河南省消除试点医务人员猪带绦虫病和囊尾蚴病防治知识培训效果

Effectiveness of training on Taenia solium taeniasis and cysticercosis control knowledge among medical professionals in disease-elimination pilot areas of Henan Province

目的了解培训前后河南省方城县消除试点医务人员猪带绦虫病和囊尾蚴病防治知识知晓率变化,评估培训效果。方法选取方城县独树镇、博望镇和杨集乡为干预乡(镇),2016—2020年每年对干预乡(镇)基层医务人员开展1次猪带绦虫病和囊尾蚴病防治知识培训;选择二郎庙乡、杨楼乡和小史店镇作为对照乡(镇),不开展培训。抽取干预乡(镇)和对照乡(镇)所有村级医生和部分乡(镇)级医生及公共卫生人员分别作为干预组和对照组,采用问卷调查方式,分别于2016年和2020年对干预组和对照组开展猪带绦虫病和囊尾蚴病防治知识知晓情况基线调查和终期评估,比较两组知晓率变化情况。结果2016—2020年方城县共调查医务人员663名,其中干预组474人、对照组189人。2016年基线调查结果显示,基层医务人员猪带绦虫病和囊尾蚴病防治知识知晓率为28.83%(47/163),其中干预组(32.47%,25/77)和对照组(25.58%,22/86)、男性(30.50%,43/141)和女性(18.18%,4/22)、村级(31.39%,43/137)和乡(镇)级医务人员(15.38%,4/26)知晓率差异均无统计学意义(χ^(2)=0.939、1.406、2.727,P均>0.05);不同文化程度和工作年限医务人员知晓率差异有统计学意义(χ^(2)=8.190、12.617,P均<0.05),且医务人员知晓率随文化程度升高而升高(χ^(2)=6.768,P<0.05);仅5.52%(9/163)的医务人员曾诊疗过猪带绦虫病或囊尾蚴病患者,仅1.23%(2/163)的医务人员近5年参加过猪带绦虫病和囊尾蚴病防治知识相关培训。2020年问卷调查结果表明,干预组医务人员猪带绦虫病和囊尾蚴病防治知识知晓率(93.55%,116/124)高于对照组(46.60%,48/103)(χ^(2)=61.845,P<0.05)。干预组不同性别、级别、工作年限以及是否接诊过猪带绦虫病和囊尾蚴病患者的研究对象知晓率差异均无统计学意义(χ^(2)=1.089、0.140、0.081、0.453,P均>0.05),仅不同文化程度者知晓率差异有统计学意义(χ^(2)=36.338,P<0.05)。与2016年基线调查结果相比,2020年干预组不同特征调查对象防治知识知晓率均明显提升。结论在猪带绦虫病和囊尾蚴病低流行区,可通过长期持续培训提高基层医务人员对该两种疾病的知晓程度,从而及时发现病例并建立敏感的病例监测体系。

Objective To investigate the changes in the awareness rate of Taenia solium taeniasis and cysticercosis control knowledge among medical professionals before and after training in Fangcheng County,a disease-elimination pilot area of Henan Province,so as to evaluate the effectiveness of the training.Methods Three townships in Fangcheng County were randomly selected as the study townships,including Dushu,Bowang and Yangji townships,while Erlangmiao,Yanglou and Xiaoshidian townships in the county were randomly selected as the control townships.The grassroots medical professionals in the study townships were given once training on T.solium taeniasis and cysticercosis control knowledge each year from 2016 to 2020,while those in the control townships were given no interventions.All village-level doctors and a part of township-level public health professionals were sampled from the study and control townships as intervention and control groups.The baseline and final assessments of the awareness of T.solium taeniasis and cysticercosis control knowledge were performed using questionnaire survey in intervention and control groups in 2016 and 2020,and the awareness of T.solium taeniasis and cysticercosis control knowledge was compared between the two groups.Results A total of 663 medical professionals were investigated in Fangcheng County from 2016 to 2020,including 474 participants in the intervention group and 189 participants in the control group.Results from the 2016 baseline survey showed that the awareness rate of T.solium taeniasis and cysticercosis control knowledge was 28.83%(47/163)among grassroots medical professionals in Fangcheng County,and there were no significant differences in the awareness between the intervention(32.47%,25/77)and control groups(25.58%,22/86)(χ^(2)=0.939,P>0.05),between men(30.50%,43/141)and women(18.18%,4/22)(χ^(2)=1.406,P>0.05)or between village-(31.39%,43/137)and township-level medical professionals(15.38%,4/26)(χ^(2)=2.727,P>0.05),while significant differences were found in the awareness rate of T.solium taeniasis and cysticercosis control knowledge among medical professionals in terms of education levels(χ^(2)=8.190,P<0.05)and duration of working experiences(χ^(2)=12.617,P<0.05),and the awareness rate of T.solium taeniasis and cysticercosis control knowledge increased with education levels among medical professionals(χ^(2)=6.768,P<0.05).Only 5.52%(9/163)of the medical professionals had a history of diagnosis and therapy of T.solium taeniasis or cysticercosis,and only 1.23%(2/163)received training on T.solium taeniasis and cysticercosis control knowledge during the past 5 years.Results from the 2020 questionnaire survey showed a higher awareness rate of T.solium taeniasis and cysticercosis control knowledge among medical professionals in the intervention group(93.55%,116/124)than in the control group(46.60%,48/103)(χ^(2)=61.845,P<0.05),and no significant differences were seen in the awareness rate of T.solium taeniasis and cysticercosis control knowledge among medical professionals in terms of gender,level of medical professionals,duration of working experiences or history of diagnosis/therapy of T.solium taeniasis and cysticercosis in the intervention group(χ^(2)=1.089,0.140,0.081 and 0.453,all P values>0.05),while there was a significant difference in the awareness rate among medical professionals with different education levels(χ^(2)=36.338,P<0.05).In addition,the awareness rate of T.solium taeniasis and cysticercosis control knowledge significantly increased among medical professionals with various chracteristics in 2020 than in 2016.Conclusions In the low-prevalence areas of T.solium taeniasis and cysticercosis,long-term and persistent training may improve the awareness of T.solium taeniasis and cysticercosis control knowledge among grassroots medical professionals,which facilitates the timely identification of T.solium taeniasis and cysticercosis and the establishment of a sensitive disease surveillance system.