云南省西双版纳州和缅甸掸邦傣族居民登革热知识和预防行为及其影响因素分析

A comparative study of dengue fever-related knowledge level and preventive behaviors and their influencing factors in the Dai people between Xishuangbanna,Yunnan,China and Shan State Special Region 4,Myanmar

目的了解中缅边境傣族居民登革热知识和预防行为及其影响因素,为以社区为基础的登革热控制提供科学依据。方法2017年12月至2018年4月,采用问卷调查的方法,对户主进行入户调查,重点人员深度访谈以及参与性观察相结合的方法,抽样调查云南省西双版纳傣族自治州(西双版纳州)和缅甸掸邦第四特区(SR4)2017年登革热发病高、中、低或无3类社区傣族登革热知识和预防行为及其影响因素。率的比较采用χ^2检验,多因素logistic回归分析影响因素。结果在西双版纳州和缅甸SR4分别完成261和259份问卷调查表,并对18名关键人员进行深度访谈。西双版纳州傣族居民知晓登革热传播媒介为"花斑蚊"或伊蚊以及幼蚊孳生地为容器型积水的户主比例分别为76.08%(95%CI:70.44%~81.23%)和89.07%(95%CI:84.53%~92.70%),报告经常翻盆倒罐家庭比例为94.64%(95%CI:91.20%~97.01%),缅甸SR4依次分别为14.29%(95%CI:10.19%~19.10%)、24.32%(95%CI:19.22%~30.02%)和72.76%(95%CI:64.44%~79.83%)。西双版纳州傣族居民登革热知识水平和登革热预防行为显著高于缅甸SR4(χ^2=41.004,P<0.001);logistic回归分析结果显示,西双版纳发生过登革热的社区开展媒介控制的家庭更多(OR=23.90,95%CI:3.07~185.82),以农业为主要家庭经济收入家庭较少开展媒介控制(OR=0.14,95%CI:0.03~0.63)。缅甸SR4发生过登革热社区开展媒介控制家庭更少(OR=0.08,95%CI:0.02~0.36);户主年龄、登革热知识及其对登革热敏感性也可影响SR4登革热预防行为(均P<0.05)。结论西双版纳傣族居民登革热知识水平较高,但需进一步加强管理来保持预防行为;缅甸SR4除需加强组织保障外,尚需通过行为改变提高登革热知识,促进预防行为。

Objective To investigate dengue fever-related knowledge level and preventive behaviors and their influencing factors in the Dai people in China-Myanmar border areas,and to provide a scientific basis for community-based dengue fever prevention and control in the border areas.Methods From December 2017 to April 2018,dengue fever-related knowledge level and preventive behaviors of the Dai people and the influencing factors were investigated using sampling questionnaire survey(household survey of householders)combined with in-depth interview of key opinion leaders(KOLs)and participatory observation in three types of communities(classified according to the incidence of dengue fever in2017,i.e.,high,medium,and low or none)in Xishuangbanna(XSBN),Yunnan province,China and Shan State Special Region 4(SR4),Myanmar.The awareness rates were compared using chi-square test,and the influencing factors were analyzed by multivariate logistic regression.Results A total of 259 and 261 questionnaires were completed in XSBN and SR4 of Myanmar,respectively.Eighteen KOLs were interviewed in depth.In XSBN,the proportion of householders who knew that spotted mosquitoes or Aedes mosquitoes are vectors for dengue fever and the proportion of householders who knew that water containers are breeding sites of Aedes mosquitoes and their larvae were 76.08%(95%CI:70.44%-81.23%)and89.07%(95%CI:84.53%-92.70%),respectively;the proportion of households which were reported to have a habit of turning over pots was 94.64%(95%CI:91.20%-97.01%).In SR4 of Myanmar,the above three proportions were 14.29%(95%CI:10.19%-19.10%),24.32%(95%CI:19.22%-30.02%)and 72.76%(95%CI:64.44%-79.83%),respectively.The dengue fever-related knowledge level and preventive behavior performance rate of the Dai people were significantly higher in XSBN than in SR4 of Myanmar(χ^2=41.004,P<0.001).The results of a logistic regression analysis showed that there were a higher dengue fever vector control performance rate in communities historically struck by dengue fever(OR=23.90,95%CI:3.07-185.82)and a lower vector control performance rate in households taking agriculture as their main economic source(OR=0.14,95%CI:0.03-0.63)in XSBN.There was a lower vector control performance rate of households in communities historically struck by dengue fever in SR4 of Myanmar(OR=0.08,95%CI:0.02-0.36).Age,dengue feverrelated knowledge level,and awareness of the disease of householders may also influence preventive behaviors against dengue fever in SR4(all,P<0.05).Conclusion The Dai people in XSBN have a higher knowledge level of dengue fever,but their preventive behaviors need to be maintained by strengthened management.The preventive behaviors of the inhabitants in SR4 of Myanmar need to be boosted by further communication for behavioral change in addition to reinforced organizational safeguard.