上山作业人群疟疾抗体阳性KAP影响因素分析

Knowledge,attitude,and practice towards malaria antibody-positive risk among population working in mountain areas: a case-control study

目的了解上山作业人群影响疟疾抗体阳性的知识、态度及行为(KAP)影响因素,为采取相应的干预措施提供科学依据。方法采用1∶3配对病例对照研究方法对在海南省有疟疾流行的万宁市南林农场和南桥乡、东方市东河镇和江边乡、乐东县乐中农场和保国农场地区上山作业人群中抽取的46例疟疾抗体阳性病例和138名疟疾抗体阴性对照人群进行疟疾相关KAP问卷调查。结果病例组上山夜宿频率4次/周、上山过夜从不预防服药、未接受疟疾防治宣传史、家中蚊帐未用杀虫剂浸泡、上山过夜不采取防蚊措施、疟疾防治知识得分不合格、有露宿习惯的比例分别为34.78%、67.39%、63.04%、80.43%、60.87%、67.39%、76.09%,均高于对照组的23.19%、21.74%、39.13%、34.06%、26.09%、28.99%、40.58%,差异均有统计学意义(P<0.05);多因素条件logistic回归分析结果表明,偶尔和从不预防服药、未接受疟疾防治宣传史、家中蚊帐未用杀虫剂浸泡、上山过夜不采取防蚊措施和疟疾知识得分不合格是上山作业人群疟疾抗体阳性的危险因素,无露宿习惯是上山作业人群疟疾抗体阳性的保护因素。结论上山作业人群疟疾抗体阳性的发生与上山夜宿频率、上山过夜预防服药情况、是否接受疟疾防治宣传史、家中蚊帐是否用杀虫剂浸泡、上山过夜是否采取防蚊措施、有无露宿习惯和疟疾防治知识得分等KAP因素有关。

Objective To explore the knowledge, attitude and practice （KAP）towards malaria antibody-positive risk among population working in the mountain areas and to provide scientific evidence for preventing malaria. Methods Based on the data of KAP and malaria antibody test from a typical sampling investigation conducted in malaria-endemicareas of Halnan province in 20ll, a gender- and age-matched case-control study was designed and completed with a ratio of 1：3 ,of which 46 cases diagnosed with malaria antibody-positive were compared with 138 controls without malaria in fection. Conditional logistic regression model was used in univariate and multivariate analyses with SPSS 17.0. Results Seven of the 12 targeted risk factors were identified to be responsible for the malaria infection by univariate analysis,in cluding drug prophylaxis （ never）, drug prophylaxis （ occasionally）, without mosquito net soaked, malaria knowledge （unqualified）, without overnight anti-mosquito measures, without health education on malaria, and not sleeping outdoors. Multivariate conditional logistic regression analysis also suggested that the seven factors were significantly associated with the positive rate of malaria antibody （ P 〈 0. 05 ）. Conclusion Regarding to the malaria antibody-positive, not sleeping outdoors is a protective factor and drug prophylaxis （ never）, drug prophylaxis （ occasionally ）, without mosquito net soaked, malaria knowledge （ unqualified）, without overnight anti-mosquito measures, and without health education on ma laria are risk factors.