中国两个狂犬病高发地区儿童暴露后处置行为调查

Self-management behaviors among children after exposure to rabies in two severe rabies epidemic areas of China

目的 了解中国狂犬病高发地区儿童狂犬病暴露后处置行为状况.方法 于2007年1月至2008年5月,采取典型抽样方法在狂犬病高发地区广东和贵州两省选取2所地市级小学、2所县级小学、4所乡镇级小学和4所村级小学,通过系统抽样方法在各个年级选择部分学生进行问卷调查.结果 2408名小学生中290人次发生狂犬病暴露,其中47.93%的小学生在暴露后自行进行伤口处理,16.55%自行前往医疗机构就诊,63.79%告诉家长或教师,23.10%的小学生暴露后未采取任何处置措施.广东省小学生暴露率低于贵州省,而暴露后处置行为率高于贵州省.在发生暴露的学生中,不同性别及不同学校级别间的暴露后自我应对情况未发现差异有统计学意义.各年级小学生暴露后用酒精消毒和主动就诊行为的比例均较低,但暴露后告诉父母或老师的比例则较高.结论 广东和贵州两省小学生狂犬病暴露后部分未进行任何处置,应加强相关教育.

Objective To understand the situation of rabies exposure and self-management behaviors among primary school students from rabies epidemic areas in China. Methods This population-based investigation was conducted in Guizhou and Guangdong provinces which had been severe epidemic areas of rabies in China from January 2007 to May 2008. Primary schools from two prefectural, two county, four township and four village levels were selected in the 2 provinces.Students were sampled from each grade of the 12 schools to collect information on post-exposure prophylaxis. Results In the 2408 primary school students interviewed, 290 person/times exposure were found from 2007 to 2008. The self wound-treatment rates was 47.93%, with 16.55% of themwent to the clinic for care-seeking initiatively and 63.79% informed their parents or teachers. However 23.10% of the students did nothing after exposure. Students in Guangdong province had lower exposure rate and higher rate of good management behaviors than in Guizhou. No significant statistical difference was found between the self-management behaviors among male and female students or among different levels of primary schools. The proportion of disinfection on wounds with alcohol and seeking medical treatment in rabies clinic initiatively were both low in all grades of the students but the proportion of telling their parents or teachers about the exposure among children was high in all grades of students. Conclusion Some students after rabies exposure did not have any disposal in Guangdong and Guizhou provinces. Related education should be strengthened.