TCNCYH Phil truang 70 (5) -2010
children with acute diarrhea in pediatric ward. Results: The average number of drugs per prescription is high (4.5; 95% Cl: 4.4 - 4.6). ORT (94.2%), vitamin and enzyme (91.8%), anti - diarrhea (70.7%), transfusion solutions (66.5%), and antibiotics (49.1%) were common drugs prescribed for children with acute diarrhea. Mineral was prescribed only in 2.6% of all eases. The rate of antibiotic prescription for acute diarrhea was 89% in district hospitals, 51.6% in provincial hospitals and 15.1%
in national hospital. Conclusions: Over - prescription of drugs and antibiotics for acute diarrhea among children persists.
Keywords: prescription, acute diarrhea, antibiotics, hospital at all level
TINH HINH SLfC KHOE BENH TAT VA LOI SONG CUA NCaCfl DAN 5 HUYEN BA vi - HA NOI NAM 2009
• •
Tran Quynh A n h \ Nguyen Phddng H o a \ Nguyen Van Yen^, Nguyen Ngoc HiJng\ Vu Thj Vdng^
^Trddng Dai hoe Y Ha Ndi; ^Sd Y te Ha Npi
Day la mot nghien cdu phd'i hdp giufa TrUdng Dai hoc Y Ha Noi va TrUdng Dai hoc NU Ewha Han Qudc. Muc tieu: md ta tinh hinh sdc khde benh tat va mdt so hanb vi nguy cd lien quan den ldi sdng Ciia ngUdi dan d huyen Ba VI - Ha Ndi nam 2009. Doi ttfgng va phtfang phap nghien cffu: md ta cit ngang ngUdi trUdng thanh tren 18 tuoi, tong so cd 960 ngUdi da tU nguyen tham gia vao nghien cifu. Sd lieu dugc thu thap bing bd cau hdi thiet ke sin. Xd ly ya phan tich so lieu bang cac phin mem Access va SPSS. Thuat toin khi binh phuang (;f) dugc sd dung nhim so sanh sU khic biet gitfa cic nhdm. Ket qua: (1) Ve tinh hinh sdc khde ciia ngUdi dan: Ty le sdc khde binh thudng 72%. Ty le sdc khde rat tdt va td't d nam cao ban nO (7,4%o va 12,2% so vdi 2,7%o va 7,2%o), khac biet cd y nghia thong ke vdi p <
0,05. Ty le ngUdi cd bleu hien trieu chdng cua benh hd hap va benh tuin hoan tha'p (6% va 9%). Ty le tu khai bio dugc chin doin mic tang huye't ap, rd'i loan chuyen hda md mau rat thap (5,3% va 1%), chUa cd trUdng hdp nao da tdng dugc chan doan li mic dii thio dUdng. (2) Ve cac hanh vi nguy cd Hen quan de'n ldi sd'ng: 50,5% nam gidi hien tai dang hiit thud'c la. T'y le phu nU hut thud'c la thu dong la 27%. T'y le nam gidi hien dang ud'ng ruau la 77%. Ty le khdng tap the due deu dan cao, gin 90%.
Tif khoa: sdc khoe, benh tat, Idi sdng, hanh vi nguy cd
I n»AT»/A'».i n«r dich mdi nhd cum A H 1 N 1 , SARS. Cd nhdng
I. DAT V A N DE ' b benh tddng ehdng da khd'ng che ddcJc nay lai
Thdng tin v l tinh trang sdc khde v l benh tat bung phat nhd ta. Nguyen nhan eua benh dich cd y nghTa rat quan trong trong viec d i n h g i l dddc cho la do sd bung nd dan sd, d n h i l m mdi thdc trang sdc khde va phan anh nhu c l u v l trddng, thie'd cac cdng trinh ve sinh, nddc cham sdc sdc khde eua ngddi dan. Trong nhdng sach... va ca do xu the toan c l u hda hien nay.
nam g i n day, eung vdi sd p h l t trien eua n l n Ben canh dd, d e benh khdng n h i l m trung kinh te - xa hdi cua da't nddc, md hinh sdc eung cd ty le mac cao trong edng ddng nhd tang khde, benh tat eua ngddi dan da ed n h i l u thay huyet ap, d i i thao dddng, beo phi. Nhdng van ddi. CIc benh n h i l m trung chda cG cd xu hddng d l sdc khde nay d i u cd lien quan den e l c thdi giam, ben canh dd xua't hien them nhdng benh quen trong cude sd'ng nhd thdi quen ud'ng rddu,
hut thud'c la, it van ddng,... Theo thd'ng ke y te nam 2003, nhdm benh n h i l m khuan va ky sinh triing ed ty le mac ddng thd ba va ty le tuf vong ddng thd hai trong md hinh benh tat.
Ba Vi la huyen tan cung phia Tay Bac eua Ha Ndi vdi dan sd tren 26 van ngddi gdm 3 dan tdc ehu yeu la Kinh, Mddng, Dao. N l n kinh te cua huyen chu yeu dda vao ndng nghiep, nha't la chan nudi. N h i l u nam qua, Ba VI I I mdt ed sd thdc dja djch te hoc quan trong cua Trddng Dai hoe Y H I Ndi. Nam 2009 trong khudn khd hdp t i e gida Trddng Dai hoe Y H I Ndi va Trddng Dai hoc Nd Ewha Han Qud'c, mpt nghien edu v l tinh hinh sdc khde benh tat va ldi sdng theo hd eua ngddi dan da ddpc thifc hien tai huyen Ba Vi, Ha Ndi. Muc tieu:
1. Mo ta tinb binh sffc kboe benb tat cua ngffdi dan d buyen Ba Vi.
2. Mo ia mgt sd banh vi nguy cd lien quan den loi sdng cua ngffdi dan d buyen Ba Vi.
II. DOI TL/ONG VA PHU'ONG PHAP NGHIEN CLfu
1. Doi tddng nghien cii'u: ngddi trddng thanh tren 18 tudi tai huyen Ba Vi.
2. Phddng phap nghien cifu: md t l cat ngang 3. C8 mau va chon mau: I p dung cdng thdc tfnh cd mau cho nghien cdu md t l :
„ ^ '^1^2 X PQ - P) d^
Trong dd: n la cd miu can cho nghien cdu; d la do chinh xic tuyet dd'i, chung toi lay d = 0,04; chon p = 50%o (tdc 0,5) de co cd miu Idn nha't ip dung dugc cho nhieu muc tieu nghien cdu. Gd miu dUdc nhin vdi 1,5 (sai so' khi chon miu), vay n = 900 ngUdi. Lay them 10%o cho viec cd the ngUdi dan td choi tham gia nghien cdu. So ngUdi can dUdc chon la 990 ngUdi.
Chiing tdi tie'n hanh chon ta't ca ngUdi Idn tren
18 tuoi d cic cum cua Gd sd tht/c dia Dich td hoc Ba Vi cho den khi du cd miu thi difng.
So lieu ddac thu thap bang bd cau hdi thiet
ke sin.
D i l u tra vien I I e l c edng t i c vien cua Cd sd thdc dja Dich t l hoc Ba V l , I I nhdng ngddi cd kinh nghiem trong phdng van bang bp cao hdi.
Ta't ca d i l u tra vien d i u ddcJc tap hua'n ky trddc khi tien h i n h d i l u tra.
4. Phan tich sd^ lieu: nghien cdu sii' dung p h i n m l m Access 2000 de nhap so lieu, phan tieh so lieu bang p h i n m i n SPSS phien b i n 16.0. Thuat t o l n khi binh phddng (j^) ddac sd dung nham so s i n h sd k h i c biet gida cac nhdm.
Nghien edu sd dung mde y nghTa a = 0,05 va khoing tin cay la 95%.
Thdi gian nghien edu: thang 10/2009.
i n . K E T Q U A
1. Tinh hinh sifc khoe benh tat ciia ngddi dan huyen Ba Vi
Cd 960 ngddi td nguyen tham gia nghien cdu, trong dd cd 444 la nam gidi va 516 la nd gidi.
Bang 1 cho thay da so ngUdi tra ldi cho rang ho cd sdc khde binh thUdng (72%o). Ty le sdc khoe rat td't va td't d nam cao hdn nd (7,4%o va
l2,2%o so vdi 2,7%o va 7,2%o); p < 0,05.
Ve sU thay doi cin nang trong thing qua:
Khoang 70%o nam gidi va 60%o nd gidi khdng thay doi can nang. Ty le giam can d nam thap hdn nd (13,2%o so vdi 22,1 %o); p < 0,05.
Bieu dd 1 cho tha'y ty le de'n cd sd y te trong I nam qua la 27,1 %o, ty le nay d nd cao hdn nam gidi (p < 0,05), ty le da tdng hi tai nan, ty le thudng cam tha'y met mdi d nam deu tha'p hdn nd (p < 0,001). Trong dd ty le met mdi gap nhiSu nha't. Mot nda so phu nd va khoang 1/3 so nam gidi tra ldi thudng cam thay met mdi.
TCNCYH Phil truang 70 (5) -2010
Bang 1. Tinb binb sffc khoe Nam
n (%)
NCf n (%)
Tong n (%) Tinh trang sdc khde
Rat tdt* 33 (7,4) 14 (2,7)
Khdng bie't 52 (11,7) 51 (9,9)
' Khic biet cd y nghTa thd'ng ke p < 0,05.
60 50 40 30 20 10 0
D Nam la NCi'
50.6
JU-^ 30.6 23.4 ^ ^ 1 -
<>
H i . H
s!s-0:~iafs
• i i
36.7
WM
l i i i •
^5S'^'|fll
iiv£M&^k
Den CSYT 1 nam Da bi tai nan Met moi qua
Bieu do 1. Mgt sd cbi sd vc tinb binb sffc kboe Bang 2. Tinb hinh benb tat
Nam NCf
47 (4,9) Td't*
Binh thddng Kem Rat kem Thay ddi can nang trong t h i n g qua
Tang can G i l m can*
Khdng thay ddi
54 306 27 24
27 58 307
(12,2) (68,9) (6,1) (5,4)
(6,1) (13,1) (69,1)
37 388 49 28
47 114 304
(7,2) (75,2) (9,5) (5,4)
(9,1) (22,1) (58,9)
91 694 76 52
74 172 611
(9,5) (72,3) (7,9) (5,4)
[7,7) (17,9) (63,6) 103 (10,7)
Tong
Cd trieu chdng hd ha'p
Cd trieu chu'ng benh t u i n hoan t)a tdng p h l u thuat
n 25 35 46
(%) (5,6) (7,9) (10,4)
n 33 51 79
(%) (6,4) (9,9) (15,3)
n 58 86 125
(%) (6,0) (9,0) (13,0) Tang huyet ap
Dai thao dddng
Rd'i loan chuyen hda md m l u
22 (5,0) 0 (0,0) 6 (1,4)
29 (5,6) 0 (0,0) 4 (0,8)
51 (5,3) 0 (0,0) 10 (1,0) Bang 2 cho thay ty le ngUdi tif bio cio cd bieu hien tneu chdng ciia benh hd ha'p va benh tuin hoan thap (6% va 9%o). Ty le da tdng phiu thuit d nd cao hdn nam, ty le chung la 13%o. Ty le dUdc chan doin mic tang huye't ip, rd'i loan chuyen hda md mau rat tha'p (5,3%o va 1%o), khdng cd
trudng hgp nao da tdng dugc chan doan la mic dii thao dUdng.
2. Mot sd^ hanh vi nguy cd lien quan den loi song
Bang 3. Mgt sd hanb vi nguy ca lien quan den Idi sdng Nam
n (%)
Nu' n (%)
Tong n (%) Hut thud'c la
Khdng hut Da tdng hut Hien tai dang hut Hut thud'c la thu ddng
135 85 224 134
(30,4) (19,1) (50,5) (30,2)
514 1 1 139
(99,6) (0,2) (0,2) (26,9)
649 86 225 273
(67,6) (9,0) (23,4) (28,4) Udng rddu
Khdng Da tdng ud'ng hben dang ud'ng Cd tap the due d i u dan
81 20 343 60
(18,2) (4,5) (77,3) (13,5)
497 1 18 28
(96,3) (0,2) (3,5) (5,4)
578 21 361 88
(60,2) (2,2) (37,6) (9,2)
Bang 3 cho tha'y mdt nda sd nam gidi tra Idi hien tai dang hiit thud'c li trong khi hiu nhu toan bo phu nd tra Idi khdng hiit. T'y le phu nO tra Idi cd hit phai khdi thuoc ngUdi khic hiit (hiit thuoc la thu ddng) la 27%o, tUang duang vdi ty le nay d nam gidi.
Ty le nam gidi tra Idi hien dang ud'ng rddu kha cad (77%) trdng khi ty le nay d nd ehi ed 3,5%. Ty le cd tap the due deu dan tha'p, g i n 10%, nhd vay cd nghTa la khoang 90% khdng tap the due d i u dan.
Nam NiJ' Chung
D Khong hoat dong E3 Co boat dong
M It boat dpng 0 Hoat dong nhi§u
Bieu do 2. Mffc do boat dgng than the
Bleu do 2 cho tha'y da so ngUdi tra Idi cd mde do hoat dong than the nhieu (72,4%o). T'y le nay d nam cao hdn nd nhifng sU chenh lech khdng dang ke (p > 0,05).
TCNCYH Phil truang 70 (5) -2010
III. BAN LUAN
1. Tinh hinh su'c khde
Ket q u i nghien cdu eho thay da sd ngddi dan cd sdc khde td binh thddng den tdt va rat td't (khoing 87%). So cdn lai rdi v i o nhdm sdc khde kem va rat kem (khoang 13%). Ty le nay tha'p hdn ty le ngddi td 1 5 tudi trd len d ndng thdn td d i n h gia sdc khde y l d trong D i l u tra Y te Qud'c gia 2001 - 2002. Ty le tren eua D i l u tra Y te Qudc gia 2001 - 2002 la 16,7%.
Mot diem dang ehu y I I ty le sdc khde td't v l rat td't d nam v l nO k h i c biet cd y nghTa thd'ng ke (p < 0,05). Theo ket q u i nay thi sd phu nd t r i Idi cd sdc khde tdt va rat td't tha'p hdn nam gidi. Tinh hinh nay ed the la do nam gidi td tin hdn phu nd khi danh g i l tinh trang sdc khde b i n than v l nam gidi it de y de'n d e da'd hieu bat thddng khi cdn q u i nhe, eung ed the dd vai trd sinh de eua phu nd va g i n h nang edng viee ndi trcs, nudi eon ma phu nd khdng d m tha'y sdc khde ddcic td't va rat td't nhd nam gidi.
Hdn mot nda so ngddi ddcJc hdi khdng ed sd thay ddi can nang trong thang qua. Thdng thddng ngddi dan d ndng thdn it khi chu y theo ddi can nang nen chi khi sd thay ddi rat d i n g ke ho mdi p h l t hien ra. Hdn nda dd'i tdcSng nghien cdu d i u la ngddi trddng thanh, Ida tudi da dn dinh ve sd phat trien the ldc. Ty le phu nd giam can trong t h i n g qua cao hdn nam gidi (cao hdn khoing 10%) cd the la do phu nd quan tam den sdc khde cua ban than hdn nam gidi.
Nghien edu da dda ra mdt so ehi so v l tinh hinh sdc khde nhd ty le den ed sd y te met nam qua, ty le da tdng bi tai nan, ty le thddng e l m thay met mdi. C l 3 ty le nay d nd d i u cae hdn nam. Dae biet ed tdi 5 0 % phu nd t r i Idi thddng cam tha'y met mdi, d i l u nay the hien nhdng ganh nang ma phu nd phai chju du'ng trong cuoc sd'ng I n h hifdng den sdc khde khdng chi v l the- chat ma edn v l tinh t h i n .
Vdi da sd ngddi dan (87%) td danh gia ed tinh hinh sdc khde td trung binh trd len, nen ty
le cd bieu hien trieu chdng benh, ty le m l e mot sd benh khdng cao. Ty le cd bieu hien trieu ehdng benh hd ha'p, t u i n hoan la 6,0% va 9,0%
(bang 2). Dac biet ty le mac d e benh trong nhdm benh khdng lay rat tha'p. Khdng ed ai da tdng ddac chan doan d i i thao dddng, ty le tang huye't I p 5,3%, ty le da ddcic chan doln rd'i loan md m l u chi cd 1%). Day I I ty le do ngddi dan td khai b i o , e i n ed d e nghien edu chuyen biet v l e l c benh nay de danh g i l day chda phai la van d l sdc khde d viing ndng thdn hay edng t i e p h l t hien va ehan d o l n e l c benh nay tha'p hdn n h i l u so vdi thdc trang .
2. Mot sd hanh vi nguy cO lien quan den loi sdng
Mot nda sd nam gidi ddcic hdi t r i Idi hien dang hut thud'c la (50,5%) (bang 3). Ty le nay tddng dddng vdi ty le nam d ndng thdn hiit thud'c la trong D i l u tra y te qud'c gia 2001 - 2002 (56,4%). G i n nhd toan bd phu nd khdng hut thud'c la (99,6%). Day cung la dac diem chung eua phu nd d e l e vung ndng thdn Viet Nam td bao ddi nay. Ty le nd d ndng thdn hut thud'c trong D i l u tra y te qud'c gia 2001 - 2002 eung rat tha'p, ehi cd 1,8% [2|.
Ty le nam gidi hien dang ud'ng rdciu kha cao 77°/o, cao hdn n h i l u so vdi ty le nam gidi d ndng thdn udng rddd cda D i l u tra y te qud'c gia 2001 - 2002 la 4 6 % [2]. Theo mpt nghien cdu eua Kim Bio Giang nam 2004 v l tinh hinh sd dung rddu bia d nam gidi thudc huyen Ba Vi, thi ty le nam gidi d Ba Vi ud'ng rdciu bia la 87,5% [3|.
Ty le ngddi cd tap the due deu dan trong nghien edu nay edn tha'p, k h o i n g 10%. Mac dii vay, khi dddc hdi v l mde dd hdat ddng than the, thi da sd' d i u tra Idi la d mde do boat ddng n h i l u (72,4%) (bleu do 2). TJilu nay phan anh thdc te g i n h nang lao ddng eua ngddi dan d
ndng thdn khi ma edng viec chu yeu la n g h i ndng. Lieu cd phai chinh do mde do hoat ddng than the n h i l u ma ty le ngddi dan ed tinh trang sdc khde kcsm tha'p (khoang 1 3%) hay khdng?
III. KET LUAN
Tinh hinh sdc khde: sdc khde binh thddng 72%. Ty le sdc khde ra't tdt va td't d nam eao hdn nd (7,4% va 12,2% so vdi 2,7% va 7,2%) (p < 0,05). T"/ le ngddi ed bieu hien trieu ehdng cua benh hd ha'p va benh t u i n h o l n tha'p (6%
va 9%). T'/ le tu' khai b i o dddc ehan doan m l e tang huyet I p , rd'i loan chuyen hda md m l u rat tha'p (5,3% va 1%).
Hanh vi nguy ed lien quan de'n ldi sd'ng:
50,5% nam gidi hien tai dang hut thud'c la. Ty le phu nd hut thud'c I I thu ddng la 27%. Ty le nam gidi hien dang ud'ng rdeju I I 77%. Ty le khdng tap the due d i u dan cao, gan 90%.
72,4% ed mde dp hoat ddng than the nhieu.
TAI LIEU THAM KHAO
1. Bo Y t e (2003). Nien g i l m thd'ng ke y t e . 2. Bo Y te - Tong cue thd'ng ke (2003). B i o cao ket qua D i l u tra y te Qud'c gia 2001 - 2002.
Nha xua't ban Y hoe.
3. Kim Bao Giang, Nguygn Duy Luat (2007).
Tinh hinh sd dung rddu bia d nam gidi thudc huyen Ba V l , H I Tay. Tap chf Y hoc thdc hanh sd 585. 9 3 - 9 7 .
4. WHO (2004). Global Status Report Alcohol.
5. Nguyen Hoang Thanh, Hoang Van Minh (2007). Nghien cdu tinh hinh sdc khde cua ngddi trung nien va ngddi eao tudi tai huyen Ba vi tinh Ha Tay nam 2006. Tap chi Y hoc thdc hanh sd585. 76 - 80.
Summar
HEALTH STATUS, DISESES AND LIFE STYLE OF PEOPLE LIVING IN BAVI, HANOI IN 2009
This research is cooperated by the Hanoi Medical University - Vietnam and the F:wha Women University - Korea. Objective: to describe the health status and diseases of people who live in Bavi Distric:t - Hanoi in 2009 and some health risk behaviours in their lifestyle. Research subjects are the adults over 18 ages. There are 960 people who volunteered to take part in this study. Method:
cross - sectional descriptive study. The questionnaires was applied to collect data and these data were analysised by the softwares Access and SPSS. Test Chi - squares (x^) was used to compare the difference among groups. Results: 1, Regarding people's health status: 72% people have normal health. The rate of very good health and good health in male is higher than in female (7.4% and 12.2% compared to 2.7% and 7.2%), this difference is statistical significance with p < 0.05. The rate of people have some symtoms of the respiratory disease and the cardiovascular disease is low (6% and 9%). The rate of people who declare that they were diagnosed to suffer hypertension and lipydostrophy is very low (5.3% and 1%), no cases were diabetes. 2, Regarding risk behaviours related to lifestyle: 50.5% male are currently smoking, 99.6% female is no smoking. The rate of female who are second - smoking is 27%. The rate of male who are currently drinking alcohol is 77%. 1 0% people do the physical cxcercises regularly. 72.4% have high physical activity level.
Keywords: health, diseases, lifestyle, risk behaviours
TCNCYH Phil truang 70 (5) -2010
NGHIEN CLfu TINH HINH MAC CAC TRIEU CHLfNG CAP TINH THUOC H O I CHU'NG THUOC LA XANH 6 NG\J6i NONG DAN
TRONG VA CHE BIEN THUOC LA 5 XA LAU T H U O N G ,
HUYEN VO NHAI, THAI NGUYEN VA CAC YEU TO LIEN QUAN
Kim Bao Giang, Hoang Van Minh TrUdng Dai hoc Y Ha Ndi
Hdi chdng thud'c la xanh thifdng gap d ngUdi ndng dan trdng thud'c li. Hoi chdng nay bao gom nhieu trieu chifng nhU budn ndn, ndn, met mdi, choing vang, thinh thoang thay dd'i dot ngdt huyet ip va nhip lim, v.v. Muc tieu: nghien cdu nay nhim (1) md ta tlnb hlnb mic cac trieu chdng thudc hdi chifng thud'c la xanh d ngUdi ndng dan trong va che bie'n thud'c la; (2) phan tich md'i lien quan giu'a tlnb hinh mic cac trieu chdng thudc hgl chdng thud'c la xanh va mgt so ye'u to kinh te, van hda va thdi gian tham gia ttrong va che bie'n thud'c la. Doi ttfgng va phtfang phap nghien cffu: nghien cdu md ta cat ngang tren 597 dd'i tugng tif 15 tuoi trd len d xa Lau ThUdng, Vd Nhai, Thai Nguyen. Phdng van ca nhan difgc thUc hien sd dung bg cau hdi phdng van cd ca'u triic. Thong tin ci nhan, thdng tin ve cac trieu chifng thuoc hoi chifng thud'c li xanh da mic trong mgt thang trUdc ngay phdng van va thdng tin ve thdi gian tham gia trong che bie'n thudc la dugc thu thap. Ket qua: fy le mic it nhat mgt trieu chifng thudc hdi chdng trong 1 thang la 40,2% (33,9 % d nam va 46,4% d nO); sd trieu chdng mic trung binh la 1,4 (1 d nam va
1,8 d nU), so trung vj ciia so cic trieu chifng mic trong so ngUdi cd dm la 3. NU cd ty le mic cao ban nam 1,7 lin; ngUdi trdng va che bien thud'c li tif 20 ngay/thing trd len cd nguy ca mic cao gap 6,1 lin so vdi ngifdi chi lam 10 ngay/thang. Ket luan: cd md'i Hen quan chat che giifa thdi gian tham gia trong va che bie'n thud'c li vdi mic trieu chdng ciia hgl chdng thud'c la xanh. Phu nO, hgc van tha'p va kinh te kem la ye'u to dU bao ciia mic cac trieu chdng nay cao hdn.
Td khoa: trieu chdng cap tinb, hoi chdng thudc la xanh, nong dan trdng thudc la
I. DATVAN DE
Theo mdt sd nghien edu nguy cd ddi vdi sdc khde cua nhdng ngddi trdng thud'c I I x l y ra trong toan bd q u i trinh trdng trot thud'c I I , ngay td khi bat d i u gieo hat eho den khi thu hoach [2, 4, 7].
Theo d c nghien cdu, thddng xuyen hai v l tiep xue vdi cay thud'c I I khien ngddi ndng dan ed the mac hdi chdng thudc la xanh, I I mot dang n h i l m doc do chat nicotine ngam qua da trong q u i trinh td khi trdng, eham sdc de'n thu hoach. Hdi ehdng nay cd eac trieu chdng dien hinh budn ndn, ndn, met mdi, choang vang, thinh thoing thay ddi dot ngdt huyet ap va nhip tim [4, 7]. De gdp p h i n tim hieu thdc trang mac e l e trieu chdng nay d ngddi ndng dan trdng thud'c II d Viet Nam, chung tdi thdc hien nghien cdu n l y vdi muc tieu:
1. Mo ta tinb binb mac cac trieu chffng tbugc boi cbffng tbudc la xanh d ngffdi nong dan trong va cbc bien tbudc la.
2. Phan ticb mdi lien quan giffa tinb binb mac cac trieu cbffng thuoc boi cbffng thudc la xanh va mgt sd ye'u td kinh te, van boa, va thdi gian tham gia trong va che bien tbudc la.
II. DOI TL/gfNG VA PHUONG PHAP NGHIEN CL/U
1. Thiet kc nghien diU
Nghien cdu md t l eat ngang dddc tien hanh tren nhdng ngddi ndng dan td 15 tudi trd len trong gia dinh trdng va che bien thud'c I I tai xa Lau ThdcJng, huyen Vd Nhai, tinh Thai Nguyen td t h i n g 02 den thang 06/2010.
2. Cd mau va chon m l u : sd dung cdng thdc tinh ed m l u eua To chdc Y te The gidi cho nghien edu md t l , vdi mde y nghTa a = 0,05; ty- le mac it nha't mot trieu ehdng p = 0,25 va dp ehinh x l c tddng dd'i 6 = 0,2. Vdi he sd' thiet ke la 2, cd mau cud'i cung la n = 578 ngddi. Cd mau tddng dng vdi sd' ngddi tren 15 tudi trong 200 hd gia dinh. C I c hd gia dinh dddc chon theo phddng phap chon mau n h i l u giai doan:
chon sd hd trong tdng thdn tddng dng vdi ty le sd dan eua e l c thdn trong xa; trong tdng thdn, chon nhdng ho gia dinh ed dien tich trdng thud'c la td eao xud'ng thap cho de'n khi du ed m l u cua thdn dd. Ta't ca thanh vien cua 200 hd gia dinh dddc ehdn da ddng y tham gia nghien edu.
3. Chi so nghien cifu chinh: ty le mac tdng trieu chdng thude hdi chdng thude la xanh; so trieu ehdng trung binh da mac trong mdt thang trddc ngay phdng van theo tdng nhdm; ty sua't chenh mac it nha't mot trieu chdng td phan tich hdi quy logistic theo e l e nhdm kinh te, van hda va xa hdi.
4. XiJ I'y va phan tich so' lieu: so' lieu dddc iam sach va nhap sCs dung phan f m l m Epidata, phan tieh bang STATA 10. Thd'ng ke md ta gdm tinh t i n sua't, ty le hien mac, trung binh va trung vj sd' trieu ehdng hien mac.
Thd'ng ke phan tieh gdm phan tich hdi quy logistic de tinh t o l n ty sua't ehenh mac it nhat mgt trieu ehdng thude hdi ehdng thud'c la xanh d cae nhdm kinh te, dan so, van hda va thdi gian tham gia vao trdng va che bien thud'c I I . Thdi gian n l y dddc tinh thdng qua hdi sd' ngay lam viee cho tdng hoat ddng: lam da't, gieo hat, trdng, cham sdc, bdn phan, chat tang trddng, thu hai, say va Idu trd thude I I . Sd gid trung binh trong mdt ngay lam viee ddac thu thap.
Tdng thdi gian tham gia sau dd ddcic cdng lai theo tdng hoat ddng va ehia cho 8h lam viec de ra sd ngay lam viee trong thang (Tdng thdi gian
= Z (sd ngay x sd gid)).
5. Dao dufc nghien cu'u: ddi tdcing dddc g i i i thieh rd v l mue tieu va ndi dung nghien cdu.
Chi dd'i tddng ddng y mdi ddcic lifa chcpn.
IN.KETQUA
Ket q u i nghien edu gdm thdng tin thu ddcic td 200 hd vdi tdng so 597 ngddi. So dd'i tdcing la nam ehiem 49,4%. Nhdm ed dd tudi td 1 6 - 24 ehiem 19,2%; td 25 - 44 chiem 44,4%, td 45 - 60 ehiem 26,5% v l tren 60 tudi chiem 9,3%.
v l trinh dd hoc van ty le thude nhdm dddi tieu hoe la 12,7%; td't nghiep tieu hoe la 2 3 , 1 % ; td't nghiep trung hoc ed sd I I 48,6%; td't nghiep trung hee phd thdng trd len la 16,6%. Se dd'i tdc?ng thude ho gia dinh kinh te kha trd len ehiem 7,4%, thude kinh te trung binh chiem 67,3%, thudc kinh te ngheo va can ngheo chiem 25,3%.
Trong so nay cd 40,2%o ngUdi mic it nha't mot trieu chdng trong vdng 1 thing trUdc ngay phdng van, ty le d nam la 33,9 % va nif li 46,4%o. So ngUdi cd 3 trieu chdng trd len chie'm 20,6%o. Trong so cac trieu chdng, ty le cd met mdi la cao nha't d ca nam vi nd, chie'm 25,5%o trong dd nO mac trieu chdng nay nhleu han nam. Cac trieu chdng pho bien tiep theo la dau nhdc dau, dau mdi ngUdi, cam ciim, hoa mit chdng mat. Vdi tat ca cac trieu chdng, nQ cd xu hudng mac cao hdn nam [bang 1).
So trieu chdng mic phai trong mot thing trUdc ngay phdng van thap nhat la 0 va cao nhat la 16 trieu chdng (d nd) va 13 trieu chdng (d nam). So trieu chdng d'm trung binh cua miu nghien cdu la 1,4 (1 d nam va 1,8 d nd). Ne'u tinh trong so nhu'ng ngUdi bi dm, so trieu chdng d'm trung binh la 3,4 (2,9 d nam va 3,8 d nd), gia tri trung vi ve so trieu chdng dm d nam la 2 vi d nd li 3. Nhu vay nO khi bi d'm cd xu hudng mic nhiSu trieu chdng hdn nam gidi (bang 2).
