1950 — 2001年我国疟疾发病趋势分析

  目的  了解我国居民疟疾防治知识、态度、行为（KAP）相互影响程度。  方法  采取多级分层抽样，于2016年9月 — 2017年3月在广西、安徽、湖北、重庆4个疟疾多发地进行调查。根据疟疾流行的分类标准，将4个省（市）所有疟疾流行县分为1、2、3类县，每一类县抽取3个县共9个县作为样本县；每个样本县随机抽取3个乡镇，共抽取27个乡镇作为样本乡镇；在每个乡镇随机抽取3个村，共81个村作为样本村，随机抽取1358位居民进行入户调查，回收有效问卷1 321，有效率97.3%。问卷内容包括居民家庭条件，个人特征，疟疾防治知识，态度，行为等相关问题，对结果采用KAP量化和多组结构方程模型（SEM）分析。  结果  KAP量化得分上，行为得分最高（0.63 ± 0.25）分，态度（0.61 ± 0.32）分，知识得分最低（0.47 ± 0.22）分；结构方程模型潜在因子之间的总效应上，疟疾知识对行为的总效应为0.4439，疟疾态度对行为的影响效应为0.19，呈“知而趋于行”的特征；不同类别县的知识态度行为相互作用参数差异有统计学意义（P < 0.05）。  结论  我国消除疟疾行动已进入防治疟疾复发阶段，应当加大对偏远地区疟疾防治的卫生宣教，形成良好的态度和行为习惯。

Shrinking the malaria map in China: measuring the progress of the National Malaria Elimination Programme

  Objective  To examine interactions among the knowledge, attitude and practice (KAP) about malaria prevention and control among community residents in rural China.  Methods  Using four-stage stratified random sampling, we conducted a cross-sectional survey in four malaria endemic regions (Guangxi Zhuang Autonomous Region, Chongqing Municipality, and Anhui and Hubei province) between September 2016 and March 2017. We first classified all counties in the four regions into three categories based on malaria prevalence level and selected 3 counties from all counties in each of the three categories. Then, we sequentially selected 3 townships from each of the county and 3 villages from each of the township. Finally we randomly recruited 1 358 adult residents in totally 81 villages of 27 townships in 9 counties for a household interview with a self-designed questionnaire on demographics and KAP about malaria. We performed quantifications on information collected and adopted multiple structural equation model (SEM) in data analysis.  Results  Valid information were collected from a total 1 321 residents (averagely aged 44.78 ±1 7.46 years for 645 males and 676 females) and the response rate was 97.3%. For all the respondents, the scores for malaria-related KAP were 0.47 ± 0.22 for knowledge, 0.61 ± 0.32 for attitude, and 0.63 ± 0.25 for behavior, respectively. The established SEM model revealed that the score for total effect of malaria knowledge on behavior is 0.443 9 and the score of total effect of attitude towards malaria on behavior is 0.19, indicating a much greater influence of knowledge than that of attitude on behavior. The parameters of established SEM model for interaction between malaria-related KAP components varied based on the data collected from different counties (α = 0.05).  Conclusion  Health education on malaria prevention and control needs to be promoted among residents in remote rural areas to improve KAP among the population for control malaria epidemic in China.