深圳市宝安区5岁以下婴幼儿轮状病毒胃肠炎的社区干预研究

目的 了解深圳市宝安区5岁以下婴幼儿看护人轮状病毒胃肠炎的知信行,评价轮状病毒胃肠炎的社区干预效果。 方法 在深圳市宝安区辖区内选取轮状病毒发病率、人口特征、医疗水平和经济水平接近且地理位置不相邻的两个街道分别作为干预街道和对照街道。对干预组辖区内的医疗场所规范其消毒处理,在医疗场所和社区内进行轮状病毒胃肠炎的健康宣教。调查干预前后两街道的婴幼儿看护人轮状病毒胃肠炎的知信行,干预后两街道儿童的轮状病毒胃肠炎的发病率。 结果 干预街道看护人干预前后轮状病毒胃肠炎知识知晓率(χ²=14.897,P<0.001)、看护人使用开水煮的方式对婴幼儿奶具消毒的比例(χ²=7.978,P=0.046)、消毒餐具的频率(Z=2.358,P=0.018)、使用开水煮的方式消毒餐具的比例有提高(χ²=20.608,P<0.001)。干预后,干预组疫苗接种的比例高于对照组(χ²=4.334,P=0.037)。流行季节过后,干预街道RVGE患病率较对照组低,差异有统计学意义(χ²=4.927,P=0.026)。 结论 通过规范医疗场所的消毒处理;加大医疗场所和社区的健教宣传,提高了婴幼儿看护人对轮状病毒胃肠炎的知识水平、促进其形成健康的看护习惯,可降低婴幼儿轮状病毒胃肠炎的发病率,为轮状病毒胃肠炎的社区干预提供可行方法。

Community intervention of rotavirus gastroenteritis among young children aged 5 years below in Baoan District,Shenzhen City

Objective To investigate the knowledge, attitude and practice (KAP) about rotavirus gastroenteritis (RVGE) among caregivers of children aged 5 years below in Baoan District, Shenzhen City, and to evaluate the effect of community intervention on RVGE. Methods We selected two non-adjacent streets with similar incidence rate of RVGE, population characteristics, medical level and economic level in Baoan District, Shenzhen City to respectively serve as the intervention street and the control street. Medical institutions in the intervention street were sterilized and disinfected according to the norms; meanwhile, health education about RVGE was conducted in the medical institutions and communities. The caregivers’ KAP about RVGE in the two streets was investigated before and after the intervention, and then the incidence rates of RVGE in the children of the two streets were surveyed after the intervention. Results After the intervention, the awareness rate of RVGE in the caregivers of the intervention street(χ²=14.897,P<0.001), the proportion of the caregivers performing baby-feeding bottle disinfection by boiling water(χ²=7.978, P=0.046), the frequency of tableware disinfection(Z=2.358, P=0.018)and the proportion of performing tableware disinfection by boiling water(χ²=20.608,P<0.001)were all increased. After the intervention, the proportion of vaccination was higher in the intervention street than in the control street(χ²=4.334,P=0.037). After the epidemic season, the incidence rate of RVGE was lower in the intervention street than in the control street, with a statistically significant difference(χ²=4.927,P=0.026). Conclusions The intervention about standardizing the disinfection of medical institutions and strengthening health education in medical institutions and communities raises the caregivers’ awareness of knowledge about RVGE, promotes the formation of a healthy care habit and finally reduces the incidence rate of RVGE in young children. The Results show that the above-mentioned countermeasures are viable ways for community intervention of RVGE.