收稿日期: 2020-07-17
网络出版日期: 2020-11-12
基金资助
瑞银集团慈善基金会项目(9051)
Evaluation of the effect of health education on clonorchiasis in primary schools in Xinfeng County of Jiangxi Province
Received date: 2020-07-17
Online published: 2020-11-12
Supported by
UBS Optimus Foundation(9051)
目的 在华支睾吸虫病流行区小学开展华支睾吸虫病健康教育并对效果进行评价。方法 2017-2019年,在江西省信丰县华支睾吸虫病综合防治示范区内选择3个乡（镇）,每个乡（镇）选2个村,分别作为对照组和干预组。2017年进行基线调查,通过问卷调查了解对照组和干预组的小学学生与村民对华支睾吸虫病的传播途径和危害的知晓情况、食“鱼生”的态度和行为。其后,干预组在村小学开展综合的健康教育措施,包括每学期播放1次华支睾吸虫病防治动画片,出1期板报,写1篇作文,开展1次面向家长的宣讲活动;对照组不采取干预措施。2019年对干预组和对照组的学生和村民的健康教育效果进行评估,方法同基线调查。结果 对照组和干预组分别有298名和254名学生,147名和168名村民参加了基线调查和效果评估。干预前后,干预组学生对华支睾吸虫病传播途径、危害的知晓率分别从44.49%（113/254）、0提升至79.13%（201/254）（P < 0.01）和23.22%（59/254）（P < 0.01）,将来不食“鱼生”的信念从75.2%（191/254）上升至94.09%（239/254）（P < 0.01）,食“鱼生”的行为分别为2.36%（6/254）和0.39%（1/254）（P > 0.05）;对照组学生的知晓率分别从11.41%（34/298）和0.33%（1/298）上升至53.02%（158/298）（P < 0.01）和22.48%（67/298）（P < 0.01）,将来不食“鱼生”的信念从95.64%（285/298）下降至91.28%（272/298）（P < 0.05）,食“鱼生”的行为分别为1.34%（4/298）和1.01%（3/298）（P > 0.05）。干预前后,干预组学生所在村村民华对支睾吸虫病传播途径的知晓率分别为18.45%（31/168）和26.19%（44/168）（P > 0.05）,对危害的知晓率从4.17%（7/168）提升至16.07%（27/168）（P < 0.05）;将来不食“鱼生”的信念分别为95.83%（161/168）和94.05%（158/168）（P > 0.05）;食“鱼生”的行为从35.12%（59/168）降至15.48%（26/168）（P < 0.05）。对照组学生所在村村民华支睾吸虫病传播途径知晓率从56.46%（83/147）下降至39.46%（58/147）（P < 0.05）,危害的知晓率从3.4%（5/147）提升至9.52%（14/147）（P < 0.05）;将来不食“鱼生”的信念从82.31%（121/147）上升至94.56%（139/147）（P < 0.05）;食“鱼生”的行为从23.13%（34/147）降至6.8%（10/147）（P < 0.05）。结论 在小学开展华支睾吸虫病健康教育,提高了学生的防治知识知晓率,强化了将来不食“鱼生”的信念,也减少了学生所在村成人食“鱼生”的行为,对成人知晓率的提升起到了一定的作用。
诸廷俊 , 钱门宝 , 陈颖丹 , 陈喆 , 葛军 , 曾小军 , 袁长红 , 蓝明兴 , 李石柱 . 江西省信丰县小学华支睾吸虫病健康教育效果评价[J]. 中国寄生虫学与寄生虫病杂志, 2020 , 38(5) : 574 -579 . DOI: 10.12140/j.issn.1000-7423.2020.05.008
Objective To evaluate the effect of health education on clonorchiasis among primary school students in endemic areas. Methods This study was implemented in Xinfeng County, Jiangxi Province from 2017 to 2019. Three townships were selected in Xinfeng County, the demonstration area for integrated control for clonorchiasis, from each township two villages were selected to serve as the control and the intervention group, respectively. The baseline survey was conducted to understand the awareness of the transmission route and harmfulness of Clonorchis sinensis among the primary school students and villagers in the control group and the intervention group, as well as their attitude towards eating raw fish and the behavior of eating raw freshwater fish. In villages of the intervention group, comprehensive health education measures were carried out in primary schools, including watching a cartoon about the prevention and control of clonorchiasis once a semester, preparing a blackboard bulletin, writing a composition about clonorchiasis, and carrying out a propaganda activity for parents. No intervention measures were taken in the control group. In 2019, the effect of health education in students and villagers was evaluated in the intervention group and the control group using the same method as the baseline survey. Results In the control group and intervention group, 298 and 254 students, as well as 147 and 168 villagers participated in the baseline survey and evaluation survey. The students’ awareness rate of the transmission route and harmfulness of clonorchiasis in the intervention group increased from 44.49% (113/254) and 0 before intervention to 79.13% (201/254) (P < 0.01) and 23.22% (59/254) (P < 0.01) after intervention; the willingness of not eating raw fish increased from 75.2% (191/254) to 94.09% (239/254) (P < 0.01), and the behavioral rate of eating raw fish was 2.36% (6/254) and 0.39% (1/254) (P > 0.05), respectively. In the control group, the awareness rate of transmission route and harmfulness of clonorchiasis among the students increased from 11.41% (34/298) and 0.33% (1/298) to 53.02% (158/298) (P < 0.01) and 22.48% (67/298) (P < 0.01), respectively; the rate of willingness of not eating raw fish decreased from 95.64% (285/298) to 91.28% (272/298) (P < 0.05); the rate of eating raw fish was 1.34% (4/298) and 1.01% (3/298) (P > 0.05), respectively. In the intervention group, the villagers’ awareness rate of transmission route was 18.45% (31/168) and 26.19% (44/168) (P > 0.05), and the awareness rate of harmfulness of clonorchiasis increased from 4.17% (7/168) to 16.07% (27/168) (P < 0.05); the rate of willingness of not eating raw fish was 95.83% (161/168) and 94.05% (158/168) (P > 0.05), and the behavior of eating raw fish decreased from 35.12% (59/168) to 15.48% (26/168) (P < 0.05). In the control group, the villagers’ awareness rate of clonorchiasis transmission route decreased from 56.46% (83/147) to 39.46% (58/147) (P < 0.05), the awareness rate of harmfulness increased from 3.4% (5/147) to 9.52% (14/147) (P < 0.05); the rate of willingness of not eating raw fish increased from 82.31% (121/147) to 94.56% (139/147) (P < 0.05); the behaviorial rate of eating raw fish decreased from 23.13% (34/147) to 6.8% (10/147) (P < 0.05). Conclusion The health education on clonorchiasis in primary schools can improve the students’ knowledge on the prevention and control of clonorchiasis, strengthen the perception of not eating raw fish in the future, and meantime also reduce the occurrence of eating raw fish among adults, playing evident role in improving the awareness rate among adults.
Key words： Clonorchiasis; Health education; Primary school students
| [1] | Qian MB, Utzinger J, Keiser J, et al. Clonorchiasis[J]. Lancet, 2016,387(10020):800-810. |
| [2] | Qian MB, Chen YD, Liang S, et al. The global epidemiology of clonorchiasis and its relation with cholangiocarcinoma[J]. Infect Dis Poverty, 2012,1:4. |
| [3] | National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention. Report on the national survey of important human parasitic diseases in China (2015)[M]. Beijing: People’s Medical Publishing House, 2018. (in Chinese). |
| [3] | ( 中国疾病预防控制中心寄生虫病预防控制所. 2015年全国人体重点寄生虫病现状调查报告[M]. 北京: 人民卫生出版社, 2018.) |
| [4] | Zhu TJ, Chen YD, Qian MB, et al. Surveillance of clonorchiasis in China in 2016[J]. Acta Trop, 2020,203:105320. |
| [5] | Huang XH, Fang YY, Lai YS. A review on population control strategies of clonorchiasis in China[J]. J Trop Med, 2020,20(2):267-274. (in Chinese) |
| [5] | ( 黄小红, 方悦怡, 赖颖斯. 中国华支睾吸虫病的人群干预措施与防治效果研究进展[J]. 热带医学杂志, 2020,20(2):267-274.) |
| [6] | Qian MB, Jiang ZH, Ge T, et al. Association of raw-freshwater fish-eating practice with the infection of Clonorchis sinensis[J]. Chin J Parasitol Parasit Dis, 2019,37(3):296-301. (in Chinese) |
| [6] | ( 钱门宝, 蒋智华, 葛涛, 等. 生食淡水鱼行为传播华支睾吸虫病的效应分析[J]. 中国寄生虫学与寄生虫病杂志, 2019,37(3):296-301.) |
| [7] | Qian MB, Jiang ZH, Gan XQ, et al. Effect of health education on the awareness and control of clonorchiasis in primary school students[J]. Chin J Parasitol Parasit Dis, 2019,37(2):202-206. (in Chinese) |
| [7] | ( 钱门宝, 蒋智华, 甘晓琴, 等. 华支睾吸虫病健康教育对小学生知识、行为和信念的影响[J]. 中国寄生虫学与寄生虫病杂志, 2019,37(2):202-206.) |
| [8] | Qian MB, Gan XQ, Zhao JG, et al. Effectiveness of health education in improving knowledge, practice and belief related to clonorchiasis in children[J]. Acta Trop, 2020,207:105436. |
| [9] | Wang ZY. Advocating the integration of education and health and promoting the personalization of health education[J]. Chin J Sch Health, 2020,41(6):804-806. (in Chinese) |
| [9] | ( 王智勇. 倡导教育与健康的融合推进健康教育个性化[J]. 中国学校卫生, 2020,41(6):804-806.) |
| [10] | Qian MB. Behavioral mechanism and intervention strategy on the transmission of clonorchiasis[D]. Beijing: Chinese Center for Disease Control and Prevention, 2019. (in Chinese) |
| [10] | ( 钱门宝. 华支睾吸虫病传播行为的成因机制及干预策略研究[D]. 北京: 中国疾病预防控制中心, 2019. |
| [11] | Zhou P, Sun JP, Gu P, et al. Influence of different health communication methods on improving nutrition KAP of inhabitants in Changning District of Shanghai[J]. Chin J Health Edu, 2007,23(11):834-835, 864. (in Chinese) |
| [11] | ( 周鹏, 孙建平, 顾萍, 等. 不同健康传播方式对居民营养知信行的影响[J]. 中国健康教育, 2007,23(11):834-835, 864.) |
| [12] | Jin FF, Tian XY. Effect of different health communication method on infectious disease-specific health literacy among Chinese residents[J]. Chin J Public Health, 2018,34(8):1125-1128. (in Chinese) |
| [12] | ( 晋菲斐, 田向阳. 不同健康传播方式对中国居民传染病健康素养影响[J]. 中国公共卫生, 2018,34(8):1125-1128.) |
| [13] | Jiang LJ, Wang WY, Dang J. Principles and strategies of health communication efficiency based on the psychological preference of receivers[J]. Health Edu Health Promot, 2009,4(2):54-56. (in Chinese) |
| [13] | ( 蒋丽娟, 王文艺, 党姣. 从受传者的心理选择论健康传播致效的原则和策略[J]. 健康教育与健康促进, 2009,4(2):54-56.) |
| [14] | Shen XJ, Zhang BJ, Zhang SL. Application of secondary dissemination on health education among primary and middle school students[J]. Chin J Sch Health, 2011,32(2):143-145. (in Chinese) |
| [14] | ( 沈旭娟, 张宝津, 张时良. 学生二级传播方式在健康教育中的应用效果评价[J]. 中国学校卫生, 2011,32(2):143-145.) |
| [15] | Li YH, Mao QA, Shi Q, et al. The level of health literacy of Chinese residents in 2012: surveillance results[J]. Chin J Health Edu, 2015,31(2):99-103. (in Chinese) |
| [15] | ( 李英华, 毛群安, 石琦, 等. 2012年中国居民健康素养监测结果[J]. 中国健康教育, 2015,31(2):99-103.) |
| [16] | Yan LP, Wei NF, Xie RQ, et al. Analysis of health literacy influencing factors among urban and rural residents in China[J]. Chin J Health Edu, 2012,28(1):8-11. (in Chinese) |
| [16] | ( 严丽萍, 魏南方, 解瑞谦, 等. 我国城乡居民健康素养影响因素分析[J]. 中国健康教育, 2012,28(1):8-11.) |
| [17] | Yu XM, Zhang X, Zhu GR, et al. School-based health education in China Ⅱ: the influencing factors of KAP among primary and secondary school students[J]. Chin J Sch Health, 2007,28(2):107-108, 110. (in Chinese) |
| [17] | ( 余小鸣, 张芯, 朱广荣, 等. 中小学校健康教育研究(2): 学生健康知信行相关影响因素[J]. 中国学校卫生, 2007,28(2):107-108, 110.) |
| [18] | Chen YD. Revisiting Alma-Ata Declaration of primary health care, to build a healthy China[J]. Chin J Prev Med, 2018,52(5):457-459. (in Chinese) |
| [18] | ( 陈育德. 重温《阿拉木图宣言》推进健康中国建设[J]. 中华预防医学杂志, 2018,52(5):457-459.) |
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