少数民族农村贫困地区HIV/AIDS综合干预研究

目的 为少数民族农村人群提供稳定的社会、经济及卫生支持，改变贫困和缺乏知识导致的HIV高危行为，从根本上遏止 HIV/AIDS在该特征地区一般人群中的流行。方法 运用社区干预实验的方法，随机选取2个彝族聚居的行政村作为综合干预试点村，给予与扶贫相结合的形式多样的健康促进综合干预，对照村不进行干预。结果 干预后2试点村艾滋病相关知识得分率大幅提高；吸毒人群共用注射器的频率下降，重复使用的注射器清洗行为显著增加，但干预后不使用安全套者仍在70％以上。结论 贫困是制约 HIV/AIDS防治的一大因素，贫困地区 HIV/AIDS防治应采取结合扶贫的综合干预方法。     

广西改厕改水项目村妇女健康知识态度和行为调查

目的了解欧盟援建广西改厕改水项目地区农村家庭主妇的健康知识水平和改厕改水相关的卫生行为状况,为今后制定有效的、可持续的健康教育策略提供科学依据。方法选择广西欧盟援建改厕改水项目地区的隆安县爱华村和陆连村,宾阳县冯村和那宁村,柳江县白见村和三都村等6个项目村作为调查评估的样本村;每个样本村随机抽取60户,共360户,所抽取农户的360名家庭主妇作为调查对象。以入户访谈方式进行问卷调查,由调查员询问家庭主妇与改厕改水相关的健康知识、态度和个人行为状况。结果6个项目村的家庭主妇对5个相关健康问题回答正确率均在85%以上;大多数家庭主妇的健康卫生认识态度比较好,并且支持和愿意参加健康教育宣传活动;饭前洗手率、便后洗手率、喝开水等良好行为比例,爱华村和陆连村家庭主妇比较高,而冯村、那宁村、白见村、三都村等4个村家庭主妇则比较低;大多数家庭主妇将电视作为获得卫生知识的主要渠道。但不同文化程度和经济收入,家庭主妇选择获取卫生知识的渠道略不同。结论农村家庭主妇健康知识水平比较高,伴随改厕改水开展的健康卫生教育取得一定成效,但某些习惯性不良卫生行为的改变与卫生知识知晓水平的提高相比要滞后;在改厕改水项目农村地区进行健康教育干预活动的过程中,要根据不同文化程度、经济条件等选择适合的健康教育方式,使健康教育和促进科学有效地实施。     

Endemic Lassa fever in Liberia. VI. Village serological surveys for evidence of Lassa virus activity in Lofa County, Liberia

Six villages in Lofa County, north-west Liberia, and one near the coast were surveyed for the presence of indirect fluorescent antibodies (IFA) to Lassa virus (LV). Prevalences were similar among males and females, and among various age groups. The prevalence of IFA positive sera, 6.4%, in two roadside villages was significantly higher than in two matched villages "in the bush", 1.9%. It was also higher in Gbanwei, a roadside village which did not maintain traditional sanitary measures, than in Zuwulo, similarly located but with maintenance of clean-swept areas without shrubbery or rubble between the houses. In another pair of villages, the one adjacent to a Mission Clinic with a very high prevalence of IFA positive staff members had significantly higher prevalence, 14.1%, than did the other, a roadside village with 5.1% seropositives. LV antibodies were also found in 4.3% of the inhabitants of a small coastal village near Robertsfield International Airport. Though LV infections are more common in villages in which traditional practices have been modified, they are present even in villages which are relatively unchanged. In the former they appear to be continuous while sporadic in the latter. The prevalences of IFA in the villages with the highest rates are about one third of what is found in personnel of hospitals near them, suggesting that hospital staff members acquire infections from patients as well as from the communities in which they live.     

德宏州村医性病艾滋病知识培训需求及态度调查

[目的]了解云南省艾滋病流行严重地区(德宏州)村医对艾滋病相关知识知晓情况及需求状况。[方法]对德宏州436名村医进行艾滋病相关知识问卷调查。[结果]75%的乡村医师已经接受过艾滋病相关知识的培训,95%的人掌握了艾滋病的三个传播途径;职业暴露和消毒隔离等问题正确回答率较低;多数人对防治HIV/AIDS持积极、正性的态度。[结论]大多数德宏州村医已经接受过培训,了解艾滋病传播途径,为他们今后工作打下了基础,但如将进一步承担防治艾滋病预防、宣传、治疗管理、关怀救治等工作,具有针对性、实用性的培训仍然十分必要。     

实施WES项目对农村环境卫生的影响

目的 了解实施水与环境卫生(WES)项目对农村环境卫生的影响。方法 在实施WES项目的县选择8个改厕村和1个未改厕(对照)村调查户厕内苍蝇密度、蛆密度和臭度,同时按照统一调查表调查农民卫生知识、行为、改厕满意度。结果 改厕户的卫生厕所苍蝇密度、蛆密度和臭度均低于未改厕户的旧式厕所,差异均有显著性(P<0.05)。实施WES项目的村居民卫生知识水平、卫生行为和习惯均优于未开展WES项目的村。改厕户居民对卫生厕所的满意度高达94.8％。结论 实施WES项目提高了农村环境卫生整体水平。     

血吸虫病流行地区农村居民血吸虫病相关知识及行为现状

目的了解我国血吸虫病流行地区农村居民血吸虫病相关知识及行为状况。方法在中国目前仍然存在血吸虫病流行的湖南、湖北、江西、安徽、江苏、云南、四川7个省,每省随机抽取2个流行县,每县分别选取3个流行村,其中2个村为完成改厕村,1个村为非改厕村;每村随机抽取30户农户进行现场调查。结果血吸虫病流行的农村地区有90．8％的居民知道血吸虫病,71．8％居民知道血吸虫病的流行与尾蚴和钉螺相关,46．9％的居民将不沾疫水作为防止血吸虫病感染的首要措施,16．9％居民选择“改水改厕”做为预防血吸虫病流行的预防措施。报纸、电视、广播等大众传媒是农村居民卫生知识的主要来源。90．5％使用无害化卫生厕所的农户和87．7％使用非卫生厕所的农户仍然直接用农肥作为处理粪便的主要方式。83．6％中国血吸虫流行农村地区使用非卫生厕所人群愿意和接受建造和使用卫生厕所。结论血吸虫病流行地区农村的健康教育工作指导方针,应根据新时期血防以控制传染源为主的防治策略进行调整。发挥广播电视等大众传媒的作用,开展健康教育与健康促进活动。以控制传染源为宣传核心,普及预防血吸虫病知识,提高人民群众的自我防护意识和能力,建立良好的卫生行为。     

云南省建水县农村环境卫生现状调查结果

目的了解云南省建水县农村户厕和粪便处理,垃圾、污水治理情况,为制定农村爱国卫生相关规划和策略措施提供科学依据。方法根据随机的原则,选取5个乡镇20个村,每村5户为调查点,采用统一调查表入户调查。结果建水县农民以初中文化为主,主要经济来源为种植业,村内道路以部分硬化为主,集中式供水覆盖率为66．1％;卫生厕所普及率为69．5％,厕室大多有臭味和蝇蛆,粪便以直接施肥为主。垃圾主要是生活垃圾,随意堆放占60．0％,所有堆放点都有臭味和苍蝇,主要采用焚烧和填埋方式处理。生活污水明沟排放为主。79．0％的人家房屋周围有病媒生物孳生地,大多数家庭有鼠迹、蟑螂和苍蝇。土壤监测蛔虫卵阳性率15．0％。结论建水县农村垃圾、污水、粪便无害化处理率低,环境卫生状况亟需进一步改善。     

Awareness and utilisation of MCH and FP services by a rural community in Maharashtra [letter

62% of India's population is comprised of mothers and children, for whom many health agencies provide maternal and child (MCH), and family planning (FP) services. 249 adult members from three villages of Primary Health Center, Telegaon, in Wardha district, were interviewed to assess the awareness and use of these services. Each village had government and private health agencies providing MCH and FP services. Adequate knowledge of MCH and FP services, however, is one of the prerequisites for using services; 85-89.5% knew of promotive services. The awareness of nutritional programs, school health services, and health education, however, were lower in the range 7.9-36.3%. Similar findings have been reported in previous studies. The knowledge of MCH services was significantly different between educated and uneducated respondents. As for service use, antenatal care service and immunization coverages were 80-86% and 56.96%, respectively. Earlier studies found coverages of only 9.6-50% for antenatal care services and 45-69% for immunizations. FP practice was high in all three villages due to the priority given to those services by the government. This study demonstrates the ability of education facilities and services availability to increase the knowledge and practice of MCH and FP services in the interest of realizing targets established by the World Health Organization by the year 2000.     

Awareness and utilisation of MCH and FP services by a rural community in Maharashtra

62% of India's population is comprised of mothers and children, for whom many health agencies provide maternal and child (MCH), and family planning (FP) services. 249 adult members from three villages of Primary Health Center, Telegaon, in Wardha district, were interviewed to assess the awareness and use of these services. Each village had government and private health agencies providing MCH and FP services. Adequate knowledge of MCH and FP services, however, is one of the prerequisites for using services; 85-89.5% knew of promotive services. The awareness of nutritional programs, school health services, and health education, however, were lower in the range 7.9-36.3%. Similar findings have been reported in previous studies. The knowledge of MCH services was significantly different between educated and uneducated respondents. As for service use, antenatal care service and immunization coverages were 80-86% and 56.96%, respectively. Earlier studies found coverages of only 9.6-50% for antenatal care services and 45-69% for immunizations. FP practice was high in all three villages due to the priority given to those services by the government. This study demonstrates the ability of education facilities and services availability to increase the knowledge and practice of MCH and FP services in the interest of realizing targets established by the World Health Organization by the year 2000.     

2016-2019年吉林省农村环境卫生监测分析

目的 了解吉林省近年来农村环境卫生状况及其动态变化,评价农村居民生活环境卫生质量,为政府制定政策和公共卫生干预措施提供科学依据.方法 2016-2019年每年选取吉林省240个行政村监测点,采用现场观察、调查询问等方式收集数据.结果 2016-2019年,吉林省农村卫生厕所普及率分别为44.19％、35.34％、28....     

血吸虫病流行地区农村改厕卫生效益分析

目的评估血吸虫病区的改厕工作卫生效益。方法在目前仍然存在血吸虫病流行的湖南、湖北、江西、安徽、江苏、云南、四川等7个省,每省随机抽取2个血吸虫病流行县,每县分别选取3个村,其中2个村为完成改厕村,1个村为非改厕村;每村随机抽取30户农户,进行现场调查和厕所粪便样品检测。结果改厕地区人群血吸虫感染率比非改厕地区人群低47.32%;改厕地区人群肠道传染病发病率比非改厕地区人群低42.31%;使用卫生厕所人群血吸虫病患病率比使用非卫生厕所人数低63.5%。结论在中国血吸虫病流行的农村地区,通过卫生厕所的推广与建设,可降低居民血吸虫感染率和肠道传染病发病率。     

成都市武侯区度假材卫生状况调查

本文对成都市武侯区度假村的卫生状况进行了问卷调查和卫生指标监测。结果表明：该区度假村卫生组织管理和基础卫生设施项目合格率为40．6％;从业人员卫生知识及法规回答正确率为73．7％;卫生指标监测合格率为82．8％;其中空气细菌总数超标率为56．5％,床上卧具细菌总数超标率625％．茶杯大肠菌群阳性检出率为53．8％。本文对改善度假村卫生质量提出了建议。     

中国血吸虫病流行农村地区卫生厕所施工管理状况分析

目的：了解中国血吸虫病流行地区卫生厕所施工管理状况,以及其对卫生厕所建造质量的影响。方法：在湖南、湖北、江西、安徽、江苏、云南、四川7个省,每省随机抽取2个流行县,每县选取2个完成改厕的流行村,1个未完成改厕的村,进行村级调查。在已经完成改厕的村,每村随机抽取30个农户家庭进行现场调查。结果：家庭卫生厕所为村里组织或上级委派的施工队建造的占90.3%,参与卫生厕所建造的施工单位（个人）有90.0%经过了相关的专业技术培训,有67.5%具有建造资质,上级单位委派施工队建造的三联式沼气池式卫生厕所占74.0%,村委会组织施工队建造的三格化粪池式卫生厕所占89.8%,34.4%的三格化粪池式卫生厕所地下部分建造设计和49.3%的三格化粪池式卫生厕所第一、二、三格容积比例符合《血吸虫病流行地区农村改厕技术规范（试行）》三格化粪池厕所的设计与施工要求。结论：中国血吸虫病流行农村地区,由上级政府委派施工队和村委会组织施工队建造是家庭卫生厕所建造施工的主要方式,三格化粪池式卫生厕所地下部分的合格率偏低,第一、二、三格容积比例不当是影响三格化粪池式卫生厕所地下部分建造质量的主要因素,应该加强施工队伍的培训和施工的监督管理。     

贵州省少数民族地区儿童计划免疫IEC策略制定的需求调查

目的了解贵州省少数民族地区群众对计划免疫的认知水平及计划免疫宣传教育的现状，为信息、教育与传播(infomaation education and communication，IEC)策略的制定及传播材料的设计提供依据。方法选取黔东南地区剑河和榕江县共8个村子作为调查地点；采用自行设计的计划免疫知、信、行问卷调查了189名7岁(含)以下儿童母亲，组织儿童主要看护人的小组讨论，对村长／支书及乡村医生进行个人深入访谈。结果被调查地区群众对儿童预防接种基本持有正确的态度，但缺乏预防接种的基本知识，他们现有的浅显的预防接种信息大多来自医生和村干部；被调查地区计划免疫宣传教育很缺乏，但村民对计划免疫知识是渴求的，他们对医生或村干部的话充满信任，对宣传画、民歌／快板书等宣传形式十分喜爱，且有一部分人有一定的化，可阅读简单宣传语；电视和VCD机的家庭拥有比例分别为72．5％、34．4％。结论本次需求调查为制定贵州省少数民族地区儿童计划免疫IEC策略提供了依据。     

Implementing community-based perinatal care: results from a pilot study in rural Pakistan

OBJECTIVE: This pilot study investigated the feasibility of delivering a package of community-based interventions for improving perinatal care using lady health workers (LHWs) and traditional birth attendants (Dais) in rural Pakistan. METHODS: The intervention was implemented in four of eight village clusters (315 villages, total population 138,600), while four served as a comparison group. The LHWs in intervention clusters received additional training focused on essential maternal and newborn care, conducted community education group sessions, and were encouraged to link up with local Dais. The intervention was delivered within the regular government LHW programme and was supported by the creation of voluntary community health committees. FINDINGS: In intervention villages, there were significant reductions from baseline in stillbirth (from 65.9 to 43.1 per 1000 births, P < 0.001) and neonatal mortality rates (from 57.3 to 41.3 per 1000 live births, P < 0.001). The proportion of deliveries conducted by skilled attendants at public sector facilities also increased, from 18% at baseline to 30%, while the proportion of home births decreased from 79% to 65%. A household survey indicated a higher frequency of key behaviours (e.g. early and exclusive breastfeeding, delayed bathing and cord care) in intervention villages. CONCLUSION: The improved stillbirth and neonatal mortality rates observed indicate that community health workers (i.e. LHWs and Dais) can be effective in implementing a community and outreach package that leads to improved home care practices by families, increased care-seeking behaviour and greater utilization of skilled care providers. These preliminary observations require confirmation in an adequately powered trial.     

血吸虫病流行地区农村卫生厕所状况分析

目的了解我国血吸虫病流行地区卫生厕所施工方式和建造人员的状况以及其对卫生厕所建造质量的影响。方法在湖南、湖北、江西、安徽、江苏、云南、四川7个省,每省随机抽取2个血吸虫病流行县,每县选取2个完成改厕的流行村,1个未完成改厕的村,进行村级调查。在已经完成改厕的村,每村随机抽取30个农户进行现场调查。结果家庭卫生厕所为村里组织或上级委派的施工队建造的占90.3%,参与卫生厕所建造的施工单位(个人)有90.0%经过了相关的专业技术培训,有67.5%具有建造资质,上级单位委派施工队建造的三联式沼气池式卫生厕所占74.0%,村委会组织施工队建造的三格化粪池式卫生厕所占89.8%,34.4%的三格化粪池式卫生厕所地下部分建造设计和49.3%的三格化粪池式卫生厕所第一、二、三格容积比例符合《血吸虫病流行地区农村改厕技术规范(试行)》要求。结论中国血吸虫病流行地区农村,由上级政府委派施工队和村委会组织施工队建造是家庭卫生厕所建造施工的主要方式,三格化粪池式卫生厕所地下部分的合格率偏低,第一、二、三格容积比例不当是影响三格化粪池式卫生厕所地下部分建造质量的主要因素,应该加强施工队伍的培训和施工的监督管理。     

Personal health practices and attitudes toward nonsmokers' legal rights in Japan

To evaluate a role of education to acquire a healthy lifestyle (health education) in achieving a smokeless society, the relationship between attitudes toward the legal right to be free from involuntary smoking in public places, based on human rights, and personal health practices was determined using answers to a questionnaire from 887 randomly-selected citizens of Osaka. The answers were analyzed within four subgroups of respondents divided by smoking status and sex. Among the respondents, three significant relationships of attitude scores to health practices were identified. Within subgroups of female subjects, questionnaire attitude scores decreased as health practice scores increased. Among male non-smokers, those who had high health practice scores also had high attitude scores. Among male smokers, there was no statistical association between health practice scores and attitude scores. Our results demonstrated that attitudes toward the legal right to be free from involuntary smoking among male-nonsmokers were closely related to personal health practices, and implied the effectiveness of health education among this subgroup for the advancement of their legal right to be free from involuntary smoking.     

Treatment of minor illness in primary care: a national survey of patient satisfaction, attitudes and preferences regarding a wider nursing role

BACKGROUND: This study investigated patient opinion about the provision of nurse-led vs. doctor-led primary health care in the treatment of minor illness. DESIGN: A postal questionnaire survey including discrete choice experiment (DCE) of a national sample followed by telephone interviews with respondent volunteers. SETTING AND PARTICIPANTS: A large random sample of the population of Scotland from a range of general practices including traditional and extended practice nursing roles was invited to participate. MAIN OUTCOME MEASURES: Patient satisfaction with, opinion of and preference for practice nurse (PN) vs. doctor consultation in primary care in relation to gender, age, education and income. RESULTS: Questionnaire response rate was 49% (1343 of 2740). Women, younger people, the less well-educated and those with higher income had a more positive attitude towards the PN. Older people had a more positive attitude to the doctor. Results from the DCE indicated that whilst most respondents would prefer a doctor consultation, many would be happy to consult with a nurse if other aspects of the consultation were improved. Forty-eight people were interviewed. The main perceived differences between doctors and nurses were academic ability and qualifications. Most respondents thought nurses could deal with relatively minor problems and should be able to prescribe some drugs. CONCLUSION: Patients would always want their choice of health professional to be available at first contact. However, this study suggests that, in primary health-care practices, if nurses take on more roles previously the preserve of doctors, patients would accept them, particularly if patients receive information on nurses' capabilities.