TAP CHi Y Dl/QC HQC C%K THg - SO 11-12/2018
N G H I E N ClTU T I N H H I N H V A K I E N THU^C, T H A I B Q , THlTC H A N H VE S i r D U N G M U O I I O D C U A N G U ' 6 l D A N T ^ PHU'CFNG I H T N G P H t ,
Q U ^ C A I R A N G , T H A N H P H O C A N T H O N A M 2016 Phgm Thi T&m'\ Qudch Hailinh^
1. Tru&ng dgi hgc Y Dugc Cdn Tha 2. Trung tdm Y ti Du phdng tinh Bgc Lieu
*Email:pttam@ctump. edu. vn T O M T A T
Bgt van di: Iod can thiit cho tong hgp hormon gidp, dieu chinh qud trinh phdt triin ca thi. Hien nay, do bao phu mudi iod (M) suy gidm ddng ki. Rdt it nghiin ciiu kiin thdc, thdi do, thuc hdnh vi su dung MI dugc thuc hiin tgi Hung Phu. Muc tiiu nghiin cuu: Xdc dinh ty li hg gia dinh (HGD) su dying MI, ty li kien time - thdi dg - thuc hdnh dung vi sir dung Ml vd cdc yeu td lien quan din thuc hanh sir dung MI cua ngudi ddn tgi phu&ng Hung Phii, qugn Cdi Rang thdnhphd Can Tha ndm 2016. Ddi tugng va phu&ng phdp nghiin cuu: Nghiin ciru cdt ngang mo td trin 420 ngudi ngi trg chinh tgi Hung Phu, dp dy.ng phirang phdp chgn mdu cum. Ket qua:
56.4% hg gia dinh sii dmg mudi iod. ty li kiin thuc, thdi do. thuc hdnh dung vi sir dung MI ldn lugt la 29%; 95.8%; 59,5%. Thitc hdnh sir dung MI cd liin quan vdi kiin thuc (p<0.001), thdi dp (p<0,05) vd trinh dg (p<0,05). Kit lugn: ty li HGD su dyng MI cdn khd thdp so vai muc tiiu qudc ti (>90%). ty li thdi do dung cao han so v&i kien thiic vd thdi dg diing.
TH khda: Mudi Iod, tinh hinh. kiin thuc, thdi do, thue hdnh, Himg Phu.
A B S T R A C T
S E R V E Y O N S I T U A T I O N A N D K W O W L E D G E , A T T I T U D E , P R A C T I C E T O W A R D S I O D I Z E D S A L T U T I L I Z A T I O N O F P E O P L E IN H U N G PHU
W A R D , C A I R A N G D I S T R I C T , C A N T H O C I T Y 2016 Pham Thi Tam', Quach HaiLinh^
1. Can Tho university of medicine and pharmacy 2. Center for preventive medicine of Bac Lieu Background: Iodine is an essential compenenl of the hormones produced by the thyroid gland and it controls the normal development of the human's organs. At present, households coverage with iodized sab are decreasing. In Himg Phu, there are scarce studies on knowledge, attitude and practice of iodized sah utilization. Objectives: To determine the rate of households using iodized salt, the percentage of true knowledge, true attitudes, true practices in using iodized salt and some related factors to practise using iodized salt Materials and Method: A cross - sectional study on 420 the main housewifes at Hung Phu ward implemented on the cluster sample method. Results: The rate of households using iodted sah is 56,4%, 29%> of total have true knowledge, majority (95,8%) respondents have true attitude, 59,5% true practice. Practice on utilization of iodized salt at household level is related to knowledge (p<0,001), attitude (p<0,05) and education level (p< 0,05). Conclusion: The rate of households using iodized salt is lower international goal (>90%), the percentage of true attitiide is higher true knowledge and practice.
Keywords: Iodized salt, situation, kwonledge, attitude, practice. Hung Phu.
I. B ^ T VAN DE
Iod can thiet cho tdng hgp hormon giap va diSu chinh qua tiinh phat trien cua nhiSu ca quan trong ca th^. Thilu iod se gay ra cac tac hai nghiem trpng nhu budu co, chgm phat triSn tri tue, ddn ddn, sdy thai, de non,...cd thS phong ngira bdng each sir dung MI thudng xuySn va liSn tuc. Theo thong kS cua benh viSn ngi tiSt 1993, chi mdt s6 it dan 338
TAP CHi Y Dl/QC HOC CXN THO - SO 11-12/2018
sdng d ven bien va Ha Ndi du iod, tiong dd 10% sd xa khdng thidu iod la do can tiiiep bd simg iod thanh cdng [2]. Hien nay, do bao phii mudi iod suy giam dang kS. Tmh dSn 2013, Can Tha la mgt tiong cac tmh/thanh cd dp bao phu mudi iod ludn d miic tiidp (43,3%) [1].
Mat khac, cd rdt it nghien ciiu kiSn thiic, thai do, thuc hanh vS sir dung MI thuc hien tai Hung Phu, do dd nghien cuu nay cd the ctmg cap mgt sd manh mdi cho van dS nay va cd the iam ca sd cho cac nghiSn cihi khac. Vi nhihig ly do ti-en chiing tdi tiSn hanh nghiSn ciiu nay vdi 3 muc tiSu: (1) Xac dinh ty IS hg gia dinh su dung mudi iod va cac ly do khdng sir dung mudi iod cua ngudi dan phudng Hung Phii, quMi Cai Rang, thanh ph6 Cdn Tha nam 2016. (2) Xac dinh ty IS kiSn fliiic, thai do, thgc hanh diing vS sii dung mudi iod ciia ngudi dan phudng Hung Phii, quan Cai RSng, thanh phd Cdn Tha nam 2016. (3) Tun hiSu cac ySu td lien quan den thuc hanh su dung mudi iod cua ngudi dan phudng Hung Phii, qugn Cai Rang, thanh phd Cdn Tho nam 2016.
IL D 6 I TU'ONG VA PHD'ONG PHAP NGHIEN CUtJ 2.1. B6i tu-gng nghien cihi
- TiSu chuan lua chpn: Ngi tig chinh tit 1 8 - 6 0 tudi, cd hp khdu thudng tni va dang sdng tgi Hung Phii va ddng y tham gia phdng van.
- TiSu chuan logi trir; Cac ddi tugng khdng hgp tac; Nhiing ngudi cd rdi l o ^ vS y thiic, tam than, dang mac benh cap tinh, khdng cd kha nang giao tiSp; Vdng mat trong thdi gian nghiSn ciiu (2 lan khdng gap).
2.2. Phirong phdp nghien cuu
- ThiSt ke nghien ciiu: md ta cdt ngang cd phan tich
- Cd mau: dugc ti'nh theo cong thiic n = Z^_a^ trong dd, a = 0,05, Z^_a = 1,96; p = 0,451 la t^ IS HGD sii dung MI tiSn toan qudc theo ket qua dieu tia danh gia cac muc tiSu phu nii va tre em - MICS4 ciia GSO 2011 [6]; d = 5%. Du phdng hao hgt mdu 10% va lam tidn dugc n = 420.
- Phuong phap chgn mau: ap dung phuong phap chpn cum (dan vi cum la khu vuc) gom 2 giai doan: (1) Chpn cum: bat tham ngau nhien 6 tiong sd 11 khu vuc cua phudng;
(2) Chgn HGD: mdi cum chpn 70 hg bang phuang pimp ngdu nhien he thdng vdi khoang each chgn (k) riSng cho timg cum, tinh bang each lay tdng sd hg cua mdi cum chia 70.
- Ndi dung nghiSn cuu:
+ Sii dung MI: xac dinh bdng each phdng vdn va quan sat thSy trong nha cd bgc MI (co nhan mac theo quy dinh). Tim hieu ly do khdng sii dimg MI ddi vdi cac trudng hgp khdng su dung va sir dung ket hgp 2 loai mudi.
+ Kien thiic - Thai do - Thuc hanh ve sir dung MI: gdm 2 gia tri: Dung; Chua dung. Danh gia thdng qua cac ngi dung tuong iing, chgn mdc 60%
Kien thitc gom 28 ngi dung (ND) phan thanh 7 nhdm ND: Mudi iod; Lgi ich sir dung; Cach su dung; Cach bao quan; Cach chgn mua; Thuc phdm/gia vi cd iod; Ddi tugng nguy CO cao thiSu iod. Kiin thuc chung ddng: > 17ND; Kiin thirc chung chua dung: <
17ND
Tiip cgn thdng tin: gdm 2 gia tri la > 2 nguon; < 1 nguon.
Thdi do gdm 12 ND ^ Thdi do dung: > 7ND; Thdi do chua dung: < 7ND.
Thirc hdnh gdm 13 ND -^ Thuc hdnh diing: > 8ND,' Thuc hdnh chua dung: <
8ND.
TAP CHf Y DiraC HQC CAN THg - SO 11-12/2018
+ Cac ySu t6 lien quan ddn thuc hanh su dung MI bao gom; cac yeu to dan so xa hpi (tu6i, gioi, dan toe, ngh6 nghiep, trinh do, kinh tS, so thanh vien trong gia dinh, tre em
< 14 tu6i); kiJn thiic; tiSp can thSng tin; thai dp; thuc hanh.
III. KET QUA
3.1. Die aiem chung cua doi tnmig nghien cihi
Trong 's6 420 d6i tupng nghien cuu (DTNC), da so la nO gioi (92,4%), phan 16m nam trong dp tuoi tu 46 - 60 (62,1%); 28,1% 31 - 45 tu6i; 1 8 - 3 0 tu6i c h i t o 9,8%. Dan tpc kinh chifai da s6 98 3% va Khac 1,7%, hju hk thupc di&l kinh t6 trung binh tra len 91,2%. PhSn lon c4c DTNC I t o npi tto (51,4%) va buon ban (30%), CCVC - HSSV 6,2% v4 khac 12,4%. Trinh dp < cdp 1 cliito 47%, cdp 2 va > c4p 3 ldn luptt la 29% va 24%. Da s6 co > 4 thanh vien trong gia dinh (75,2%), co 55,5% s6 DTNC co tie < 14 tudi trong gia dinh.
3.2. Tinh hinh s i dung va if do ldi8np sil dung muoi iod 3.2.1. Ty le hd gia dinh sit dttng mudi iod
Bang 1. Tinh hinh su dung muoi iod Tinh hinh sir dpng mu6i iod
1 Chi muoi iod I Ket hop muoi thucmg Khong sit dung
n 125 112 183
29,8
%
26,6 43,6
56,4 43,6 Hon 1/2 sd HGD cd sir dung MI (56,4%), bao gdm ti-ong dd, 29,8% HGD chi su dung MI cao ban so vdi sd HGD sir dung kdt hgp 2 loai mudi (26,6%).
3.2.2. Lydo khdngsudung Khac Khong cdn thilt Khdng biet vi sao Rua/udp thuc pham, nudi gia sue Gia ddt Khdng sach Man han Mui vi khd chiu Khong ban/ban khdng liSn tuc
Tylf% 0 10 20 30 40 50 BiSu dd 1. Cac ly do khdng sir dung mudi iod
Ly do chiSm ty le cao nhdt la man ban mu6i tiiudng (45,7%), tiSp dSn la khdng can thiSt phai sir dung MI (21,7%), chiSm ty 1^ thdp nhat la MI khdng s^ch (1%).
3.3. Kiln thu-c - Thai do - thuc hanh v^ su* d^ng muoi iod 3.3.1. Kien thue vi sir dung muoi iod
• • • 8,6
• I B i 8,1
• • • 8,8 1 1
^ ^ m ifi
• 16
12,6 1 21,7
Kieu thirc Muoi iod
Cach su dung muoi iod Cach bao quan muoi iod
Diing n 328 319 265
78,1
%
76 63,1
Chua Aimz n 92 101 155
21,9
%
24 36,9
340
TAP CHf Y Dl/OC HOC CAN THCK - s 6 11-12/2018 Ki€n thirc
Cach chon mua muoi iod Cac thirc pham/gia vi chira iod
Diing n 220
68 52,4
%
16,2
Chira diing n 200 352
47,6
%
83,8 Han VA sd DTNC cd kiSn thurc diing vS mudi iod (78,1%) va each sir dung (76%), tiep dSn la each bao quan 63,1%, thdp nhat la cac thgc phdm/gia vi cd iod (16,2%).
Bang 3. KiSn thuc ve Ipi ich sir dung va cac doi tugng nguy co cao thieu iod Loi ich sir dung muoi iod
Hieu bi6t dsLy dii (3 loi ich) Hieu biet 2 lgi ich
Hieu bi8t chi 1 lgi ich (Bu6u c6) Khong biet
n 10 87 248 75
2,4
%
20,7 59,0 17,9 Soi ttrong nguy cir cao thieu iod
Tre em Phu nii mang thai Phu nii cho con bu
150 62 33
35,7 14,8 7,9 HiSu biet ddy du lgi ich chi d^t 2,4%, 1 lgi ich (Budoi cd) chiSm 59%. BiSt tre em cd nguy co cao thiSu iod chiSm ty le cao nhdt 35,7%, thap nhdt la phu nii cho con bii.
Bang 4. KiSn thiic chxmg vS su dung mudi iod Kien thirc chung
Dung Chua dung
n 122 298
29
%
71 Kien thiic chung diing chiSm 29% trong tdng sd 420 DTNC 3.3.2, Tiip can thdng tin
Bang 5. TiSp can cac ngudn thdng tin Cac nguon thdng tin
Tivi Loa, dai
Bao Can bp yte Nguiri than Khac
n 346
95 64 42 157 20
%
82,4 22,6 15,2 10 37,4 4,8 S6 nguon thdng tin ti^p can
> 2 nguon
<1 nguon
221 199
52,6 47,4 INgUOn m o n g lin c a c UOl l u p i l g u c p caii l u u c u iiiiai la u v i \^o..,i/vf, tii,^ uivu lu nguW th&i (37,4%), thdp nhdt la cac ngu6n khac (4,8%). Hon 1/2 s5 DTNC tiSp cSn > 2 nguto (52,6%).
3 3.3. Thai do vi sit dung mudi iod 2 6. Thai dp v6 siir dung mupi iod
NQI dung Khdng cin sil dung MI moi ngay
Chi mua nhiing bpc mu6i con nguyen ven bao bi
Diing n (%) 183 (77,2) 234 (98,7)
Chira diing n (%) 54 (22,8)
3 (1,3)
TlJP CHi Y DITQC HQC CAN THO - SO 11-12/2018 NAi dung
Khi mua Ml, khong cSn xem cac thong tin ghi tren bao bi Sii dung thucmg xuyen va lien tyc moi co tac dung phong benh.
Nem Ml vao khi dang nau trgn bep
Bao quan Ml thoang mat, xa b^p tranh hoi n6ng/anh nang.
Nen rira dung cu chua Ml, phai kho sau m6i ISn sijr dung h£t.
Khong nen day kin cac dung cu chitajvll
Sii dung MI la phuang phap re nhdt^tien Ipi nhdt M phong ngira buou co * Gia MI phii hpp d£ su dyng h^ng ngay
Chi tre em mai can sii dyng Ml Phu nir mang thai khong nen sir dyng fWl Xhiii 46 chung ve sir dung muoi iod
Dung n(%) 162(68,4) 202 (85,2) 89 (37,6) 227 (95,8) 203 (85,7) 184 (77,6) 216(91,2) 217(91,6) 205 (86,5) 183 (77,2) 227 (95,8)
Chira diing n (%) 75(31,6) 35 (14,8) 148 (62,4) 10(4,2) 34(14,3) 53 (22,4) 21 (8,9) 20 (8,4) 32(13,5) 54 (22,8) 10(4,2) r " Da s6 cac DTNC co thai dp dung cf cac ngi dung, thSp nhat la 37,6% n6m Ml khi
dang ndu tren b§p. Thdi dp chung dung dat 95,8%.
3.3.4. Thuc hdnh vi sir dung mudi lad -Bang 7. Thuc hanh v6 sir dung muoi iod
L Ndi dung | Diing n (%) | Chua diing n (%) ICach ch^n mna mu6i iod
Xem bao bi nguyen ven hay kh6ng.
Xem han sijr dung
Xem trong luang muoi va ham luong iode Huong dan sir dung va each bao quan mu6i Ten nha san xuat
217(91,6) 155 (65,4) 19(8) 36(15,2) 71 (30)
20 (8,4) 82 (34,6) 218(92) 201 (84,8) 166(70) Cach sir dnng muoi iod
Nem MI khi thiic an da chin va tit bep Sii dung MI lien tuc moi ngay
78 (32,9) 188(79,3)
159(67,1) 49 (20,7) Cach bao quan muoi iod
Mua su dung va bao quan trong vong 3 thang
Riia sach va phoi kho dung cy chua sau m6i lin sir dyng hgt Noi de Ml dii xa bep, khong inh huong sue nong Dung cy chua kin
Mlsach MI kh6 rdo
T h ^ hdnh chung v^ sir d^ing muoi iod
222 (52,9) 165 (69,6) 132 (55,7) 229 (96,6) 227 (95,8) 146(61,6) 141 (59,5)
15 (6,3) 72 (30,4) 105 (44,3) 8(3,4) 10(4,2) 91 (38,4) 96(40,5) VS thuc hanh mua MI, Cd 91,6% xem su nguyen ven ciia bao bi, chi 8% xem ham lugng iod. Han 3/4 sii dung MI hang ngay (79,3%). PhSn ldn cac ddi tugng bao quan MI tiong dung cu kin (96,6%) va sir dung MI sgch (95,8). Thuc hanh chung diing dat 59,5%
3.4. Cac yeu to lien quan thvc hanh s v dung muoi iod
TAP CHf Y DLTQC HQC C&N THO - s 6 11-12/2018 isang s. i-nan tich ho
Yeu to U€n quan
quy cac yeu to li6n quan t luchanh Phan tich don bien
OR (KTC 95%) P
Phdn tich da bien OR (KTC 95%) P Nhom tuoi
18-30 46-60
2,797(1,10-7,09)
1 0,03 1,003(0,32-3,17)
1 0,996
Nghe nghiep CCVC-HSSV/Khac
Noi trp/buon ban
2,291(1,19-4,43)
1 0,012 1,349(0,61-2,98)
1 0,46
Kinhte
> Trung binh
< Trung binh
2,912(1,04-8,17)
1 0,035 1,798(0,53-6,07)
1 0,345
Trinh do
>Cap3
< C i p l
5,019(2,52-10,01)
1 < 0,001 2,335(0,98-5,54)
1 0,05
Kien thirc Diing Chua dung
7,716(4,13-14,42)
1 < 0,001 5,367(2,68-10,77) 1 < 0,001 Tiep cdn thong tin
> 2
< 1
3,284(1,84-5,88)
1 < 0,001 1,834(0,92-3,66)
1 0,086
Thai Sf Dung Chua dung
6,318(1,31-30,44)
1 0,017 8,377(1,44-48,69)
1 0,018
Cac yeu td lien quan dSn thuc hanh vdi p<0,05 la trinh dd va thai dp va p<0,001 la kiSn thiic
IV. BAN L U ^
4.1. Tinh hinh sir dung muoi iod va cac ly do khdng sir dung muoi iod
Ty Ie HGD sii dung MI la 56,4% trong do, chi su dung MI chiSm 29,8%. Ty IS nay fliap ban so vdi do bao phii MI tai DBSCL vao nam 2005 theo tiidng ke cua bSnh vien ngi tiSt (88,1%) [4] va kSt qua nghien ciiu cua NguySn Thi Tham tai xa Giai Pham, Yen Mf, Hung Yen 2014 (71,2%) [5]. DiSu nay cd the do su giam miic dp uu tien cua chuang trinh phdng chdng cua rdi loan do thiSu hut iod din dSn viec ngudi dan ciing it quan tam dSn viSc sii dung MI.
Cd 295 DTNC dugc hdi ve ly do khdng sir dung MI, ly do phd biSn nhdt la MI mgn han mudi thudng (45,7%). So vdi nghiSn ciiu cua Hoang Kim iSac ve nguyen nhSn khdng sii dung MI tai DBSCL nam 2004, tuy cd su chSnh lech vS ty le nhung ly do chiSm ty le cao nhat van la MI man ban mudi thudng (32,3%) [7], TiSp den la hhong can thiit phdi sir dung MI (21,7%), mudi thudng tiin lgi cho viec uap/rira thuc phdm, nudi gia sue (16%), MI CO miii vi khd chiu (12,6%), chiSm ty IS th5p nhat la MI khdng sach (1%), cac ly do khac: thdi quen, tuy mdn dn md sir dung logi mudi «flo,...chiSm 8,6%. Cac nguyen nhan nay phan anh boat ddng tuyen truySn chua du manh, chua tiSp c^in ngudi dan va
TAP CHI Y Dl/gfC Hpc CAN THO-SO 11-12/2018
chua eg thS. TrSn thgc tS khong phai MI cd vi man, chat nhu ngudi dan van nghi, tiiat ra iod la chat khdng mau, khdng miii, khdng vi nSn khdng iam thay ddi chat lugng ciia mudi, cam giac MI man ban muoi thudng la do hp khdng dugc tuyen truyen rang MI dugc sii dung hSu hSt la mudi tinh do da dugc nghien, rCra hay da dugc nau len vcri dp tinh khiSt cao dan ddn do man cao vi v^y khi nSm MI can nem lugng it hon so vdi mudi thudng. Do dd, chi cSn diSu chinh giam bdt lugng mudi nSin trong khi n^u thiic an dS nidn an khdng bj man. Cd thS day cung la ly do can trd dang kS viec khong sir dimg MI nhat la khi nhan thiic cua ngudi dan cdn ban chS ho^c vi MI dat nen tiSt kiem da dimg ca 2 loai mudi dan dSn tinh t^mg ngudi dan dimg MI nhung thu nhap iod VMI khdng dii. DS cai thien tinh t r ^ g nay can phai quan tam, day manh truyen thdng toan dien dS ngudi dan de hp hieu c&n kS va sii dung MI hieu qua nhat.
4.2. Ki^n thirc - thai do - thyc hanh v^ su* dung muoi iod
KiSn thiic diing nhdm ndi dung MI (78,1%) va each su dimg MI (76%) chiSm ty le cao nhat so vdi cac nhdm ndi dung cdn l^. Kien thiic diing v^ each bao quan chiim 63,1%, each chpn mua dat 52,4% va cac thuc pham/gia vi cd iod chi dat 16,2%. So voi nghien ciiu ciia tac gia Nguyen Thi Tham cd su khac bi?t, cd dSn 92,7% biSt each sii dung xong chi 28,8% biSt each bao quan MI [5]. Thuc ttang nay ndi ISn rang ngudi dan chua dugc cimg cap kien thiic vS MI, hp khdng biSt dugc iod la mdt chat de bay hai khi d nhiet dp cao, nen ttong qud trinh su dung hg khdng bi^t rang nSn nSm MI khi da nSu chin va tat bSp va khi bao quan phai dS noi xa bSp liia, ttanh nang ndng. VS lgi ich sii dung MI, 59%
biet tac dung phdng budru cd thap hon nghien ciiu cua Phgm Thi Nhi (92,9%) [3J, biet dugc 2 lgi ich la buou cd va dan dgn/cham phat ttien tti tue chiem 20,7%. HiSu biSt day dii tac dung (Budu cd, dan dgn/cham phat trien tri tue, say thai, de non) chiem ty IS rSt thap chi 2,4%. So voi tac gia Nguyen Tlu Tham, cd dSn 80,6% biet lgi ich sii dung MI [5].
MI phdng ngita budu cd la kiSn thiic kha phd biSn song ty 1^ na^ khd thSp, diSu nay cho thay ngudi dan dugc tiep can thdng rat han che, boat ddng truyen thdng chua tdt. Ddng thai, hg khdng biet ve cac roi loan khac do thieu iod dSn ddn hanh vi khdng dimg MI do khdng budu cd. ThSm vao dd, kiSn thiic vS cac ddi tugng nguy co cao thiSu iod 1^ rat thap, 35,7% tte em, phu nu mang thai 14,8% va 12,9% phu nii mang thai. Nhdm ndi dung nay hau nhu rat it ngliien ciiu de cap d^n trong ngi dung nghiSn ciiu, tuy nhien lai rat quan ttgng, hiSu biSt ve nhdm ndi dung nay qua thap din dSn viec it chii ttgng ban ttong vi^c su dung MI ttong nhiing HGD cd nhiing ddi tugng nay Iam tang nguy co thiSu iod d cac doi tugng na^ ndi riSng va cac thanh viSn khac ttong gia dinh ndi chung. KiSn thiic chung diing chiSm ty 1^ rit tiiap, chi dat 29% cao ban nghien ciiu ciia Pham Thi Nhi (19,7%) [3], cd the do dia ban chiing tdi nghien ciiu la dd thj uSn ngudi dan cd ki^n thiic cao han, tiep can thdng tin tdt hon.
Thai dp va thuc hanh dugc khao sat ttSn 237 HGD cd sir dung MI, k^t qua ghi nhan dugc ty 1$ thai do dimg rdt cao 95,8%, ty le thuc hanh diing chi dat 59,5% cao han so vdi nghien ciiu cua tac gia Phgm Thi Nhi tai Binh Minh, Vinh Long nam 2015, vdi ty le tiiai dp va thuc hanh diing i k lugt la 88,9% va 32,6% [3]. Cd su chenh lech vd ty 1$ diing giiia thai dp ya thgc hanh va ty IS kiln thiic diing cung thdp ban hai ty I? ttSn la do khao sat thai dp ddi tugng dugc cung dp thdng tin va chi cdn dua ra y kiSn vS thdng tin dd, co the doi tugng cd nghe qua va ggi nhd ve nd se de d a i ^ dua ra y kiSn diing, nhung neu dS ddi tugng tu cung cdp kiSn thiic mdt each chinh xdc theo nOi dung nghien ciiu thi se rat khd. Ben canh dd, ttong khao sat thai dg ngudi dan cdn cho rang nhiing y kien vira neu ra 344
TAPCHTY Di/qrc HQC CAN THa - so 11-12/2018
la mgt thdng tin tuySn truyen va cho rang diing. Ddi khi thuc hanh diing la do ngau nhien, vi muc dich khac khdng phai do hieu biet. phan lon DTNC ndi rang day bii mudi kin dS chdng cdn trimg, bao quan tranh nang ndng de mudi khdng bi am, chii hg khdng biet iod cd the bay hoi hay neu MI am thi iod se dgng lai duoi day Ip, lugng mudi d phia tren se khdng dii iod trong khi phdn mudi phia duoi thi lai du lugng iod.
4.3. Mgt so yeu to lien quan den thyc hanh su* dung muoi iod
Trinh do > cap 3 thuc hanh diing gdp khoang 2 ldn so vdi trinh do < cdp 1 (OR = 2,335), KTC 95%, 0,984 - 5,541, su khac biet co y nghia tiidng ke p < 0,05. KiSn tinic diing thuc hanh diing gdp khoang 5 ldn so vdi kiSn thiic chua diing (OR = 5,367; KTC 95%, 2,675 - 10,77), su khac biet cd y nghia thdng ke vdi p < 0,001. Thai do diing thi tiiuc hanh diing gdp khoang 8 ldn so vdi thai do chua diing (OR = 8,377, KTC 95%, 1,441 - 48,69), su khac biet cd y nghia thdng ke vdi p = 0,018. KSt qua nay ciing tirang tu nghiSn cmi ciia Phgm Thi Nhi, tim dugc sir lien quan giiia thuc hdnh vdi trinh dp (OR = 2,69, p<0,001)) va kiSn thiic (OR = 2,63, p<0,001), tuy nhiSn chua tim dugc mdi lien quan gjiia thuc hanh va tiiai dp [3].
V. KET L U ^
Ty Ie su dung MI cdn thap 56,4% so vdi muc tiSu cua qudc tS (>90%), ly do khdng sir dui^ MI chiSm ty IS cao nhat la man ban mudi thudng (45,7%). Ty IS thai dp diing ve su dung MI (95,8%) cao hon so vdi kiSn thitc (29%) va thuc hanh dimg f59,5%). Trinh dd
> cdp 3, kiSn thiic va thai do diing thuc hanh dimg cao ban < cap 1, kiSn thiic va thai dp chua diing.
TAI LIEU T H A M K H A O
1. Bg Y Tg (2015), Bdo cdo ddnh gid 09 ndm thi hdnh n^hi dinh sd 16S/2005/ND-CP ngdy 29/12/2005 eua chinh phu ve sdn xudt vd cung ung muoi i-dt cho ngudi dn. Ha Npi.
2. Le Kun Chieng va cac cpng su (1993), "Dieu tta thgc trying tiiiSu i-6t d Viet Nam nam 1993", Mdt sd cong trinh nghiin ciru khoa hgc tiiu biiu cua cdc du dn qudc gia thuc hiin tgi binh viin Ngi tiit 1969-2003, NXB Y hpc. Ha N^i, tt. 122-128.
3. Pham Thj Nhi (2016), Nghiin ciru tinh hinh sir dung muoi iod vd kiin thdc. thdi do, thuc hdnh ctia nguai ddn tgi phu&ng Bdng Binh, thi xd Binh Minh, tinh Vinh Long 2015, Luan van tdt nghtSp bac sp Y hgc Dg phdng, Dai hoc Y Dugc Cdn Tho.
4. Nguyin Vinh Quang va cac cpng su (2009), "Tinh hinh sir d\ing mudi i-6t va thu nhan i-dt cua phu nu co con dudi 5 tudi nam 2008, 2009", Ky yiu hgi nghi ngi tiit - ddi thdo du&ng todn qudc ldn VI, NXB Y hpc. Ha Npi, tt.493-498.
5. Nguyin Thi ThSm (2014), "KiSn thuc, thuc hanh va mdt sd ySu td lien quan den sii dung mudi iode tai xa Giai Pham, huyen Yen My, tmh Hung Yen, nam 2014", Yhgc Duphdng.
XXIV(9), tr.58.
6. Tdng cue Thdng ke (GSO) (2011), VietNam Diiu tra ddnh gid cdc mue tieu tre em vdphu ntr207/,HaNgi.
7. Hoang Kim Udc (2004),"Nghien cuu dinh tinh xac dinh nguyen nhan khong sir dung mudi lode va d l nghi mpt so giai phap cu the nham nang cao su dung muoi iode tai DBSCL", Hdi nghj khoa hgc todn qudc chuyin ngdnh Ngi tiet vd chuyin hda ldn thir hai, tt. 184-187.
(Ngdynhgn bdi: 14/11/2017-Ngdydi^iitddng: 08/01/2018)
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