ve smh an loan thflc pham (VSATTP) tai tuye'n tinh, huyen, xa tai vrnhPliuc.
Phieu dieu tra va bao cao vu ngp dpc thflc pham Bidn ban la'y mau xel nghiem,
Phieu tra ldi ket qua xet nghiem
So theo doi nhan mau va tra ket qua xet nghiem, 2. Phuflng phap nghien curu
Thiet ke nghien cifu: Hoi cuU.
Dja diim nghien cifu: Ttnh VTnh Phuc, Thdi gian nghien cifu: Tfl thang 10 ndm 2011 den thang 08 ndm 2012,
Cd mdu:
Tuyen tinh:
Toan bp can bp phdng Nghiep vu Chi cue VSATTP tinh VTnh Phuc (6 ngfldi).
Todn bd d n bp khoa Xet nghiem Trung lam Y te dfl phdng VTnh Phuc (11 ngfldi).
Tuyin huyen: Toan bd can bd cua 9 Trung tam VSATTP cCia huyen (29 ngfldi).
Tuyen xa: 137 cdn bp chuyen trach chflflng trinh VSATTP cfla 137 xa/phfldng trong tinh.
Thu thap sd lieu dinh Iflflng:
Hoi cflu tai lieu Iflu trir. Bao cao NDTP, phieu dieu tra vu NDTP, so theo ddi NDTP tai cac tuyen bang bang kiem thu thap thdng tin.
Phdng van can tjp Iri/c liep lam d n g tac VSATTP tai tuyd'n tmh. huyen, xa t>ang bo cau hdi thiet ke sdn
Phflflng phap xu* ly va phan tich so lieu: Phan
tich sd lieu bang phan mem SPSS 16.0.
KET QUA VA B A N LUAN
1. Hoat dong dieu tra bao cao va lay mdu xet nghiem NDTP
Blng 1: Thdi gian bao cao cac vu NDTP S6 iltong ngiitj mac/vy
Vunq6d6c>30nqi/di Vunq6d6c<30nqiia
Mode Sovu
5 31 36
Tticfi qian bSo cSo (qid) lilode
4,5 12,5 11.5
Cliamnhat-Nlianlinlial 8-1 36-1 36-1 Bang tren cho thay cac vy ngo ddc vdl so luting ngfldi mac ldn (> 30 ngfldi) d thdi gian bao d o nhanh hon. Thdi gian bao cao sau khi xay ra ngp ddc Ihudng la 4,5 gid, cham nhat 8 gid va nhanh nhat 1 gid. Cac vu ngd ddc d sd ngfldi mac vfla hodc ft (< 30 ngfldi) d thdi gian bao cao cham hon. Thdi gian bao cao sau khi xay ra vu ngp dpc thfldng la 12,5 gid, cham nhd'l la 36 gid (1,5 ngay), nhanh nhat]a 1 gid.
Bang 2: Phan bd cac mdu xel nghidm dflpc lay theo tuyen (n=36)
Cac tuyen Tuven xa Tuven huyen
Tuyen linh T6nq so
So vu NDTP dirge iay mlu xet nqhiSm dat yeu cau
0 3 9 12
Tyl6%
0 S,3 24,9 33.2 Trong so 36 vu NDTP chi cd 12 vy Idy dflpc mau x6t nghiem dat yeu d u (33,2%). Trong dd, luyen xa khong lay dflflc mdu nao. Tuyen huyen chi lay dutic 3/36 vu (8,3%) va tuyen tinh lay dflflc 9/36 vy (24,9%). Day la van de Chi eye VSATTP tinh d n quan tam trong viec dao lao, tap huan d n g lac lay mau x e l nghiem cho cac d n bd y le tuye'n dfldi, de ket qua xet nghiem tnang cac vu NDTP dat ^ ie cao hon, chinh xac han.
Ddi tupng iay mau xet nghiem Nqucn mac NqucT tanh Thuc pham Dunq cu. bao q6i
Khac
Cacvunq6d6c(n=36) Sdvu iay duoc mau
3 1 10 0 0
TJie%
7.1 2.4 23.8 0 0 Qua bang tren cho thay:
S d vu lay dflflc mdu benh pham t f l ngfldi mdc dat tJ Id 7 , 1 % .
S d vu lay dfloc mau thu'c pham nghi ngd d d ldm x6t nghiem dat ty le 23,8%.
Ddi tflpng dflflc lay m a u xet nghiem Id ngudi l^nii chi dflflc lay 1 lan Irong 1 vu ngp doc (chie'm 2,4% sd vu).
Dung cy, bao gdi thflc pham khong dupc l l y Idm mau xet nghidm trong c^ 4 n d m t f l 2007 - 2010.
Y HOC THLTC HANH (924) - s 6 7/2014
Bang 4: Ket qua xet nghidm trong cdc vu NDTP (11=36)
KfiquSxetncitiigm 86w&ndUDcnquyen nlian sinh iioc SSniflm ARX nguyen ntian hod tKX:
S0«i tim OAK nquygn nhdn khdc Sfivu khOng fim diroc nquven niiSn
SfiluOTiq I Tvl§%
20 55.6 5 13.9 2 5.5 9 1 25,0 Trong d c vy NDTP dupc Idy mau xdt nghiem, 55.6% xet nghiem cho ket qua Id nguyen nhdn vi sinh;
13,9% do nguyen nhdn hod hpc va 5,5% do nguydn ntian khac vd 2 5 % s d v y khdng tim dfloc nguyen nhdn ggy b^nh
2. Thyc t r a n g n g u d n n h a n lute l a m c d n g t a c d i e u tra b i o cao v a lay m l u x d t n g h i e m v u N D T P
Bang 5' Trinh d d cdn b d Idm cdng tdc chuydn mdn VSATTP
Trinti
Oai hoc Tniig So cdp TAig
a
Tuy^t'nh S6 ludng
4 2 0 6
Tyie 66,/
%
33,3 0 100
Tuyln huyin So luonq
10 19 0 29
T*
35 65 0 100
Tuyen xa So luonq
6 125
6 137
T}iS
%
4.4 91,2 4.4 100
Tonq Sd luonq
20 146 6 172
sd
Tyie
%
11.7 84.8 3.5 100
Thflc I r a n g n g u d n n h a n l u c l a m c d n g t a c V S A T T P cOa tinh c d n n h i e u h a n c h e ' v e t r i n h d o c u n g n h f l k i n h nghiSm. T j Id c a n b d d t r i n h d p d a i h o c c a o nhd't t a i tuydn tinh c h i e m 6 6 , 7 % ; t u y e n h u y e n td 3 5 % v d t u y e n xa chi d 4 , 4 % . T r i n h d d t r u n g c d p t a i t u y e n t i n h la 33,3%; t u y d n h u y e n la 6 5 % v d c a o n h d t d t u y e n x a v 6 i 9 1 . 2 % .
Bdng 6 T h a m n i e n c d n g l a c t r o n g n g d n h c f l a c a n b6 lam cdng l a c V S A T T P d c a c t u y e n
nieo Dua 2 nam Tiin 2nam T<ng
a
Tuyln tinh SS ludnq 4 2 6
TJ i e % 66,6 33,4 100
Tuvin huvin S«
iudnq 9 20 29
Tjid
%
31.1 68,9 100.0
Tuyln xa S8 luonq
61 76 137
T } B
%
44.5 55.5 100.0
T d n q s l Si iutmq
74 98 172
T f l S
%
43.0 57.0 100.0
Trong todn tinh, tham nien cdng tac trong fTnh vflC VSATTP cCia cdc can bd d n it. T j Id can bp c d thdm niSn trong ngdnh tren 2 ndm chi chiem 5 7 % , Trong d d
T^i tuydn tinh s d can bd Idm cdng lac VSATTP cd Ihdi gian cdng tdc trong ngdnh t f l 2 ndm trd len chi chidm ty Id 33,4%; s d can bd d tham nien Idm viec dufti 2 nSrri chidm l y Id cao (66,6%).
Tai tuydn huydn, s d cdn bo tuydn huydn d tham niftn 2 ndm trd ldn chidm ty Id 6 8 , 9 % ; s d Iflflng cdn d iamvi$c dfldi 2 ndm chidm ty Id 3 1 , 1 % .
T9J tuydn xd ty Id cdn b d c d thdm nidn t f l 2 ndm trd Wn chidm 55,5%; dfldi 2 ndm chidm 44.5%.
Bang 7: S d lan tham gia dieu tra vy NDTP cOa d n bp d cac tuydn
Tuyln Tuyln tfnh (n= 6}
Tuyln huyen (n = 29) Tuyen xa(n = 137) Tonq sd(n = 172)
Chua tCing Oiam gia dilu tra Sdiuonq
0 8 104 112
T * l l % 0 27.6 75.9 66,1
Da timg Iham gia dieu lia S6iuanq
6 21 33 60
T j I S I t 100 72.4 24.1 33.9 T o a n t i n h c d 3 3 , 9 % c d n tra c h u y d n t r a c h d a I h a m g i a d i e u t r a c d c v u N D T P . T y Id c a n b d d a t f l n g t h a m g i a d i d u t r a c a c v u N D T P c a o n h a t d t u y d n t i n h ( 1 0 0 % c a n b p d a t f l n g t h a m g i a d i e u t r a ) ; d t u y e n h u y e n Id 7 2 , 4 % ; t h a p n h a t d t u y e n x a v d i 2 4 , 1 % c a n b d d a t f l t i g t h a m g i a d i e u t r a .
B a n g 8 : S o ngUdi d f l f l c t h a m g i a I d p t a p h u a n v d l a y m a u x e t n g h i e m fa-ong v y N D T P
Tuyen
Tuyln tfnh (n = 11) Tuyen huyen (n = 29) Tuyln xa(n = 137) Tdnq so (n = 177)
Da tham gia tirliOpb^lfen So luonq
9 24 18 51
T y i e % 81.8 81.6 13.1 28.8
Chua Iham gia Wpnio Sdiuonq
2 5 119 126
T y B % 18.2 18.4 86.9 71.2 T i n h c h u n g t r e n l o a n t i n h s o I f l p n g c d n d ' d m c d n g t a c V S A T T P d f l p c t a p h u a n v e k y t h u d t l d y m S u x e t n g h i d m t r o n g v y N D T P t h a p , c h i d a t 2 8 , 8 % . T a i t u y d n t i n h , t y le c a n b p d f l p c t a p h u d n v e k y t h u a t l d y m S u x d t n g h i e m t r o n g v u n g p d p c d a t 8 1 , 8 % ; t a i t u y d n h u y d n d a t 8 1 , 6 % . T a i t u y e n x a , t y le n d y t h d p n h d i , c h i d a t 1 3 , 1 %
B a n g 9: H i d u b i e t ciia c a n b p v d k y t h u d t l l y m S u x e t n g h i e m b e n h p h d m t h e o p h i e u d i e u t r a
Tuyln Tuyln tinh (n = 11) Tuyln huyen (n = 29) Tuyen xa(n = 137)
Tong sd{n = 177)
Bilt d c h dung m l u vSb^oqu^n blnh phim Sdiuonq
11 27 121 159
T J B % 100.0 93.1 88.3 89.0 N h i n c h u n g t r o n g t o a n t i n h , 8 9 % s o c d n t)d bidt e a c h d f l n g b e n h p h a m v a b a o q u a n b d n h p h d m , T r o n g d d , l y le d n Ira t u y e n l i n h b i e t e a c h d f l n g b d n h p h d m v a b a o q u a n m a u b e n h p h d m t r f l d c v d t r o n g k h i v a n c h u y e n la 1 0 0 % ; t a i t u y e n h u y e n la 9 3 , 1 % v d t a i t u y d n x a la 8 3 , 3 % .
3 . C d n g t a c g i a m s a t v e V S A T T P
B a n g 1 0 ' C d n g t a c k i e m t r a g i a m s a t c f l s d c h d b i e n t h f l c p h d m
So CO sd c h l biln thuc pham Tdnqsocdsd So CO sd duoc kiem tra So CO sd dat tieu chuan VSATTP
Ty ie % dat beu chuan VS 2007 1908 1908 1327 69.6
2008 2543 2543 1639 64.5
2009 2175 2175 1433 65.9
2010 2350 2350 1625 68,7 S d CO s d t h f l c p h d m d x u h f l d n g t d n g Idn t f l 2 0 0 8 - 2 0 1 0 ; d n g t a c k i e m t r a g i a m s a t l u d n d a t 1 0 0 % s d c f l s d d f l f l c q u a n ly, T y Id c f l s d d a t t i e u c h u i n V S A T T P I r e n todn l i n h t h a p nhd'l v d o n d m 2 0 0 8 ( d a t 6 4 , 5 % ) , c a o n h a t la n d m 2 0 0 7 ( d a t 6 9 , 6 % ) .
Y HOC THUC HANH (924) - s 6 7/2014
KET LUAN
1. Hoat ddng dieu tra bdo cao va lay m l u xet nghiem NDTP
Thdi gian bao d o cac vu NDTP cdn chdm, thfldng Id 11,5 gid sau khi xay ra vu NDTP.
Sd vu NDTP dflflc lay mdu xet nghiem khdng nhieu. Da sd d c vu NDTP do luyen tinh lay mdu xet nghiem (dat 24,9%), tuydn xd khdng lay duflc mau xel nghiem ndo dat yeu d u .
Nguyen nhan chu yeu cua d c vy NDTP la do nguyen nhan vi sinh, chie'm 55,6% sdvy.
2. Thuc trang nguon nhan luc lam cong tdc VSATTP'
Ngudn nhan lut Idm cdng tdc VSATTP trong tinh cdn nhieu han chd ve trinh dp cung nhfl kinh nghiem.
Nhdn lflc tai tuye'n huyen va luyen xa chu yeu la can t)p d trinh dp tnjng d p (65% vd 91,2%).
Toan tinii chi cd 33,9% can bp ciiuyen trach da tflng Iham gia dieu tra cac vu NDTP.
Tai tuyen xa, ty le can bd chfla dflpc tap huan nghiep vu cao (86,9%).
3. Cdng tac giam sat ve VSATTP
Cdng lac kiem tra giam sat cac cfl sd che bien thflc phdm tai tinh ludn dat 100%.
SUMMARY
THE MANAGEMENT OF FOOD POISONING CONTROL IN VINH PHUC FROM 2007 TO 2010
Backgrounds: The food safety and hygiene has an important role not only for individual, community, and human development, but also related to the economic, social, culture and political security development in each region, each nation. Using the unguaranteed food can create acute food poisoning with the tiow of many symptoms, but the more dangerous is that the poison contained in some organs of the human body can lead to cancers later, and the impact to the next generation. In order to reduce the number and level of food poisoning cases, the control of food poisoning in the province need to be enhanced.
We conduct this research with the aims to evaluate the management situation of food poisoning control in Vinh Phue from 2007 to 2010. The main finding of this research will help the health officers realize the efficiency of food safety and hygiene control in Vinh Phuc in order to issue the appropriate solutions.
Methods: Retrospective study.
Results:
1. Investigation activities and report test samples of food poisoning
Time reported of food poisoning cases are slow, usually 11.5 hours after the incident of food poisoning.
The number of test samples of food poisoning cases is low. Most samples tested of food poisoning cases wem taken by provincial level (24.9%), commune did not get any standard samples.
The main cause of food poisoning is bacteria, accounting for 55.6% of the cases.
2. The situation of human resources working in food hygiene and safety
Human resource working in food hygiene and safety in the province is limited to the degree and experience. Human resource at tiie district and commune level has mostly intermediate level (65%
and 91.2%).
There are only 33.9% staffs have been involved in tiie investigation of food poisoning cases.
At tiie commune level, the percentage of worfre/s who are not trained is high (86.9%).
3. Surveillance of food hygiene and safety The inspection and supervision of food processing facilities in the province always get 100%.
Keywords: Food poisoning, food hygiene and safety.
T A I LIEU THAM K H A O
1. Nguyen Thanh Binh, Nguyen Vdn Canh, Vo Thi Minh Thp, La Thi My Linh (2005), "Oanh gia tinh hinh ngo doc thyc pham tinh Binh Thuan tfl ndm 2000 - 2004", K ) y ^ Hdi nghi khoa boc VSATTP lan tha ///, Nha xuat ban Y hpc, Ha Npi, tr, 437 - 442.
2. Tran Dang, Chu Qudc Lap, Trflong Thi Thuy Thu (2005), "Bp may to chflc trong quan ly nhd nUdc v5 VSATTP", k^ yeu Hoi nghi khoa hoc VSATTP lan thif ba.
Nha xuat ban Y hpc, Ha Noi, tr.60 - 69.
3. Tran Odng, Hoang Thuy Tien, Trflflng Thuy Thu (2007), "Thyc trang dpi ngu can bp, cdng chflc trong qu^n ly nha node ve ve sinh an toan thfld pham". K^ yeu H6i nghi khoa hoc VSATTP lan thif tu, Nha xuat ban Y hoc, HaNpi,tr.39-43.
4.1slguyen Sy Hao, Tfl My Linh (2003), "Danh gia tinh hinh NDTP tai thanh phd Ho Chi Minh tfl ndm 1995 - 2002", Kj? yeu Hoi nghi khoa hoc VSATTP lan th^ hai, Nha xuat ban Y hoc. Ha Noi, tr.58 - 62.
Vj TRI BAM PHANH MOI TREN 0 HOC SINH T R O A N G DAN TOC NOI TRU XA THAI AN, QUAN BA, HA GIANG NAM 2014
V6 TRUONG NHU NGOC, D O A N THANH TUNG, HA NGOC CHliU - Vidn BT Rdng Hdm HX$t PHAM H O A N G TUAN - BV Rdng Hdm Mdt Trung Wang
QUACH HUY CHLfC -B^YtS T6M TAT
Mye tieu: Ddnh gid vi tri bdm pbanb mdi trdn bgc sinh tn/dng ddn tdc ndi tru xa Thdi An. Qudn Ba, Hd
Giang. Bdi tufgmg: HQC sinh tm^mg ddn tdc n0i tni x&
Thdi An. Qudn Ba. Hd Giang tudi 1-12 ^n khdm (9/
tr?m y ti xd Thdi An. vdo ngdy 13/04/2014. Phuvng
Y HOC THUC HANH (924) - s 6 7/2014
