上海市浦东新区医疗机构病媒生物控制现状分析

Current status of vector control in medical institutions in Pudong New Area,Shanghai, China

目的了解上海市浦东新区医疗机构病媒生物防控现状,为有效开展监管、监测和控制提供依据。方法采用资料收集及现场调查相结合的方法,收集医疗机构病媒生物控制工作记录及委托合同,调查控制措施及经费支出情况,并按照国家标准开展蚊虫孳生、防蝇防鼠设施、蜚蠊侵害等情况调查。结果社区卫生服务中心(以下简称社区医院)及二级和三级医院(以下简称二三级医院)病媒生物控制工作执行率分别为70.21%(33/47)和100%(16/16)。33家开展病媒生物控制的社区医院中,22家(66.67%)自行承担经费,其余11家(33.33%)由街镇爱卫部门拨付。社区医院容器指数为10.06%,明显高于二三级医院(3.70%),两者差异有统计学意义(χ~2=5.435,P<0.05)。社区医院和二三级医院防蝇设施合格率分别为33.06%和50.00%(χ~2=5.674,P<0.05),防鼠设施合格率分别为75.76%和93.09%(χ~2=39.532,P<0.01),蜚蠊侵害率分别为4.60%(68/1 479)和1.00%(4/398)(χ~2=10.973,P<0.01)。结论社区医院病媒生物控制执行率不高,需要加强督导。医疗机构防蝇防鼠设施合格率不高,可能为正常诊疗和医院内感染控制带来风险,需要引起医疗机构高度重视。

Objective To investigate the current status of vector control in medical institutions in Pudong New Area,Shanghai, China, and to provide evidence for effective supervision, the surveillance, and control. Methods Data capture and on-site investigation were combined to collect logs and commission contracts about vector control in medical institutions, examined the control measures and expenditure of funds, and investigated mosquito breeding, fly-proof and rodent-proof facilities, and cockroach infestation in the field according to national standards. Results The implementation rates of vector control in community hospitals and secondary/tertiary hospitals were 70.21%(33/47) and 100%(16/16),respectively. Among the 33 community hospitals conducting vector control measures, the work was self-funded in 22(66.67%) hospitals, and was financed by the Patriotic Health Campaign Committee of sub-districts/towns in the remaining11(33.33%) hospitals. The container index was significantly higher in community hospitals than in secondary/tertiary hospitals(10.06% vs 3.70%, χ~2=5.435, P<0.05). There were significant differences between community hospitals and secondary/tertiary hospitals in terms of the pass rate of fly-proof facilities(33.06% vs 50.00%, χ~2=5.674, P<0.05), the pass rate of rodent-proof facilities(75.76% vs 93.09%, χ~2=39.532, P<0.01), and the infestation rate of cockroaches(4.60% [68/1479] vs 1.00% [4/398], χ~2=10.973, P<0.01). Conclusion The implementation rate of vector control in community hospitals is relatively low, needing strengthened supervision. The relatively low pass rates of fly-proof and rodent-proof facilities in medical institutions are a potential threat to normal clinical practice and nosocomial infection control, and medical institutions should pay great attention to them.