石家庄市人间布鲁菌病干预措施效果评价

Effects evaluation of intervention measures on hu man brucellosis in Shijiazhuang City

目的通过对布鲁菌病（简称布病）职业人群实施健康教育和行为干预等综合防治措施，探索人间布病防控的有效措施，为科学防治布病提供理论依据。方法2011—2013年，通过对石家庄市所辖平山县、赞皇县、井陉县、元氏县、行唐县和鹿泉市6个县（市）布病职业人群开展健康教育和行为干预等措施，分析干预前后职业人群健康知识知晓率、健康行为形成率、布病发病率、血清学阳性率及急性期、慢性期患者就诊率，评价干预措施的效果。结果通过干预，职业人群布病健康知识知晓率由57．35％（12450／21708）上升到91．10％（20022／21987，χ^2=6400，P〈0．01）。健康行为形成率由43．59％（4731／10854）上升到75．29％（8274／10989，χ^2=2400，P〈0．01）。干预前布病发病率为4．89／10万，干预后第一年（2012年）上升到6．14／10万，干预后第二年（2013年）又下降到5．92／10万。通过干预，职业人群血清学阳性率由11．64％（81／696）下降到5．33％（43／806）；急性期、亚急性期患者就诊率由50．91％（56／110）上升为94．03％（126／134），慢性期患者就诊率由49．09％（54／110）下降为5．97％（8／134）。结论健康教育和行为干预等措施的实施有效地提高了职业人群布病防治知识的知晓率。通过改善生产、生活行为方式减少感染机会，降低布病发病率，提高急性期患者的发现率，防止病情慢性化。

Objective To study the effects of intervention measures on brucellosis utilizing integrated methods, such as health education and behavior intervention for occupational groups, in order to provide a scientific basis for controlling brucellosis. Methods Health education and behavior intervention measures were carried out in occupational groups at risk of brucellosis in Pingshan, Zanhuang, Jingxing, Yuanshi, Xingtang counties and Luquan town of Shijiazhuang City in 2011 - 2013. The rates of knowledge awareness, health behavior forming, brucellosis incidence, and serological positive, treatment of acute or chronic patients before and after the intervention were compared. Results After the intervention, knowledge awareness rate of occupational group was increased from 57.35% （12 450/21 708） to 91.10% （20 022/21 978, χ^2 = 6 400, P 〈 0.01）. Health behavior forming rate was increased from 43.59% （4 731/10 854） to 75.29% （8 274/10 989, χ^2 = 2 400, P 〈 0.01）. Brucellosis incidence was 4.89/100 thousands before the intervention and increased to 6.14/100 thousands after the first year （2012） intervention, then declined to 5.92/100 thousands the second year （2013）. Serological positive rate was reduced from 11.64% （81/696） to 5.33% （43/806）. Acute and sub-acute patient＇s treatment rate increased from 50.91% （56/110） to 94.03% （126/134）, chronic patients treatment rate declined from 49.09% （54/110） to 5.97% （8/134）. Conclusions The awareness rate of the hazard of brucellosis in occupational group is increased through health education and improving health behavior, brucellosis incidence is reduced. Meanwhile, the detecting rate of acute patients is increased and chronieity of the disease may be avoided.