KI^N THU'C VA THyC HANH PHONG
C H 6 N G S 6 T XUAT HUY^TDENGUE TAI HAI PHU'aNG LY THAI T 6 VA HANG BAI QUAN HOAN KI^M, THANH P H 6 HA NOI, NAM 2009
Nguyen Hong Thanh , Vu Sinh Nam *, Nguyen Thi Kim Tien*, Phan Trong Lan Trung tam YTDP tinh Dien Bien,
*BgYti,HdNpi
TOM TAT
Bing nghien cu-u m6 ta clt ngang co phan tich, chung toi da tiln hSnh nghi§n cu-u danh gia thuc trgng kiln thuc, thyc hdnh cua ngu-di ddn ve phong chong sot xult huylt Dengue (SXHD) a hai ptiudng Ly Thai To (noi c6 ty 1$ mic SXHD cao)vd Hang Bai (noi co ty le mic SXHD thip) quan Hodn Kiem. M6i phuong ction 110 ho gia dinh (HGO) theo phu-ong phap chpn miu nglu ntiien h# thing. Phong van HGO ve kiln thij-c, thu'C hdnh phdng chIng b$nh (PCB) SXHD, dilu tra ve sinh vd thu thap bp gdy (BG). Kit qua cho thiy ca 2 phudng c6 mgt 2 lodi vec to Ae. aegypti vd Ae. albopictus. Kiln thu'C vd thuc hanh cua ngu'di ddn ve phdng chong SXHD phu'dng Ly Thdi T l cao hon phu-ong Hdng Bdi (p < 0,05). Co moi llgn quan thudn giua kiln thii-c vd thgc hdnh ph6ng chong SXHD (p < 0,05). C6 mli lifen quan nghjch glu-a v$ sinh ngoai canh vdi tinh trang nha co BG Aedes (p < 0,05). Bien phap phong chIng v6cto hieu qua a phu'dng Ly Ttiai T6 Id tha ca, thau rua dung eg chu-a nu-dc (DCCN) vd tieu huy dgng eg phi thai (DCPT), tang cudng truyen thdng d l ngudi ddn tg- gidc loai trg- cac 6 BG.
Tu- khoa: s6t xult huylt Dengue (SXHD), kiln thuc, thg-c hdnh, phdng chIng
I. DAT VAN DE
Nam 2008, sd mic SXHD tai quan Hoan Kilm tang len 339 ca, gap hon 6 lin 2007 va ty le mic/100.000 dan la 190,5 cao gip gin 3 lin ty le mic/100.000 dan ciia thanh phd Ha ngi (64,04).
Ly Thai Td la phudng ed ty le mac cao nhat la 587,6/100.000 dan, gip 10 lin ty le mic ciia Ha Ngi. Ngugc lai, phudng Hang Bai cd ty le mac thip nhit (21,54/100.000 dan) [1].
Ngay tir khi cd ca benh SXHD mic rai rac tren dja ban quan, Trung tam Y te quan va cac Tram Y te da trien khai cac bien phap phdng chdng djch: Giam sat, phat hien ca benh, td chuc chien djch di?t BG, phun hda chat, tuyen truyen
van ddng cdng ddng tham gia phdng chdng SXHD.
Tuy nhien, djch van biing phat va cd chieu hudng lan rgng. Din nay, benh SXHD chua cd thuoc dilu trj dac hieu va chua cd vac xin phdng benh. Diet vecto, dac biet la diet BG/lang quang vdi su tham gia tich eye cua cdng ddng la bien phap hieu qua nhat trong phdng chdng SXHD. Mudi tmyen benh sinh san va phat trien gan lien vdi boat ddng ciia con ngudi, va do con ngudi tao dieu kien cho mudi phat trien trong nha minh. Vi vay, thyc trang kien thirc, thuc hanh ciia ngudi dan ve phdng chdng SXHD va mgt sd yeu td lien quan can dugc lam rd trong nghien ciru nay vdi muc tieu: Mo id kien thirc, thuc hdnh phdng chong SXHD cua Tac gia: Nguyen Hdng Thanh
Dja chi: Trung tam Y tl du phdng tinh Dien Bien Di?ntho?ii: 0914255722
E-maiJ: nguyenhongthanh 109(ggmail.com
Tap chi Y hpc dy phong. Tap XXI, sd 3 (121) 187
ngudi ddn vd mpt so yeu td lien quan lgi hai phirdng Ly Thdi To vd Hdng Bdi qudn Hodn
Kiem, Hd Npi, nam 2009.
IL PHLTONG PHAP NGHIEN ClTU 2.1. Doi tugng nghien cuu:
Hg gia d'mh tai hai phudng Ly Thai Td va Hang Bai,
Mdi trudng ve sinh, nha d cua cac hg gia dinh tai hai phudng nghien ciru.
BG/loang quang trong cac dung cu chira nude.
2.2. Thdi gian va dja diem nghien cuu:
Thdi gian: Tir thang 4 nam 2009 den thang 10 nam 2009
Dja diem: Phudng Ly Thai Td va Hang Bai - Hoan Kiem - Ha Ngi.
2.3. Thiet ke nghien ciru:
Md ta cat ngang cd phan tich.
2.4. Phuong phap chgn mau:.
Co mau:
n = •
^L.PO-P)
Trong do:
n: Cd mau tdi thieu
Z: He so tin cay, 95%, Z ,96.
p: la ty le ngudi dan ed kien thirc tdt ve phdng chdng SXHD, (47%).
d = 0,10 (dd chinh xac mong mudn).
Ap dung cdng thirc tinh, n = 96. Du phdng ddi tugng khdng phdng van dugc, hoac khdng ddng y, tang cd mau 10% va lam trdn sd 110 ngudi.
Vay sd hg can dieu tra d mdi phudng la:
110 hg gia dinh (chgn 1 ngudi/1 HGD).
Chgn mau tai thuc dia: Chgn mau ngau nhien he thdng dua vao danh sach hai phudng, tien hanh qua 3 budc: lap danh sach, chgn hp gia dinh, chgn ddi tugng dieu tra.
Phuong phap thu thap sd lieu: su dung cac cdng cu thu thap sd lieu sau:
Phieu hdi: Kien thirc, thirc hanh PCB SXHD ciia ngudi dan dugc ket cau 4 phan.
Nhirng thdng tin chung: gdm 6 cau hdi.
Kiln thiic vl PCB SXHD: gom 9 cau hdi.
Thuc hanh cua ngudi dan ve PCB SXHD
Bang kiem quan sat dieu tra dac diem ciia hg gia dinh:
Du trir nude, loai nude dir trir
Ve sinh trong nha: ve sinh ngoai canh.
Qui trinh dieu tra mudi va BG Aedes trong cac hg gia dinh tai thuc dia va each ghi chep theo thudng qui ciia Vien Ve sinh Djch te Trung uong.
188
Tap chi Y hpc dy phong. Tap XXI, sd 3 (121)III. KET QUA VA BAN LUAN
3.1. Kien thirc, thuc hanh cua ngvdi dan vl phdng chong SXHD
Bang 1. Kiln thirc cua ngudi dan hai phudng v l phdng chdng SXHD
Kiln Thuc
Bilt bilu hi^n ciia b^nh SXHD Bilt b^nh SXHD do muoi truyen Mudi truyin b^nh SXHD la mudi v l n Thdi gian muoi dot la ban ngay Muoi van tru d|lu trong nha Bilt noi song cua BG Aedes
Cach phong SXHD la digt muoi va BG Biet each di^t mu5i, BG SXHD
P.Ly' Sd lugng
87 106
73 68 63 73 109
61
rhai To Ty l?%
79,1 96,4 66,4 61,8 57,3 66,4 99,1 55,5
P.Hang Bai Sd lugng
51 100
42 63 45 44 106
20
Ty l?%
46,4 90,9 38,2 57,3 40,9 40,0 97,2 18,2
Qua din lieu bang 1, phin Idn ngudi dugc phdng vin d 2 phudng diu cd kiln thirc vl SXHD la do mudi truyin va bilt each phdng benh (90,9-99,1%).
Ngudi dan phudng Ly Thai To (noi cd so mic SXHD cao) hilu bilt ve bilu hien cua benh, mudi truyin benh, bilt noi sdng BG va thdi gian mudi Aedes hiit mau la 61%, bilt noi trii dau ciia mudi vin con thap (55,5 - 57,3%).
Ngudi dan phudng Hang Bai (cd sd mic SXHD thip) hilu bilt vl bilu hien ciia benh SXHD,
muoi truyin benh, biet noi sdng ciia BG, thdi gian hiit mau, noi sdng BG, noi trii dau cua mudi thip dudi 57%, dac biet la hilu bilt ve each diet BG, mudi truyin bfnh chi dat 18%.
Nghien ciiu cho thiy ngudi dan phudng Ly Thai Td cd kiln thirc vl benh SXHD dat cao hon so vdi phudng Hang Bai. Ty le ngudi cd kiln thuc khdng dat d phudng Ly Thai Td thap ban 2,3 lin phudng Hang Bai (p < 0,05). Ty le ngudi cd thyc hanh dat d phudng Ly Thai Td cao hon so vdi phudng Hang Bai (p < 0,05).
Tap chi Y hpc du phdng. Tap XXI, sd 3 (121) 189
Tyle 90 80 70 60 50 40 30 20 10 0
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oe s n Ap dung
o
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54.50
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Nam Phun Dung Dung Lirai Day nap Thau Tha ca Thu
Man thuoc huong den, vat chan be, nia nhat phuy... DCCN PLPT Bilu dd 1. Thyc hanh v l phdng chdng SXHD t^i phudng Ly Thai To
S? 80 p 70
60 50 40 30 20 •
10 • 0
Q Ap dang D Ap dung dung
- r ^ — • — • I • ' , — Dung Luai iten. vat chan Nam
Man
Phun thuac
Dung huomg
Day nap Thau raa b i DCCN phuy..
Tha ca Thu nhat PLPT
Bilu dd 2. Thyc hanh v l phdng chdng SXHD tai phudng Hang Bai
Bieu do 1, bieu do 2 cho thay ty le thuc hanh diing cac bien phap phdng chdng SXHD edn thap. (3 phudng Ly Thai Td, ty le thyc hanh diing cao nhat ia bien phap thu gom DCPT (54,5%) va thip nhit la tha ca vao DCCN (11,8%). Ngudi dan phudng Hang Bai ty le thuc hanh dimg cao nhat la bien phap day nap be, phuy, xd (36,4%) va thip nhit cung la tha ca vao DCCN (4,5%). Ty le cac bien phap dung each d hai phudng deu thap va
ty le thyc hanh cac bien phap dung ve phdng chong SXHD d phudng Ly Thai Td diu cao hon phudng Hang Bai.
Ket qua da chi rd ty le ho gia dinh dat ve sinh trong nha tai phudng Ly Thai Td (71,8%) cao ban 9% so vdi phudng Hang Bai (62,7%), nhung su khac biet nay khdng cd y nghTa thdng ke (p > 0,05). Ty le hd gia dinh dat ve sinh ngoai nha tai phudng Ly Thai Td (89,1%) cao hon 33% so vdi phudng Hang Bai (p < 0,05).
190
Tap chi Y hpc dy phdng, Tap XXI, sd 3 (121)3.2. Moi lien quan giua kien thirc, thvc hanh cua ngvdi dan doi vol PC SXHD
Bang 2. Mdi lien quan giua kiln thu^ va nha cd bp gay tai hai phudng Ly Thai To va Hang Bai
Kiln thu'C phdng chdng bf nh
SXHD Khong dat Oat Tong cpng
Phudng Lj^ Thai To Tinh trang nha Cd bp g|ly
10 18 28
26,3%
25,0%
25,5%
Khdng cd bp gay 28
54 82
73,7%
75,0%
74,5%
0R= 1,07; x2 = 0,02; (CI 95%: 0,4 - 2,6); p>0,05
Phudng Hang Bai Tinh trang nha Cd b9 g|ly
13 9 22
16,9%
27,3%
20%
Khdng cd bp gly 64
24 88
83,1%
72,7%
80%
OR = 0,54; x2 = 1,6 (CI 95%: 0,2-1,4);
p > 0,05
Bang tren cho thay, ngudi ed kien thiic Q phudng Hang Bai ngudi ed kien thirc khdng dat, nha cd BG cao gap 1,07 lan ngudi khdng dat, thi nha cd BG thap hon 0,54 lan CO kiln thirc dat. Tuy nhien, su khac biet nay ngudi cd kien thiic dat, su khac biet khdng cd y khdng cd y nghTa thdng ke (p > 0,05). nghTa thdng ke (p > 0,05).
Bang 3. Mdi lien quan giua kiln thi>c va nha cd ngudi mic SXHD t^i phudng Ly Thai To va Hang Bai
Ki§n thu'C PCB SXHD
Khong dat Oat Tong cpng
Phudng Ly Thai T l Nha cd ngudi mic SXHD Cd
2 13 15
5,3%
18,1%
13,6%
Khong cd 36
59 95
94,7%
81,9%
86,4%
OR = 0,25; x2 = 3,5;
(CI 95%: 0,05-1,2); p> 0,05
Phudng Hang Bai Nha cd ngudi mic SXHD Cd
9 6 15
14,1%
13,0%
13,6%
Khdng co 55
40 95
85,9%
87,0%
86,4%
OR = 1,09;x2 = 0,2;
(CI 95%: 0,36 - 3,3), p > 0,05
So lieu bang fren cho thiy, ngudi cd kiln lin ngudi cd kiln thiic dat. Tuy nhien, su khac thirc khdng dat, d nha cd ngudi mic thip hon 0,25 biet nay khdng cd y nghTa thdng ke (p > 0,05).
Tap chi Y hpc dy phong. Tap XXI, sd 3 (121)
191
Bang 4. Mdi lien quan giua thyc hanh va nha cd bp gay t^i hai phudng Ly Thai To va Hang Bai
Thyc hanh PCB SXHD
Khong dung Oiing Tong cpng
Phudng Ly Thai To Tinh tr^ng nha Cd bp gly
14 14 28
21,9%
30,4%
25,5%
Khdng cd bp gay 50
32 82
78,1%
69,6%
74,5%
0R= 0,64; x2 = 1,03; (CI 95%: 0,27 - 1,5); p > 0,05
Phudng Hang Bai Tinh trang nha Cd bp g|y
18 4 22
20,5%
18,2%
20,0%
Khdng cd bp gay 70
18 88
79,5%
81.8%
80,0%
OR = 1,2; x2 = 0,06; (CI 95%: 0,35 - 3.9);
p > 0,05
Bang 4 cho thay, tai phudng Ly Thai Td, 0,05). IChdng tim thiy mdi lien quan giira thuc ngudi ed thyc hanh khdng dimg, thi nha cd BG hanh va tinh trang nha cd BG tai phudng Hang thap hon 0,64 lan ngudi cd thyc hanh dung, su Bai (p > 0,05).
khac biet nay khdng ed y nghTa thdng ke (p >
Bang 5. Mdi lien quan giua vp sinh ngoai canh va nha cd bp g$y Aedes tai hai phudng Ly Thai To va Hang Bai
Ve sinh ngo^i
canh
Khdng dgt Oat Tong cpng
Phudng Ly Thai To Bpg?y Cd
9 19 28
75%
19,4%
25,5%
Khdng cd 3
79 82
25%
81,6%
74,5%22 OR = 12,5; x2 = 17,4;
(CI 95% = 3,1 - 50,6); p < 0,05
Phudng Hang Bai Bpgay Cd
17 7
30,6%
11,5%
20%
Khdng cd 34
54 88
69,4%
89,5%
80%
OR = 3,4; x2 = 6,2;
(CI95%=1,4-9,2);p<0,05
Ket qua bang 5 cho thay, tai phudng Ly khdng dat, cd BG cao gap 3.4 lan nha co vti Thai Td nha cd ve sinh ngoai canh khdng dat, sinh ngoai canh dat tai phudng Hang Bai (p cd BG cao gap 12,5 lan nha cd ve sinh ngoai < 0,05).
canh dat (p < 0,05). Nha cd ve sinh ngoai canh
192
Tap chi Y hpc dy phong, Tap XXI, sd 3 (121)Bang 6. Mdi lien quan giira kiln thu'C va thyc hanh phdng chdng SXHD t9i hai phudng Ly Thai To va Hang Bai
Kiln thiFC
Khong dgt Oat Tong cpng
Phudng Ly Thai To Thyc hanh Khdng dung
24 40 64
63,2%
75%
58,2%
Dung 14 32 46
36,8%
35%
41,8%
0R= 1,37; x2 = 0,59;
(CI95% = 0,6-3,1);p>0,05
Phudng Hang Bai Thyc hanh Khdng dung
66 22 88
85,7%
66,7%
80%
Oung 11
11 22
14,3%
33,3%
20%
OR = 3; x2 = 5,2:
(CI 95%: 1,14-7,8): p< 0,05
Bang tren cho thay ngudi cd kien thirc khdng dat, cd thyc hanh khong dimg cao gip 1,4 lin ngudi cd kiln thiirc dat, sy khac biet nay khdng cd y nghTa thdng ke (p>0,05). Tai phudng Hang Bai ngudi ed kiln thirc khdng dat, cd thyc hanh khdng dimg cao gap 3 lan ngudi cd kiln thiic dat (p < 0,05).
IV. BAN LUAN
Theo Td chirc Y tl thi gidi, mot trong cac ylu td trong Chien lucre toan ciu phdng chong vec to SXHD la phdng chdng vec to cd chon loc va cd su tham gia cua cong ddng cung nhu CO quan lien nganh [2]. De huy ddng cdng ddng tham gia va cd hieu qua, thi cong ddng do phai cd kiln thurc va thyc hien tdt cac bien phap vl PCB SXHD.
4.1. Kien thvc, thvc hanh cua ngvdi dan ve phong chong SXHD:
Kit qua dilu tra d 2 dja dilm nghien ciru cho thiy ty le ngudi dan bilt nguyen nhan mac b?nh SXHD la do mudi truyin va each phdng b?nh SXHD la diet mudi va bp gay d 2 phudng diu d?it ty le cao (tren 90%). Ci phudng Ly Thai To, ty le ngudi dan bilt vl bilu hien benh SXHD, biet mudi vin truyin la vec to truyin
benh SXHD va noi sdng cua bo gay Aedes ciia mudi truyin benh SXHD edn thip. Nhu vay chi cd 66% ngudi dan dugc thuc su dupe nghe hoac nhin thiy mudi van va tren 61 % ngudi dan bilt noi bo gay truyin benh SXHD sinh song la chum vai, be, thiing, phuy. con ddi vdi cac DCCN nhu lo hoa. bat ke chan tran. DCPl thi it ngudi bilt din. Day chinh la 1 trong nhung nguyen nhan din din viec sir dung cac dung cu tich trii- nude khdng diing va ho da vd tinh tao mdi trudng cho mudi sinh san, sinh ra cac d bg gay.
Ty le ngudi bilt thdi gian mudi ddt con thip, van edn gin 40% ngudi dan tra Idi mudi truyin benh SXHD dot ngudi vao ban dem.
chi cd tren 57% ngudi dan bilt mudi truyen benh SXHD dau d trong nha. Trong cac bien phap phdng chdng mudi va bg gay cua mudi truyin benh SXHD thi da sd ngudi dan chi bilt bien phap nim man, phun thudc, day nap be.
con cac bien phap khac thi rit it ngudi biet.
do vay ma ty le ngudi dan biet each diet muoi va bg gay cua mudi truyen benh SXHD thap (55,5%). Kit qua tren cho thiy kiln thirc thieu hut, khdng ddng diu ed thi la nguyen do dan din viec thyc hanh khdng dung.
Tap chi Y hpc dy phong. Tap XXI, sd 3 (121) 193
Ngudi dan d phudng Ly Thai Td (65,5%;
41,8%) cd kien thiic, thyc hanh dat cao hon ngudi dan d Hang Bai (30%; 20%) va cd sy khac biet (p < 0,05). Nhu vay, noi cd nhilu ca benh SXHD (Ly Thai Td) thi cac hoat dgng phdng chdng SXHD dugc trien khai nhieu, thudng xuyen hon nhu chien dich VSMT, chien djch truyen thdng ... ddng thdi d dd ngudi dan ciing quan tam ve benh hon, nen thuc hanh PCB SXHD cung dugc bd sung, cung cd ban.
Ket qua nay chung td d phudng Ly Thai Td la noi cd nhieu ngudi mac SXHD thi cac hoat dgng phdng chdng SXHD trien khai thudng xuyen va ngudi dan cung quan tam hon ve cdng tac PCB. Phudng Hang Bai da nhieu nam khdng ed ea benh nen ngudi dan it de y va boat dgng ve phdng chdng SXHD it dugc quan tam hon. Ket qua nghien ciiu ciing chii de d xa Dai Yen huyen Chuong My nam 2003 va 2 phudng Thjnh Liet va Tran Phu quan Hoang Mai nam 2007, ty le nay deu thap hon phudng Ly Thai Td va Hang Bai [3], [4] chiing td rang kien thirc PCB SXHD cua ngudi dan ngay cang dugc nang cao, cdng tac truyen thdng giao due sue khde ve PCB SXHD thyc sy cd hieu qua, ddng thdi ngudi dan da quan tam ban ve sire khde cua minh.
4.2. Moi lien quan giira kien thurc, thvc hanh cua ngvdi dan doi vdi PCB SXHD:
Ty le ngudi dan thuc hanh dat ve phdng chdng SXHD d phudng Ly Thai Td thap (41,8%). Mat khac trong nghien ciru nay chiing tdi khdng tim thay mdi lien giira kien thirc, thyc hanh va nha cd bg gay. Mgt sd nghien ciiu da chi ra rang: mac du kien thiic phdng chdng SXHD ngay cang tdt, nhung nhieu ngudi van khdng thyc hanh. Theo ket qua cua mgt sd nude, tuy ngudi dan da biet rd noi mudi sinh san la DCCN, nhung DCCN cua hg van chua dugc bao ve [5]. Cac nghien ciiru cua Nguyen Nhat Cam d Quan Ddng Da nam 2001, Hd Thj Phuong Nhu d Dai Yen - Chuong My nam
2003, Dang Thj Kim Hanh d Thjnh Liet va Trin Phu nam 2007 cung khdng cd moi lien quan nay [3], [4], [6].
d phudng Ly Thai To, ngudi dan ap dung cac bien phap phdng benh SXHD tap trung chu ylu la: thu nhat phe thai phi lieu, day nip DCCN, diing vgt dien, thau riia DCCN (tren 47%). Ty le nay deu cao hon d phudng Thjnh Liet va Tran Phu nam 2007 [3]. Nhieu nghien ciru da khang djnh khi day kin cac DCCN thi se khdng cd bg gay, tuy vay viec day kin nap cac DCCN trong thuc te khdng dugc nhu mong mudn. Tai thuc dja nghien ciiu hau hit cac DCCN cd thi tich tren dudi 500 lit la tec i ndc va be tdn thi deu cd nap kin, nhung cung khdng it cac DCCN cd nap nhung khdng kin, nhu phuy, be cau, thiing. Cac bien phap khac nhu nam man, dimg huong, phun thudc mudi lai rat thap (dudi 31,8%). Cac ty le nay deu thap ban ket qua nghien ciiu d quan Ddng Da nam 2001, Dai Yen - Chuong My 2003 va phudng Thjnh LieL Tran Phu nam 2007 [3], [4], [6]. Cd le do kien thiie ciia ngudi dan ve biet noi mudi dau, thdi gian mudi ddt thap (neu d tren), hieu qua cua huong mudi va thudc diet mudi da giam, mat khac dieu kien kinh te ngay cang nang cao ngudi dan sii dung may dieu hda nhieu nen ngudi dan it sir dung. Ty le tha ca rat thap (4,5%), thap ban nghien ciiu d quan Dong Da 2001, Dai Yen - Chuong My 2003 va phudng Thjnh Liet, Tran Phii quan Hoang Mai nam 2007 [3], [4], [6]. Kit qua nay cung phii hgp vdi tinh trang vec to tren 2 dja ban nghien ciru.
Cd mdi lien quan thuan giura ve sinh ngoai canh vdi tinh trang nha cd bg gay Aedes d ca 2 phudng Ly Thai Thai Td va Hang Bai, nghTa la nha cd v? sinh ngoai canh khdng dat cd nhieu bg gay hon nha cd ve sinh ngoai canh dat. Mat khac ket qua dieu tra d bg gay ciia Ae. aegypti va Ae. albopictus ca 2 phudng diu chung la be ddi ciu. be canh, DCP F. Di^ng thdi
194
Tap chi Y hpc dy phong. Tap XXI, sd 3 (121)ty if nha cd vf sinh ngoai canh khdng dat d phudng Hang Bai cao hon phudng Ly Thai Td, phu hgp vdi kit qua bg gay dilu tra dugc (mat do bg gay Aedes albopictus Hang Bai cao hon Ly Thai To).
Kit qua nghien ciiru cho thiy mdi lien quan thuan giiia kiln thiirc vl PCB SXHD va thuc hanh phdng chdng SXHD d phudng Hang Bai. Ngudi cd kiln thiirc vl phdng benh tdt thi thuc hanh PCB tdt hon (p < 0,05). Tuy nhien trong nghien ciru nay van con 35% HGD d Hang Bai thyc hanh PCB SXHD khdng dat, nhung lai cd kiln thiic dat. Kit qua nay ndi rang, khdng phai tat ca nhung ngudi cd kiln thurc tdt la thyc hanh tdt, ma tir kiln thiic din hanh dgng edn ca 1 van de. Mat khac nghien curu nay chiing tdi chi phdng van 1 ngudi trong HGD, nlu ngudi dugc phdng vin cd kiln thiic phdng benh tdt, nhung hg khdng cd kha nang thuylt phuc hoac hg khdng quan tam den gia dinh thi thuc hanh se khdng eg ket qua tdt. Day CO the la nguyen do khdng tim thay mdi lien quan nay d phudng Ly Thai Td.
Nhu vay, de loai trir cac d bg gay Ae- des a 2 phudng Ly Thai Td va Hang Bai vi?c phai nang cao kiln thiirc song hanh vdi ky nang thuc hanh PCB SXHD cho ngudi dan va Y tl phai giiJ vai trd ndng cdt, chu dgng tham muu chinh xac, kjp thdi cho cip Uy, chinh quyen dja phuong, dl dua ra dugc kl hoach hanh dgng.
Chuyin doi dan chiln djch VSMT, truyin thdng giao due sure khde sang cac boat ddng mang tinh chit thudng xuyen, ddng thdi van ddng din tirng HGD quan ly diing each cac DCCN, nen giai phdng cac loai thiing, phuy chiia nude nhim muc dich "chilm chd" va thudng xuyen tieu hiiy cac phi lieu phi thai, tang cudng tha ca vao cac DCCN nhu phuy, thimg, be canh, be dgi cau.
V. KET LUi^N
Kien thurc ngudi dan d phudng Ly Thai
Td vl phdng chdng SXHD tdt ban ngudi dan d phudng Hang Bai (p < 0,05).
Ty le thuc hanh dat vl phdng chdng SD/
XHD ciia ngudi dan 2 phudng diu thip va ty le thyc hanh phdng chdng SXHD d phudng Ly Thai Td cao han phudng Hang Bai (p < 0,05).
Cd mdi lien quan thuan giira kien thirc va thuc hanh phdng chdng SXHD (p<0,05), ngudi dan cd kien thiic phdng chdng SXHD cang tdt thi thuc hanh cang dat.
Cd mdi lien quan nghjch gitra ve sinh ngoai canh vdi tinh trang nha cd BG Aedes (p
< 0,05), nha cd ve sinh ngoai canh cang tdt thi cang cd it BG.
Khdng cd mdi lien quan giira kien thirc.
thuc hanh ciia ngudi dan ve phdng chdng SXHD vdi tinh trang nha cd BG va nha cd ngudi mic benh SXHD.
TAI LIEU THAM KHAO
1. Trung tam Y tl quan Hoan Kiem (2008), Bdo cdo tdng ket cdng tdc Y te nam 2008.
Trung tam Y tl quan Hoan Kilm, Ha Ngi.
2. WHO (2007 ), "Dengue Net Global surveil- lance of dengue and dengue haemorrhagic fever (DHF)"
3. Hd Thj Phuong Nhu (2003), Thuc trgng vd mpt sd yiu Id lien quan den vec lo truyen benh SXHD lgi xd Dgi Yen, huyen Chuong A^ linh Hd Toy nam 2003. Luan van thac sy Y tl Cdng cdng Dai hgc Y te Cdng cdng.
4. Dang Thj Kim Hanh (2007), Thuc trgng vd mpt sSyiu to lien quan din qudn the mudi truyin benh sot Dengue/sot xuat huyet Den- gue tgi 2 phuong Thinh Liet vd Trdn Phu, qudn Hodng Mai, thdnh pho Hd Npi. ndm 2007, Luan van thac sy Y tl Cdng cdng, Dai hgc Y tl Cdng cgng.
5. Will Parks, Linda Lloyd (2007), Huong ddn lap ki hogch truyin thdng vd huy dpng cpng ddng phdng chdng sdt xudl huyet, Td chiirc T?ip chi Y hpc dy phdng, TSp XXI, sd 3(121) 195
Y te the gidi, Geneve.
6. Nguyen Nhat Cam (2001), Xdc dinh d Bp gay ngudn vec to truyen benh SXHD vd mpt sdyeu
Id lien quem d qudn Ddng Da thdnh phd Hd Npi ndm 2001, Luan van thac sy Y te Cdng cdng Dai hgc Y te Cdng cdng. Ha Ngi.
KNOWLEDGE AND PRACTICE ON DENGUE VECTOR CONTROL IN LY THAI TO AND HANG BAI COMMUNES, HOAN KIEM DISTRICT, HANOI CITY, 2009
Nguyen Hong Thanh , Vu Sinh Nam *, Nguyen Thi Kim Tien*, Phan Trong Lan * Center for Preventive Medicine of Dien Bien province,
* Ministry of Health, Hanoi
The knowledge and practice on dengue vector control were evaluated through descrip- tion and crossing study at two communes Ly Thai To (high prevalence of dengue) and Hang Bai (low prevalence of dengue), Hoan Kiem district, Hanoi city during 2009. 110 house- holds each commune were selected by random sampling. Householders were interviewed on dengue knowledge, and dengue vector con- trol practice. Indoor, outdoor environmental hygiene condition and Aedes larval positive warter containers in and around the houses were recorded. Research result showing that both vector species Aedes aegypti and Aedes albopictus were found at the two communes.
Knowledge and pratice on dengue and dengue vector control of Ly Thai To's inhabitant were higher than that of Hang Bai commune (p <
0,05). Positive relationship between dengue knowledge and dengue vector control practice and negative relationship between outdoor en- vironmental hygiene and Aedes larval positive houses were found at the study (p < 0,05). In- troducing fish, cleaning-up water containers, destroying discards, and improving active par- ticipant of community are appropriate dengue vector control measures recommended by au- thors for the two communes.
Key words: Dengue haemorrhagic fever (DHF), knowledge, practice, prevention
196 Tap chi Y hpc dy phong. Tap XXI, sd 3 (121)
