跨中缅泰的三种民族社区登革热暴发疫点处置和防控定性比较研究

目的 了解跨境主要民族社区中登革热暴发疫情处置措施,改进以社区为基础登革热防控。方法 在中国和缅甸分别抽取2017年有登革热暴发疫情傣族、景颇族和佤族社区各一个,采用重点人员深度访谈和参与式直接观察相结合定性研究方法,调查登革热暴发疫情处置、防控干预和管理措施。结果 共完成6个社区的调查,中国景洪市郊曼朵傣族村使用环境治理为主防控措施,对发现积水伊蚊阳性家庭进行经济处罚;缅甸南邓佤族社区实行领导负责制,实行环境治理和化学杀虫剂喷洒灭蚊并重防控措施,对发现有登革热病人和积水伊蚊阳性的社区领导进行惩处和追究行政责任;中国盈江县那邦镇景颇寨和沧源县芒卡镇芒岗佤族村,缅甸掸邦东部第四特区万东傣族村和克钦邦第二特区歪咱克钦族村四个社区主要使用化学防治措施,分配环境治理任务给各家各户,然后定期督促检查。结论 6个社区登革热媒介控制和管理精细程度不同,推荐进一步加强管理,开展行为改变交流,促进以环境综合治理为主媒介控制,遏制登革热暴发疫情。

Comparatively qualitative study of responses to dengue fever foci in communities of three ethnical minorities crossing China-Myanmar -Thailand borders

Objective To understand responses to outbreaks of dengue fever (DF) among communities of major ethnic groups in cross-border, so that to improve community-based DF control and prevention. Methods A community with a DF outbreak in China and Myanmar in 2017 was sampled for Dai, Jingpo and Wa ethnic groups, respectively. A combination of in-depth interviews and participatory direct observation were used to investigate responses to DF outbreaks. Results Total six communities have been studied. In Mando that is a Dai village in Jinghong City suburb of China, environmental management (EM) was used as the main interventions, households with Aedes positive water would be fined as a punishment. In Nandeng that is a Wa community in Shan Special Region Ⅱ of Myanmar, community leaders were empowered to be responsible for dengue control. Both EM and spraying or fogging with chemical insecticides were used to control dengue vectors. Community leaders would be fined and administratively punished in a case that there were DF patients or Aedes positive water. The chemical control measure was mainly depended on in four other communities of Jingpo village of Nabang town of Yingjiang County and Manggang Wa Village of Mangka Town of Cangyuan County, China, and Wangdong Dai village of East Shan Special region IV and Waza Kachin village of Kachin Special Region II, Myanmar. Assignment of EM was given to each household with regular supervisions, and responders did not mention any penalty on inappropriate performance at household level. Conclusion Six communities used different dengue vector control and EM methods. Further EM and behavior change communication were recommended to improve intensity of integrated EM for vector control to fight against any possible DF outbreaks.