Y HOC VIET NAM THANG 5 - SO 2/2014
TAi LIEU THAIVI KHAO
1. Au Thanh Tung, "The contribution of polymerase chain reaction (PCR) to the diagnosis of tuberculous pleurisy", Y Hoc TP. Ho Chi Minh, Special issue of internal medicine - Voi. 5 - Supplement of No 2 - 2001, pp. 29 - 34).
2. Kumar P, Sen MK, Chauhan DS, et al.,
"Assessment of the N-PCR assay in diagnosis of pleural tuberculosis: detection of M. tuberculosis in pleural fluid and sputum collected in tandem", PLoSOne, 2010, 5 (4), pp. el0220.
Martins LC, Paschoal IA, Von Nowakonski A, et al., "Nested-PCR using MPB64 fragment improves the diagnosis of pleural and meningeal tuberculosis". Rev Soc Bras Med Trop, 2000, 33 (3), pp. 253-7.
Maurya AK, Kant S, Kushwaha RA, et al., 'The advantage of using IS6110-PCR vs. BACTEC culture for rapid detection of Mycobacterium tuberculosis from pleural fluid in northern India", Biosci Trends, 2011, 5 (4), pp. 159-64.
,^r
KIEN THU'C THAI DO VE PHONG CHONG HIV/AIDS
COA N G U O I DAN HUYEN DONG Ht, THAI N G U Y £ N NAM 2013
T6IVI TAT
MMC tt^u: Mo ta ki§n thirc thai dd ve phong chong HIV/AIDS va xac djnh mot so y^u to lien quan den Wen thii'c, th^i dp vS phong ch6ng HIV/AIDS ciia ngu'di d3n 6 xa Hoa ThuWng va Quang Sdn, huyen Dong M^, tinh Thai Nguyen. Doi tu'dng v i phu'dng phdp: NghlSn ciTu md ta cSt ngang co phSn tfch tl€'n h^nh trSn 400 ngu'cfi dan tuoi tir 15- 49 dang sinh s5ng tai 2 xa Hoa Thi/png va Quang Sdn. Ket qua:
95,0%'ngu'di dan biet HIV/AIDS lay qua quan he tinh dye khSng an toan; dung chung bdm kim tiem (89,8%)j^ truyen mSu (78,0%)^. 8,2% ngu'di dan dio rSng muoi, con trung dot co the lay truyen HIV. 81,8%
ngu'di dan biet nguyen nhan gay benh HIV/AIDS do vi nit; biet doi tu'dng co nguy cd bj lay nhiem HIV/AIDS la ngu'di mua ban dam (97,8%), tiem chich ma tuy (97,2%), nhin vien y te (38,8%) va Ial xe du'dng dai (26,0%). T';' le ngu'di dan co thai dd binh thu'dng vdi ngu'di HIV/AIDS IS 54,0%, con 13,0% ngu'di dan co bleu hl§n xa Icinh vdl ngu'di bj nhiem HIV/AIDS. Co mm lien quan giij^ trinh d$ hpc v3n vdl hieu biet ve HIV/AIDS cung nhu' co moi lien quan giii^a trinh dp hpc Vein v^ thSi dp phong diong HIV/AIDS.
Tie khoi: Ki^n thirc, thai do, phong chSng HIV/AIDS.
SUMIVIARY
KNOWLEDGE A N D ATTITUDE TOWARDS H I V / A I D S PREVENTION AMONG PEOPLE
I N DONG HY D I S T R I C T , T H A I NGUYEN PROVINCE I N 2 0 1 3
Nguyin Minh Tuin*
* Tr^ng D^l hpc Y Dugc Thai Nguyen Phan bi^n khoa hgc: GS.TS Hoang Khai L^p
Objective: To describe knowledge, attitude towards HIV/AIDS prevention and to identify several risk factors related to HIV/AIDS prevention in residents at Hoa Thuong and Quang Son communes in Dong Hy district. Subjects and method: An analytic, cross- sectional descriptive study conducted on 400 people, aged 15-49, living in above communes . Results:
95.0% of people knew HIV/AIDS transmitting through sexual intercourse; sharing needle or sharing (89.8%);
blood transfusion (78.0%). 8.2% of people said that HIV/AIDS could be transmitted by mosquitoes and insects. 81.8% of people knew HIV/AIDS caused by vims; subjects were at high risk of HIV/AIDS to be the commercial sex (97.8%), injection drug users (97.2%), health workers (38.8%) and long distance drivers (26.0%). The percentage of people with the positive attitude to HIV/AIDS was 54.0%. However, 13.0% of people had the negative attitude to people Infected with HIV/AIDS. There was an association between level of education and understanding about HIV/AIDS as well as between educational level and attitude regarding HIV/AIDS.
Keywords: Knowledge, attitude, HIV/AII3S prevention and conb^ol
I. OAT V A N OE
AIDS la mpt dai djch anh huidng \xi\ moi ngi/di dan d tat ca luc dia tren toan the gidi. S6 lieu tir UNAIDS chi ra rSfig is thdi diem cuoi nSm 2011 tren the gidi co khoang 34 tri^u ngu'di dang s6ng chung vdi AIDS, l/dc tinh khoang 0,8%
ngu'di tru'dng thanh tuoi tir 15-49 tren toan the gidi dang song chung vdi HIV. 6 Vi^t Nam, tinh den ngay 31/5/2013, so tru'dng hdp n h i l m HIV
Y HOC VIET NAM THANG 5 - SO 2/2014
hien con song la 213.413 tru'dng hdp. So benh nhan AIDS con song la 63.373 tru'dng hdp va hdn 65.000 tru'dng hdp tu" vong do AIDS. Ty le nhiem HIV toan quoc theo bao cao la 243 ngu'di tren 100.000 dan, trong do Thai Nguyen la dia phu'dng co ty le ngu'di nhiem HIV du'ng thi^ 3 toan quoc (610,6/100.000) [1]. Hoa Thu'dng va Quang Sdn la 2 xa thupc huyen Dong Hy, ndi co so ngu'di nghien chich ma tuy chiem tj- Ie kha cao, nhuhg kien thirc thai dp phong chong HIV/AIDS ciia ngu'di dan trong cpng ^ n g con han che, Tim hieu kien thirc thai dp ve phong ciiong lay nhiem HIV/AIDS ciia ngu'cfi dan nham de ra mpt so giai phap phii hdp nang cao sir hieu biet ve benh va phong benii cho ngu'di dan la mpt v i ^ lam can thiet. Vi the de tai du'dc tien hanh nhSm muctieu:
1. Mo ta kien thut thai do ve phdng chong HIV/AIDS cua ngudi dan xa Hoa ThUdng va Quang Sdn, huyen Dong Hy, tinh Thai Nguyen nSm2013.
2. Xac djnh mgtsoyeu tdlien quan din kiin thut, thSl do ve phong chong HIV/AIDS cua ngudi dan d xa Hod ThWdng va Quang Sdn, huygn 0dngH-y', tinh ThaiNguyen.
W. Ofii TU'ONG VA PHU'aNG PHAP NGHIEN COXI 2.1. Offi tu'ang, dja diem vd thdi gian nghign cit\x
Nghien ciru du^c tiSn hcinh tren doi tu'dng la ngu'di d3n tuoi tir 15- 49 dang sinh song tai 2 xa Hoa ThuWng va Quang Sdn, huyen Dong Hy, tinh Thai Nguygn vao thang 6 nSm 2013,
2.2. Phu'dng phdp nghien cu'u 2.2.1. Tliiet ki ngliiin ah/: Nghien citu mo ta, thi€t ke cSt ngang phan tfch.
2.2.2. Cff mSu vi p/tuVng p/tdp c/jpn mau - C3 mau: dp dung cong thu'c tinh cd mau mo ta 11/1^ du'dc cd mau toi thieu la 385, cong them 5% va l^m tron thanh 400 ngudi.
- Chpn mau: chpn chu dich 2 xa co ty te ngu'di nghl$n ma tiiy va nhiem HIV cao ta xa Hoa Thu'dng vh Quang Sdn. Phan bo mau ngang bang
cho 2 xa, mot xa 200 ngu'di va chpn theo phi/dng phap ngau nhien ddn. Trong tru'dng hdp ngu'di du'dc chpn vang mat dai ngay tai dja ban nghien cuU thi chpn ngu'di 15-49 tuoi cung ho gia dinh de thay the.
2.3. Chi tieu nghien cuti va each danh gia - Dac diem nhan khau hpc: tuoi, gidi, dan tpc, trinfi dp hpc van, tinh trang hon nhan.
- Kien thirc ve HIV/AIDS: du'dng lay truyen, tac nhan gay benh, doi tu'dng nguy cd, trieu chuhg benh AIDS.
- Thai dp ve HIV/AIDS: doi xu" binh thu'dng, xa lanh, hoac giup dd.
- Cac cau tra ldi deu du'dc lu'dng hoa bang each cho diem tren nguyen tac tra ldi dung cho 1 diem, tra ldi sai cho 0 diem. Doi vdi kien thiTc, neu tra ldi dudc >50% so cau hoi duWc danh gia la CO kien thirc tot, neu tra ldi <50% so cau hdi du'dc danh gia la kien thu'c kem. Doi vdi thai dp, neu dat > 50% so cau hoi du'dc danh gia la co thai dp tich ci/c, neu dat <50% du'dc danh gia la thai dp tieu cu'c.
2.3. Phu'dng phap thu th$p sff ii$u Phong van bang bp cau hoi ty dien: doi tu'dng nghien culi tra ldi cau hoi du'di siTgiam sat ho trd cua dieu tra vien de giai thich cac cau hoi neu ngu'di dan chu^ hieu.
2.4. xa iy va phdn tfch so li^u So lieu du'dc xii ly va phan tich tren phan mem SPSS 18.0 bang cac thuat toan thong ke y hpc, ili.KETQUANGHlENCl^U
Trong so 400 ngu'di dan 15-49 tuoi du'dc phong van, ngu'di dan tpc Kinh chiem ty 1^
66,5%, dan tpc thieu so chiem ty Ie 33,5%, ty 1$
nam va nu' gan tu'dng du'dng (46,0% la nam, 54% la nu^, trinh dp hpc van tir trung hpc pho thong trd len chiem ty le cao nhat (63,8%), tiep theo la tmng hpc cd sd (32,2%) va tir tieu hpc trd xuong (4,0%).
3.1. Kien thuTc ve HIV/AIDS ciia ngu'di ddn fld/iffl 1. KIgn thu'c ve dudng lay truyen HIV/AIDS
Ou'6nq I3v truvSn BSt tay
MuSi, con trunq dot
Ouan he tinh dgc khonq dunq bao cao su Truyen mau
DCrnq chunq txAn kim tiem
M5c chunq quSn ao ydi nqUdi bl nhiem HIV/AIDS
So lu'dng (n=400) 32 33 380 312 359 14
Ty l« »/o 8,0 8,2 95,0 78,0 89,8 3,5
Y HOC VIET NAM THANG 5 • SO 2/2014
Bang 1 cho thay ty Id ngddi dan cd hieu biet dung ve dudng Idy truyen HIV kha cao^ nhd quan he tinh due khdng dung bao cao su, ddng chung bdm kim aim, truyen mau. Tuy nhien van din 8,2% ngu&i dan cho rang HIV/AIDS cd the lay khi 6/ muoi dot va 8,0% cho rang HIV/AIDS cd the lay qua bdt tay hoac mac chung quan ao vdi ngddi bi nhiem HIV/AIDS (3,5%).
Bang 2. Kien thu'c ve tac nhan qay Tac nhan gay benh Virut
Khonq biet
benh HIV/AIDS So Pu'dng (n=400)
35 327 38
Tv le °/o 8,7 81,8
9,5
Bang 2 cho thay van con 9,5% ngddi din khdng biet hoac hieu sai ve tac nhan gay benh HIV/AIDS S do vi khuan (8,7%).
Bangs. KIgn tiiiic ve dol tUdna co nquy cd cao bl lav nhiem HIV/AIDS Nhdm nguy cd cao
Nqu'di mua ban dam Nqu'di tiem chich ma tuy Nqu'di buon ban ma tuy Nhan vien y te Lii xe dudnq dai Khonq biet
So lu'dng (n=400) 391 389 45 155 104 1
Ty la o/o 97,8 97,2 11,2 38,8 26,0 0,2 Bang 3 cho thay ngddi din cd hieu biet tddng doi tot ve cac dol tddng cd nguy cd cao bi liy nhiem HIV/AIDS, dac biet la nhom doi tddng mua ban dam (97,8%) va tiem chich ma tuy (97,2%).
Bang 4. Kien thCrc ve dau hieu va trieu chirng cua benh nhan AIDS Da'u higu, trieu tril'ng
la chay keo dai Ld loet toan than Suy klet, sut can nhanh Khonq biet
So iu'dng (n=400) 285 276 315 23
TV IS % 71,2 69,0 78,8 5,8
Bang 4 cho thay 78,8% ngu'di dan cho rang ngUdl bl AIDS a> bieu hien gay sut nhanh, tiip theo la ia chay keo dai (71,2%), Id loet toan than (69,0%), cdn Ial 5,8% khong blit diu hlSu, trieu chuhg oia benh nhan AIDS.
Bang 5. Thai dp cua ngu'di dan doi vdi ngu'di nhiem HIV/AIDS Thai do
Xa ianh Giiip dS Binh thu'dng
So iu'dng (n=40a) 52 132 216
Ty le % 13,0 33,0 54,0
Bang 5 cho thay 54,0% ngddi dan cd thai do cdxd binh thddng ddi vdl ngddi bi nhiem HIV/AIDS, 33,0% san sang giup dd ngddi nhiem HIV/AIDS, nhdng van con 13,0% ngddi din cd bieu hi$n xa lanh ngudi bi nhiem HIV/AIDS
3.2. M6t so yeu to lien quan den kien thu'c, thii d$ phdng chSng HIV/AIDS Bang ft Moi lien quan qlDS trinh do hoc van vdl kien thu'c ve HIV/AIDS
Trinh do hoc van lieu hoc trd xuong Trunq hoc cd sd Trung hoc pho thong trd len Tong so
P (testy')
Hiiu biet ve HIV/AIDS Tot
So lu'dnq 9 115 250 374
Ty le % 56,3 89,1 98,0 93,5
<0,05
Kem So lu'dng
7 14
5 26
ly le % 43,7 10,9 2,0 6,5
<0,05
Y HOC VltT NAM THANG 5 - SO 2^014
Bar^ 6 cho ttiay ty ie hmj biit tot ve HIV/AIDS cua ngu'di dan tang dan tiieo binh do hgc van, sU khac tMet cd y nghia thdng ke v&i p<0,05.
Bang 7. Moi lien quan giii:a trinh dp hpc van vdi thai dp phdng chong HIV/AIDS Trinh dp hpc van
Tieu hpc trd xuong
Thai do phong chong HIV/AIDS Tich CLTC
So lu'dng Tyle°
Tieu cu'c So lu'dng Ty le % Trung hpccd sd
10 37,5
109 20 15,5
Trung hoc pho thong trd len Tong so
PCtestjcO^ <0,Q5 <0,05
Bang 7 cho thay co sdkhac biet ve thai do doi vdl benh HIV/AIDS d cac cap dp hgc van. Ngudi cd trinh do hgc van cang cao thi cang cd thai do tich cut hdn ve phdng chong HIY/AIDS (p<0,05).
Bang 8. Moi lien quan giua Tinh tr^ng hon nhin Chua CO qia dinh Co qia dinh Tdng so P(test,')
tinh tranq hon nhan vdl kien thu'c ve HIV/AIDS Hieu biet ve HIV/AIDS Tot
So lUdng 165 209 374
Ty le % 94,3 92,9 93,5
>0,C5
Kem Sd lUdnq
10 16 26
T'/le%
5,7 7,1 6,5
>0,05
Bang 8 cho thay khong co sd khac biet ve kien thdc giiia nhOiig ngddi da co gia dmh va ngudi chua (^gia dinh (p>0,05).
Bang 9. Moi lien quan qiila tinh Tinh trang hon nhan
ChUa CO qia dinh Cd gia dinh Tongsd Pftestx^)
tranq hon nhan vdi thai do phonq chong HIV/AIDS Thii do phing chfing HIV/AIDS Tich CU'C
So lu'dnq 152 203 355
Ty le % 86,9 90,2 88,8
>0,05
Tieu cUc So lu'dng 23 22 45
Ty le % 13,1 9,8 11,3
>0,05
Bang 9 cho thay nhOhg ngddi cd gia dinh cd thai do tich cdc trong phdng chdng HIV/AIDS Ii90,2%%
cdn ngddi chda cd gia dinh cd thai do b'ch cut: trong phong chong HIV/AIDS la 86,9% nhdng sdkhic bidt chda co y nghia thong ke vdip>0,05.
iV. BAN LU$N
Hien nay bien phap cd ban nhat de phong chong HIV/AIDS van la truyen thong cung cap kien thiit HIV/AIDS cho cong dong. Tren cac phudng ti?n thong tin dai chung thudng xuyen cd cac chu'dng trinh pho ijlen kien thu'c ve phong chdng HIV/AIDS. Chinh vi vay, tai 2 xa nghien ciili tuy chua co cac hoat dong can thiep giam
^ c hai nhung ngu'di din cd Iden thCfc kha tot ve c3n bi|nh nay. Ket qua nghien CU\J cho thay ty le ngu<(l dan cd hieu biet dung ve du'dng Ily truyen HIV khi cao, 95,0% biet Ily truyen HIV ia do quan h | linh due khong dimg bao cao su, 89,8%
do diing chung bdm kim tiem, 78% do truyen mlu. Tuy nhien van cdn mpt ty le khong nhd
ngudi dan khong biet hole hieu sai ve du'dng lay truyen, tac nhin gay benh, 8,2% ngUdI din cho ring HIV/AIDS cd the ily khi b| muoi hole cdn trung dot va 8,0% cho ring HIV/AIDS cd the Ily qua bat tay, 3,5% cho ring Ily qua mic chung quan ao vdl ngUdi b| nhiem HIV/AIDS. 9,5%
ngu'di din khong biet tac nhan gly ra HIV/AIDS va 8,7% cho ring HIV vl khuan. NhU vay kien thii'c ciia ngudi dan tai 2 xa nghien cub thap hdn kien thifc cua ngudi din huyen Thach Phu, Unh Ben Tre [3], thap hdn kien thtJc ciia sinh vien d mot so nudc nhu Trung Qudc, Iran [4],[5] v l tUdng tu nhu nhdm din toe Thai [2]. Oieu nay ed the do dia ban nghien eiru tai 1 huyen mien nui nen kha nang tiep can thdng tin cdn han che. Ket
Y HOC VIET NAM TKANG 5 - SO 2/2014 qua nghien cirtj cung cho tiiay van cdn 13,0%
ngudi din cd thai do xa lanh ngUdI b| nhiem HIV/AIDS. Vi vay, truyen thong ta can thiet de nang cao kien thii'c va giam ky thi dol vdl ngUdi nhiem HIV/AIDS tai cong dong mien niil.
Kien thii'c, thai do ciia ngUdI dan bj anh hudng bdi trinh do hpc van. Nhihig ngUdI cd trinh dp hpc van tliap tir tieu hpc trd xuong ed kien thu'c va thai do kem hdn han nhu'ng ngu'di cd trinh dp hpc van trung hpc cd sd va trung hpc phd thdng trd len. Dly cung la ket luan ciia nhleu nghien ciiu trong va ngoai nUde [3],[4]...
Dieu nay cd the do nhan thife ciia ban thin doi tuHng hoac anh hu'dng ciia chUdng trinh giao due vi d bac tieu hpc chua ed chu'dng trinh giao due gidi tinh va HIV/AIDS. Trong nghien cifu nay tuy ehua t'm thay moi lien quan giiia tinh trang hdn nhin vdi kien thife va thai dp phdng chdng HIV/AIDS, tuy nhlen nhtjtig ngu'di chua cd gia dinh cd xu hudng kien thifc tdt hdn, cdn ngu'di da ed gia dinh cd thai dp tdt hdn. Oieu nay cd the do nhifng ngUdi chua ed gia dinh thudng tre hdn nen kha nang cap nhat kien thifc tdt hdn, ngu'dc Ial nhifng ngUdI da cd gia dinh thudng cd nhCfng quan niem hdn nhan va gia dinh gan vdl thai dp dol vdl HIV/AIDS. Do dd de truyen thdng ed hieu qua can luU y den dae tfnh ciia cac nhdm ddi tUdng.
V. K£T LUAN
Qua dieu tra 400 ngddi dan 15-49 tuoi tai 2 xa Hoa ThUdng va Quang Sdn thupc huyen DBng Hy, tinh Thai Nguyen, chung tdl rut ra mpt so ket luan sau:
5.1. Kien thii'c, t h i i do cua ngu'di dan ve phdng chSng HIV/AIDS
- 93,5% ngudi din cd kien thifc tot ve benh HIV/AIDS. Ty le hieu biet sai ve dudng Ily truyen HIV nhu bit tay (8,0%), muoi dot (8,2%), m?c Chung quan ao (3,5%). 9,5% ngUdI dan khdiig biet tae nhin gly ra HIV/AIDS, 5,8% khdng biet dau hieu, trIeu chifng ciia benh nhan AIDS.
- 88,8% ngudi dan ed thai dp tich ci/c trong phdng chong HIV/AIDS. 54,0% ngUdi diri ed thai dp cu' xif binh thu'dng, 33,0% san sang giup dd ngudi nhiem HIV/AIDS, cdn 13,0% ngUdI dan ed bieu hien xa lanh ngu'di bi nhiem HIV/AIDS.
5.2. Mot sdi yeu tdi lien quan den kien thii'c, thai do vie phdng chong HIV/AIDS - Cd mdi Hen quan giu'a trinh dp hpc van vdl kien thu'c ve HIV/AIDS: ty le hIeu biet tot ve HIV/AIDS d ngUdI cd trinh dp hpc van tieu hpc trd xudng chiem 56,3%, trung hpc cd sd la 89,1%, tif frung hpc pho thdng trd len ia 98,0% (p<0,05).
- i::d moi lien quan giOa trinh do hpc van vdi thai dp phdng chdng HIV/AIDS: thai do tfch ci/c ve plidng chdng HIV/AIDS d ngddi cd trinh dp hpc van tieu hoc trd xudng chiem 62,5%, trung hpc cd sd la 84,5%, tif trung hoc pho thdng trd len ia 92,5% (p<0,05).
- Chua thay cd mdi lien quan giiia tinh trang hon nhin vdi kien thifc va thai dp phdng chong HIV/AIDS cua ngu'di dan (p>0,05).
VI. KHUYIN NGHI
Cdng tic truyen thdng ve HIV/AIDS can chu y den ddi tUdng ed trinh dp hpe van tieu hpc trd xudng, tap trung vao eae ndi dung lien quan d€n dudng Ily truyen va tic nhan gay benh nham han che sU xa lanh, ky thi ddi vdi ngUdi nhiem HIV/AIDS.
TAI uf U THAM KHAO
1. B9 Y te (2012), Bao cao so tnidng hop nhiim HIV/AIDS va cdng tac thut hi$n Chuitng trinh Phong chdng HIV/AIDS nam 2011, lieho^h cho n^m 2012, Hi Ha.
2. Phan Thj Thu Hu'dng (2012), Thfic tiang iciSi thdc, thai do, hanh vi va hieu qua md hinh can thiep phong ISy nhiem HIV trong nhdm din (|!c Thai 15-49 tudi tfi 2 huyin thugc tinh Thanh Hia, Luan an tien sT y hpc, TrUdng Dal hpc Y t& cdng cpng. Ha Npi.
3. Nguyin Duy Phong, Cao N99C Nga, Binh The Trung (2005), "Kien thifc thai dp thut hanh aia ngu'di dan huyen Thanh Phu tinh Ben Tre ve phong chong lay nhilm HIV/AIIDS", Tap chl Yhgc TP. Ho Oil Minh, Tap 9, Phu san sd 1, tr. 178-181.
4. Tan X., Pan ] . , Zhou b., Wang C, Xie C (2007), "HIV/AIDS knowledge, attitudes and behaviours assessment of Chinese students: a questionnaire study", Int J Environ Res Putltic Heaith, 4, pp. 248-253.
5. Tavoosi A., Zaferani A., Enzevaei A., Tajik P., Ahmadinezhad Z. (2004), "Knowledge and attitude towards HIV/AIDS among Iranian students", BI^C Public Health, 4, p. 17.
