M O T SO QUAN NIEM CUA NGJOfl DAN HUYEN CHUdNG MY y 6 l DU PHONG DICH CUM GIA CAM N A M 2006 ' , ,
Hd Thi H l e n \ NguySn PhUdng Hoa^ Tran HuU Bich^
'Trddng Dai hoc Y te Cdng cdng, ^ Trddng Dai hoc Y Ha Ndi Muc tieu: md ta quan nidm cua ngddi din vdi dich cum gia cam (CCC). Doi tugng va phuang phap nghien cdu: 38 ddi tuang la ngudi din tham gia vao chan nudi, budn ban, giet mo, sd dung gia cam tai huyen Chuang My duac phdng van siu ban cau true. Sd lieu duac phin tich theo chu de. Ket qua: ket qua nghien cdu cho thi'y, nhan thdc cua ngudi dan ve dich va nguy ca liy nhiSm CCC chUa day du. Dang chu y la thai do chu quan cua ngudi din ddi vdi su xuat hien dich CCC. Nhieu ngudi cho rang gia cam cua ho cd rat it nguy ca nhiSm cum. Ngddi dan cd hieu biet khdng day du ve phuang thdc liy truyen CCC, tac dung ciia tiem vie xin cho gia cam cung nhd anh hudng cua viec lua chon hinh thdc chan nudi gia cam doi vdi lay nhiim dich. Kit luan: ngUdi dan tai cdng dong cdn cd nhdng quan niem va thai dd sai lam ve dich CCC, diy chinh la yeu td thuin lai lam tang nguy ca lay nhiim dich CCC.
lii khoa: cum gia cam, dU phong, quan niem
I. D A T V A N D E
Cum gia cam la mpt benh t r u y i n nhiem lUu hanh rpng rai d n h i l u qudc gia do vi rut cum A H 5 N 1 . Day la loai vi rut ddc Iflc eao, lay lan rat nhanh va cd the giet chet hang trieu gia e l m trong thdi gian n g i n . Vi rdt nay da vupt qua hang rao loai sinh hpe de gay benh cho ngOdi ty le td vong rat eao, len tdi 5 6 % [4]. Djeh cum gia e l m do H5N1 xul't hien tai Viet Nam vao eudi nam 2003 va da trd t h i n h mpt mdi lo ngai Idn cho sdc khoe cdng ddng. Viet Nam da ed rat nhieu nd lOc trong viec kiem solt dich CGC. Tuy nhien, djch van t l i dien dai dang do n h i l u nguyen nhan.
Huyen Chifdng My la ndi cd d djch cum gia e l m dau tien cua tinh Ha Tay cu, nay thupe dja ban Ha npi. Ngay 27/12/2003 tai trai gia e l m gidng cua cdng ty cd phan Thai Lan d xa Thuy Xuan Tien cd hon 8,000 con ga bi chet va chi sau 2 ngay cd bieu hien benh va hdn 100,000 con ga cua trai dd da bi tieu buy ngay sau dd. Tuy nhien, djch CGC v i n lan rpng tren dja ban huyen vdi tdc dp rat nhanh, chi 1 5 ngay sau da cd 23/32 xa/thj tran cdng bd cd dich, trong dd cd thj tran Chdc Son va xa Dai Yen [3]. Cd mpt trUdng hpp td vong
do cum A H5N1 tai xa Dai Yen da dUdc ghi nhan [2]. Nghien cdu nay dUpe tien hanh vdi muc tieu:
Mo ta quan niem cua ngUdi dan ve dU phong va nguy ca xay ra dich cum gia cam tai dia phuang.
II. DOI T U O N G v A PHUONG PHAP N G H I E N CCU
Nghien cdu dope tien h i n h theo phopng p h I p nghien cOu dinh tinh. Phdng van sau vdi 38 dd'i tOpng.
Ddi tOdng cua nghien cdu bao gdm 38 ddi tUpng la nhOng ngUdi ehan nudi, budn ban, giet md va sd dung gia e l m tren dia ban thj tran Chdc Sdn va xa Dai Yen thupe huyen ChUPng My. C I c ddi tUdng dupe lOa chpn theo phifdng p h I p chpn mau cd chu dich, phan bd deu tren hai xa va cd dp tudi tO 22 - 68 tudi. Cae ddi tOpng nay lam n g h i ehan nudi, budn ban, g i l t md, va sd dung gia cam tai ChOdng My - Ha Npi nam 2006. C I c ddi tOdng nghien cdu dupe chpn theo phUPng p h I p thuan tien. Mdi eupc phdng van sau keo dai tO 45 - 90 phut. Sd lieu dope phan tfch theo chu d l .
• Ndi dung thu thap sd lieu: cac cau hdi phdng
van sau nham thu thap cac thong tin xoay quanh eae ehu d l ehinh: nhan thdc eua ngUdi dan v l k h i nang trd lai eua dich, kien thdc v l phUdng thdc lay t r u y i n CGC giOa gia e l m va sang ngUdi, va k i l n thdc v l tiem vac xin cho gia cam.
I I I . K E T Q U A
Quan niem ve sU xuat hien cua dich cum gia eim va nguy ca lay nhiem benh
Cae dd'i tUpng trong nghien cdu cd quan niem v l sU xuat hien cua dich cum gia e l m khac nhau.
Phan Idn eac ddi tUpng cho rang nguy cP x l y ra dich tai dia phUPng la tha'p hoac khdng cd. Mot so' ngudi eho rang d e phOdng tien thdng tin dai chdng da phdng dai nguy co bung phat djch.
"Em khdng thiy cd nguy cd gl, ho cd lam rum beng len nhd the chd em cha thay gl ca, xung quanh day miy nam nay cd sao dau, ban than em toan lam ga vit tnfc tiep ma cd lam sao dau" [nO, 27 tudi, ngifdi chan nudi gia cam).
Dang chd y la, hau he't d e ddi tUpng d i u tin tudng rang dan gia cam cung nho b i n than hp va nhflng ngOdi xung quanh cd it k h i nang lay nhiem cdm gia cam. C I c dd'i tOpng d i u dUa ra ly g i i i khae nhau cho quan niem nay. NhOng ngOdi chan nudi qui md nhd cho rang vdi so' lOpng gia e l m it, hp se cham sdc va theo ddi can than hdn, do vay k h i nang mac benh cua gia e l m la ft.
"O day tdi chan nudi it, ve sinh chuong trai hang ngay va tiem vie xin diy du, khi cd diu hieu cai la biet ludn, do vay khdng the cd kha nang xuit hien benh tai day, ma chi cd the xuit hien d nhdng trang trai Idn, ndi nudi nhieu vl nhieu qua khdng kiem soat difdc het" (nam, 46 tudi, ngOdi ehan nudi gia cam).
Trai lai, cac ddi tUdng ehan nudi theo hinh thdc trang trai lai eho rang, vdi gia cam nudi nhdt trong trai vdi qui md Idn se it cd nguy cd m i c benh do hp cd he thd'ng kiem soljt va tuan thu eae
qui djnh v l phdng djch chat ehe hdn.
"Kha nang lay nhiim d trang trai la rit it tai vl hang tuin vin tiet trung deu dan hang ngay, ra vao la mlnh cd nddc rda tay chan qua nUdc khCf trung va quin ao nda. Ndi chung nguy cd dan gia eim cua mlnh la rit it vl gia eim cua trang trai difdc ky sd cham sdc hang ngay" (nfl, 61 tudi, ngUdi chan nudi gia cam).
Nhu da phan tich d tren, mpt sd ddi tUpng da ly g i i i quan diem cho rang nguy cP lay nhilm tha'p cua gia cani va b i n than hp bang d c h dUa ra kinh nghiem thflc te. Dd'i vdi d c hp lam nghe budn b i n , giet md gia cam, n h i l u ngUdi cho rang
"hp van lam nhU vay" tO n h i l u nam nhOng cung chOa tha'y "ed hien tOpng gi" x l y ra. Do dd, hp khdng lo l i n g v l kha nang lay n h i l m va mac benh tren gia cam eung nho tren ngOdi.
"Tdi lam td hoi hdn chuc nam nay cha co hien tifdng gl, cd bao H5N1 d dau nhdng ma rieng toi lam han chuc nam nay ma chifa cd mot ai ca. [Nhifng chi tha'y cai kha nang bl mic benh cum cd nguy hiem khong ?] Thi nd cung nguy hiem den tinh mang con ngddi nhdng ma mlnh • phdng chdng roi thi khdng sd gl ca... Lim luc- thdi phong len diy, d day chifa cd hien tifdng.
gl..., nhifng ma tren vo tuyen thdng tin cd ndi an ga la chet nhdng ma cha thiy ai d day..." (nO, 40 tudi, ngUdi cung cap gia cam).
Quan niem ve phuang thdc lay truyen cum gia cam
Khi dupe hdi ve phUdng thdc lay t r u y i n cum gia e l m , n h i l u ddi tUpng eho rang cum gia e l m cd the bj lay t r u y i n tO mdi trodng d n h i l m . Ngoai ra, cdn cd y kien cho rang viec sd dung hda chat trO sau khdng dung va hpp ly cd the la ly do gay nen CGC.
"Theo tdi thi cd may cai nguon, thd nha't la do ve sinh chuong trai khong dam bao, cai thd hai la do tie ddng ben ngoai, do mlnh nhap
lau... do mdi trddng xung quanh khdng dam bao, bi d nhiem bdi phun thudc trd sau nhieu qua" (nO, 28 tudi, ngudi ehan nudi gia cam).
Mdt sd y kien khac eho rang CGC xuat hien tO gia cam hoac d c loai chim hoang, chim di cO.
Cac chl't nho Idng hoac phan cua chung ed the lay truyin vi rut eho gia d m . Mac du mot sd ddi tOdng cd hieu biet v l ngudn lay benh la tO phan ga, song hp cung khdng g i i i thich dope rd rang rang phan ga n h i l m cum mdi la ngudn lay benh.
"Ndi chung cung td cac loai chim thdi. Chim nd bay qua cd the cai phan, Idng cua nd bay xud'ng thi ct> the nd lay tnfc tiep clio dan gia cam" (nfl, 32 tudi, ngOdi chan nudi gia cam).
Quan niem v l nguy cP lay t r u y i n sang ngOdi cung dope ngOdi dan ly giai tO kinh nghiem thflc te. N h i l u ddi tOdng khang djnh rang khong cd kha nang lay benh tfl gia cam sang ngOdi.
"Khdng cd dau, td ndi khang dinh la ga khdng cd dich... khong cd dich nao lay lan vao ngifdi mlnh... neu ma that sif lay lan vao ngifdi thi td la ngifdi giet md chet trddc vl rang la tiep xuc con ga bit td luc. trong chudng ra cho den giet md cho den khi ngifdi ta an ma ngddi van khdng lam sao, khong viec gl ca" (nO, 41 tudi, ngUdi cung cap gia cam).
Tuy nhien, cung cd mpt so' it ddi tUpng (3/38 ddi tupng) trpng nghien cdu da cd nhflng quan niem dung v l viee vi rut ed the l i y sang ngOdi va CO hieu biet dung v l d e dUdng lay t r u y i n cua benh. C I c dUdng lay nhiem tO gia cam sang ngOdi dope cac ddi tOdng d l cap kha chi tiet nhO do viec an thjt gia cam sdng, lay n h i l m trong khi che bien gia cam,, hoac qua dOdng hd hap... Cac dudng lay dOdc neu ra tOdng ddi thdng nhat so vdi cac nghien cdu k h I e da dOdc trien khai trOde day.
Tiem vac xin cho gia cam
Viec sd dung vac xin cho gia e l m cung dupe de cap den trong nghien cdu nhU la mpt bien
phap du phdng cho dan gia e l m eua d c ddi tupng. Cd 19/27 dd'i tUdng t r i ldi ed tiem vac xin eho dan gia e l m cua minh. Tuy nhien, van ed nhflng gia dinh khong ung hp viec tiem vac xin.
Mpt sd ngUdi khdng cho rang viec nay cd the phdng benh ma t r i i lai, cdn cd the gay benh cho dan gia cam cua hp.
"Khdng, em khdng tiem. Em phdng the la du roi cin gl phai tiem them, vdi lai tiem cai diy vao nghe ndi ga vit yeu di, cd con cdn bi chet, de cung it di nen em cha tiem" (nfl, 27 tudi, chan nudi gia e l m ) .
Qua v i du tren eho thay nhan thdc cua ngUdi dan dja phUPng v l tac dung dO phdng cua v i e xin phdng cum eho gia e l m edn chOa dung.
Quan niem ve hinh thdc chan nuqi gia eim Cd hai hinh thdc chan nudi gia cam dope ngOdi dan de cap den dd la nudi nhd't hdae ehan t h i rdng. C I c ddi tOdng eho rang nudi nhdt it ed nguy cd mac benh hdn viec chan tha rdng. Tuy nhien, khi ndi de'n nguyen nhan tai sao hp lai chpn bien p h I p nudi nhdt gia e l m , d c nguyen nhan dUpc dUa ra la dp nha chat hoac sp gia e l m di mat. Khdng ddi tUpng nao d l cap den ly do lien quan de'n lay nhiem cdm gia e l m khi quyet djnh nudi gia cam tha rdng.
"Nudi nhdt, nha chat the nay lam sao nudi tha difac... Chdc nang cua con ga sinh ra nd phai chay nhay, nd rin thit mdi ngon difac" (nfl, 24 tudi, sd dung gia cam).
Ket q u i nay cung thdng nha't vdi y k i l n mpt sd ngUdi chan nudi nhd da phan tich d tren cho rang, vdi quy md nhd k h i nang lay nhiem cdm gia e l m lii edn thap.
IV. BAN LUAN
Quan niem ve nguy. ca va phuang thdc lay nhiem benh
K i t q u i nghien cdu cho tha'y thai dp kha ehu
quan vdi djch cum gia cam nhu vay cd the ly g i i i bang mpt sd nguyen nhan. Thd nhl't, nhan thdc cua ngUdi dan v l tinh hinh dich benh edn thap, mpt phan la do thflc te djch trong nhflng nam vOa qua khdng nhieu tai dia phUdng. Thd hai, hau h i t ngUdi dan cho rang cac bien p h I p va chUdng trinh phdng benh tfl phia ehinh quyen cdn thap, chOa thOe sO p h i n I n h dOde nguy cd cao cua sO xuat hien dich cum gia cam. Chinh t h i i dp chu quan n l y cua ngOdi dan 11 ly do chfnh dan de'n cae bien p h I p do phdng trOde djch khdng thflc sO hieu q u i . H i u h i t d c ddi tOpng d i u tin tOdng rang dan gia e l m eung nhO ban than hp va nhflng ngOdi xung quanh cd ft k h i nang lay n h i l m cum gia d m .
Nghien cdu eung dOa ra n h i l u y k i l n trai ngOde, the hien nhan djnh sai cua n h i l u dd'i tOpng tham gia nghien cdu. Hp cho rang vi rut khdng the lay benh tO gia cam sang ngOdi dope. D i l u nay cho thay kien thdc eua ngOdi dan dia phuong v l CGC cung nhu d n h b i o v l hieu q u i edn thap, d e chuong trinh truyen thdng ve djeh cum tai dia phUdng ehUa cd hieu q u i cao. NgUdi dan dac biet la nhflng ngUdi chan nudi, giet md gia cam kha ehu quan va tin tUdng rang hp khdng bao gid bi n h i l m benh, trong khi hp chfnh la nhdng ngOdi cd nguy cd lay benh tfl gia e l m la nhieu nhat.
Nghien cdu nay ehi ra rang da sd ddi tOdng nghien cdu cho rang lay n h i l m cum gia cam la tO mdi trOdng. Quan niem nay the hien k i l n thdc chung chung, khdng day du do ddi tUdng chUa hieu rd cd che g l y benh. Viee quan niem ngudn lay CGC la do viee ehan nudi, ve sinh gia cam khdng d i m b i o dan den benh la chUa d i y du.
Tiem vac xin cho gia cam
Bien p h I p tiem v i e xin phdng cdm cho gia cam la mpt bien p h I p bao ve dae hieu dupe coi la g i i i p h I p hang dau d l khd'ng che sO lay lan cua benh. Bien phap nay dUpc khuyen cao sd dung tai nhflng khu vOc ed nhieu nguy cP nhO:
mat dp gia cam cao, d c bien p h I p an ninh sinh hpe nghiem ngat khdng phu hpp vdi d i l u kien chan nudi [5]. Tiem vac xin cho gia cam do can bp thd y va chinh quyen dja phOdng chju trach nhiem chinh. De dat hieu q u i cao can tiem du 2 mui va chi sd dung s i n pham gia e l m sau khi tiem 28 ngay. Viec sd dung vac xin cho gia cam cung dupe d l cap den trong nghien cdu nhu la mpt bien phap dO phdng cho dan gia cam ctia d c dd'i tOdng. Tuy nhien, khdng p h i i ta't c l ngUdi cham nudi gia cam d I u da thUc hign tiem vac - xin cho dan gia e l m cua minh. D i l u nay co the do cdng tac tuyen t r u y i n tai dia phUdng ve y nghTa va t i c dung eua v i e - xin phdng cum cho gia cam la chUa hieu q u i . Tuyen truyin khong day du cdn ed the I n h hUdng den cdng tac tiem phdng cho dan gia e l m cua ngudi dan nhu tiem khdng du lieu, thdi gian, hoac thdi gian sd dung gia e l m sau khi tiem v i e xin khdng b i o dam. Ke't qua nay eung phd hdp vdi nghien cdu eua La Ngpe Quang [1] d i l u tra cho thay ehi cd 85%
ngUdi chan nudi gia cam cho rang nen tiem vac xin cho gia e l m .
Quan niem ve hinh thdc chan nudi gia eim
K i t q u i nghien cdu chi ra rang g i n mpt nda sd ngUdi dupc hdi ddng y rang " t h i gia cam tU do se giup gia cam khoe nianh hdn" va "se g i l m dope t i l n mua thdc an cho chung". C I c dd'i tUpng trong nghien cdu quan niem gia cam t h i rdng thOdng la nhflng gia cam ngon, khde manh va to cd kha nang kiem thdc an cho b i n than do vay se gilm bdt mpt p h i n chi p h i cho viec mua thdc an cho gia cam. NhU vay, ye'u t d v l kinh te eung dang la mpt trong cac ly do dOa ra eho viee chpn lifa phoong thdc chan nudi gia cam phu hdp vdi ddi tupng. Cac ddi tUpng nay chUa nhan thdc difdc viec nudi t h i rdng la mdt yeu t d gay lan truyen benh cdm trong epng ddng.
Ket q u i nghien cdu da cho tha'y ngUdi dan con kha chu quan vdi cae nguy ed tO CGC. Nhieu
ngOdi chOa ed eae kien thdc dung va du de ed the phdng chdng djch cdm gia cam cd hieu q u i . TO quan niem va nhan thdc khdng day du cua ngOdi dan se d i n de'n mot loat cac hanh vi nguy cd lay n h i l m cum trong gia e l m va tfl gia cam sang ngodi.
y . KET LUAN
Nghien cdu nay da cung cap thdng tin v l quan ni^m va kien thdc cua ngOdi dan v l djch CGC.
Nhieu ngodi dan da ed nhflng quan niem va t h i i dp sai lam, day ehinh la mpt yeu t d thuan ldi lam tang nguy cd l i y n h i l m CGC tai cpng ddng. C I c ddi tuong nghien cdu hau het cho rang djch benh tai dia phUdng dang dope thdi phdng len. Kien thdc eua ngUdi dan ve lay t r u y i n CGC cdn chOa dung. Dieu nay phan nao phan anh dope t h i i dp khdng quan tam lo l i n g cua phan n h i l u ngOdi dan ve nguy cd lay benh vdi gia cam cung nhU tfl gia cam sang ngUdi.
Can day manh cdng t i e tuyen t r u y i n n l n g eao nhan thdc cho ngOdi dan, bao gdm c l ngOdi chan nudi, budn b i n , giet md, va sd dung gia cam v l nguy Cd xua't hien djch CGC. C i n tuyen t r u y i n cho ngUdi dan tren d c phUdng tien thdng tin dai chung v l eae hinh thdc ehan nudi gia e l m , ban
che chan nudi gia e l m t h i , nang cao k i l n thdc ve phUdng thdc lay, ngudn lay va d c bien phap dU phdng l i y nhiem CGC. Ben canh dd viee tiem v i e xin cho gia e l m e i n dupe b i o d i m theo quy djnh. Thflc hien cdng tac kiem djch thOdng xuyen cho gia cam.
TAI LIEU THAM KHAO
1. La Ngoc Quang (2005). Kien thdc, t h i i dp va thflc hanh phdng chd'ng cdm gia e l m cua ngOdi dan tai Nam Sleh va Chi Linh, H i i DOdng, Luan van thac sy. Dai Hpe Y te Cdng cpng.
2. Chi cue Thu y Ha Tay (2005). Bao d o tdng ke't cdng t i c phdng ehdng dich cum gia cam nam 2005. H I Tay.
3. Trung t a m Y te do phong t i n h Nam Djnh (2005). B i o cao cdng t i e y te 20-01 - 2005 va phOPng hodng edng t i c nam 2006 d i n 2010.
Nam Djnh.
4. Vien Ve Sinh Dich T i Trung Lfdng (2005).
Tinh hinh c d m A / H S N l tai Viet Nam, 2003 - 2005. Vien Ve Sinh Djch t l Trung Udng: Ha Npi.
5. Capua SM (2005). Sd dung vac xin tiem phdng nho mpt g i i i p h I p khdng che benh cum gia e l m . Td chdc Y te The gidi.
Summary
PERCEPTIONS ABOUT AVIAN INFLUENZA EPIDEMIC PREVENTION AMONG PEOPLE IN CHUONG MY DISTRICT IN 2006
Objectives: to identify the perceptions of people towards avian influepza epidemics. Methods:
qualitative design was employed 38 people involved in breeding, trading, consumption of poultry in Chuong My district were recruited to do in - depth semi structured interview. Content analysis was used.
Results: this paper presents some of the issues regarding lack of knowledge and inadequate perceptions of people about the avian influenza (Al) epidemic and risk of contracting A l . A lot of people perceived that the risk of getting Al among their poultry is very low. It is common that a lot of people were not well aware of the route of transmission of A l , the effectiveness of vaccination for poultry as well as the protective methods of breeding poultry. Conclusions: perceptions and attitudes of people towards avian influenza epidemics were incorrect. This is risk factor to lead transmission of avian influenza epidemics.
Key words: Avian Influenza, prevention, perceptions