中国和缅甸傣族对登革热的认知和求医行为及其影响因素比较

目的 调查中缅边境傣族对登革热看法、疑似病人求医行为及其影响因素,促进正确求医。方法 采用重点人员深度访谈和入户问卷调查相结合的调查和数据统计分析方法。结果 缅甸傣族和边境线上打洛镇傣族均知道傣族语登革热名字是“Paya Yong（帕雅蛹）”,但在中国距边境50 km的勐混镇和100 km景洪市郊区傣族不知道任何傣族语登革热名字;中国傣族登革热临床症状知识和登革热敏感意识显著高于缅甸傣族（P<0.01）,中国88.5%(95%CI：84.0%~92.1%)傣族户主知道登革热,50.2%(95%CI:43.9%~56.2%)视登革热为严重疾病;缅甸33.5%(95%CI：27.7%~39.6%)傣族知道登革热,27.8%(95%CI:22.4%~33.7%)认为是严重疾病。多因素logistic分析显示,对登革热意识敏感性是影响中缅两国傣族登革热求医行为首要影响因素,认为登革热能致人死亡户主的家庭更容易前往正规医院求医,中缅两国比值比（OR)分别为6.112(95%CI:2.416~15.456)和5.113 (2.081~12.576),此外中国傣族家庭决策和缅甸傣族登革热知识也影响求医行为。结论 在中缅边境地区,登革热防控不但受病原和媒介生物相互输入影响,也受社会文化相互输入的影响,需进一步通过行为改变的交流,促进求医行为。

Comparative study of Dai People’s perception to dengue and treatment-seeking behaviors of suspected dengue fever and affecting factors between China and Myanmar

Objective Currently there is unavailable drugs to kill dengue virus (DV). Early diagnosis and effective supporting treatment are a critical for reducing DV transmission and improving prognosis of dengue fever (DF) patients. The purpose of this study is to understand Dai people's perception on DF, treatment seeking behavior of suspected DF cases and related affecting factors along China-Myanmar border, so that to promote treatment-seeking behaviour. Methods This was a cross-sectional study which combined qualitative semi-structured in-depth interviews and a quantitative household questionnaire survey, and then corresponding data statistic analysis was carried out. Results The Dai people in Myanmar and Daluo Town of China on the border line know the "Paya Yong" is the DF name in Dai ethnical language. However, the Dai people in Menghun Town which is 50 km from the borderline and in suburban of Jinghong City which is 100 km from the borderline did not know any DF name in Dai ethnical language. The knowledge level of DF symptoms and perception were significantly higher in China than that in Myanmar (P<0.01).The proportions of household heads who knew DF was 88.5% (95%CI:84.0%-92.1%), and who perceived DF as a serious disease was 50.2% (95%CI:43.9%-56.2%), however, only 33.5%(95%CI:27.7%-39.6%%) and 27.8%(95%CI:22.4%-33.7%) respectively in Myammar. Multivariate logistic analysis indicated awareness susceptibility to DF was a main affecting factor of seeking treatment behavior among Dai People in both China and Myanmar. The household heads who perceived DF as a deadly disease were more likely to seek treatment in public health facilities, the odds ratio (OR) were 6.112(95%CI:2.416-15.456) in China and 5.113 (2.081-12.576) in Myanmar respectively. Dai family decision-making in China and knowledge of DF in Myanmar also influenced seeking treatment behavior. Conclusion Prevention and control of DF is not only affected by mutually imported pathogens and vectors, but also by social culture along China-Myanmar border. Behavior change communication is urgently needed to promote treatment seeking behavior further.