家庭因素对湖南省农村人群狂犬病暴露后疫苗接种的影响

The influence of familial factors on post rabies exposure vaccination in rural habitants

目的 了解湖南省农村人群狂犬病的暴露现状,探讨家庭因素对人群狂犬病暴露后疫苗接种的影响.方法 采取多阶段抽样方法,在湖南省选取4个县20个乡镇40个村,每村选取部分村民参与家庭基本情况及暴露后疫苗接种的问卷调查,采用SPSS 17.0软件分析.结果 共调查40个村864户3042名村民,自2009年1月至2010年10月共发现狂犬病暴露124人次,合计暴露率为4.08％,年平均暴露率为2.33％.单因素分析表明家庭狂犬病防治知识得分（x2=8.260,P=0.042）、家庭有无加入“新农合”（P=0.035）、2009年家庭可支配现金收入（x2=10.831,P=0.031）及住家离乡镇卫生院的距离（x2=9.07l,P=0.033）4项家庭因素与暴露后是否接种狂犬病疫苗有关.多因素logistic回归分析显示家庭狂犬病防治知识得分（OR=1.420,95％CI：1.055～1.905）与2009年家庭可支配现金收入（OR=1.480,95％CI：1.044～ 2.098）为影响狂犬病疫苗接种的独立因素.结论 加强农村居民狂犬病防治知识的宣传教育及增加家庭可支配现金收入是提高农村居民狂犬病疫苗接种率的可行措施.

Objective To understand the current situation of potential exposure to rabies among the rural habitants in Hunan province,and to study the impact related to familial factors on post rabies exposure vaccination.Methods In total,40 villages from 20 townships of 4 counties were selected by multistage sampling method.Study samples were selected from these villagers and familial basic information and vaccination post rabies exposures were recorded through questionnaires.Data were statistically analyzed by SPSS 17.0.Results Among 3042 villagers from 864 households being surveyed,124 person-time exposures were found from January,2009 to October,2010,with a total exposure rate as 4.08%,and the annual average exposure rate as 2.33%.Data from univariante analysis showed that the rates on post rabies exposure vaccination were statistically correlated with the following four factors：knowledge on the score of rabies prevention （x2 =8.260,P =0.042）,whether being involved in the new type of rural cooperative medical care （P =0.035）,family disposable cash income in the year of 2009 （x2 =10.831,P =0.031）,distance between the households and the health facilities in towns and townships （x2 =9.071,P=0.033）.Results from logistic regression analysis indicated that the score of knowledge on rabies prevention （OR=1.420,95%CI：1.055-1.905） and the annual disposable cash income of the family in 2009 （OR=1.480,95% CI：1.044-2.098） were independent factors that influencing the rabies vaccination.Conclusion Strengthening the education programs on rabies prevention in rural habitants and increasing family income were feasible way to increase the rate of rabies vaccination in rural areas of Hunan province.