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Khảo sát cộng đồng về bệnh dại tại tỉnh Cà Mau

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Bài viết "Khảo sát cộng đồng về bệnh dại tại tỉnh Cà Mau" được thực hiện nhăm xây dựng chương trình phòng chống bệnh dại hiệu quả và từng bước giảm thiểu, tiến tới loại trừ bệnh dại tại tỉnh Cà Mau và cả nước.

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Nội dung Text: Khảo sát cộng đồng về bệnh dại tại tỉnh Cà Mau

  1. KHOA HOC CONG N G H l K H A O S A T C O M G D O M G V E BEIXIH D A I T A I TilXlH CA M A L I Nguyen Le Nhdt TVudngi, Tthi Ngpc Bich^ Lfi Quang Tnmg' T6MTAT B^^nh dai la mpt b^nh lay truydn uuc Uep tir dgng vat sang nguoi va c6 hau qua nghifim Uong doi voi sue khoe ciia con nguoi va dong vaL Cac sci li^u duoc su dung trong nghien ciiu nay bao gom cac so li?u so cap va thij cap. Cac so Ii^u SCT cap dirpc thu thap bang each di^u tra va phong van Uirc ti^p. C^c s6 li^u thir cap duoc thu thap tir cac bao cao oia cac co quan co tham quy&n. Trong nghidn ctiu nay, su dung phuong phip nghien ctiu cat ngang U^n cho dugc nuoi ducmg tai tinh Ca Mau, tir thang 10/2018 den thang 4/2019. Nhung nguoi Ua loi cho cac cupc khao sat trong nghien ciru nay la nhung chu nuoi cho va nguoi dan trfin dia ban tinh Ca Mau- K^t qua nghien cuu cho thsiy. ty le tiem ph6ng benh dai Uen cho Uung binh la 3,08% tir nam 2015 - 2018. Tre em duoi 15 tuoi la doi ttrpng d^ bi dong vat tiin c6ng va it dirpc Ufim ph6ng b^nh dai. Iy II' ngiroi liem phong benh dai do cho cin la 87.40%. 88.60% nguoi dan dongy rang benh dai chii yciu dugc lay truyen tir cho. Ty 1? nguoi dirpc khao sat co tiem phong b?nh dai cho cho dat 75.50%, song so ngudi co y thirc Uem nhac l^ii theo dting lich chi dgt 64,00%. Tir kh6a; Bdnh d^, chd. cdng ddng. dieu tra, tinh Ca Mau. 1 . BAT VAN BE cac bien phap cap bach phong chdng bdnh dai trdn toan quoc nham dat dugc muc tieu ciia chuong trinh B^nh d^i la mot b^nh iruycn nhi^ni cap tinh do qudc gia. Theo ghi nhan cua Cue Y t^ Du phdng, Lyssavims gay ra a nhidu loai dong vat mau nong va nam 2014 co 67 trucmg hop tir vong vi b^nh dai, nam ngtrii, b?nh thuong lay sang ngiroi chu yeu la tir v^t 2015 cd 78 b-udng hpp, nam 2016 cd 91 trudng hpp, can cua cho mang virus dat va thirong dSn toi tu vong nam 2017 co 74 tnrdng hpp. Tinh rieng 5 thang ddu 100% khi da co bieu hi^n trieu chiing (Hatz va cs., nam 2018, ca nude cd 23 ngudi tu vong do benh dai 2012; Yousaf va cs., 2012). Nguon mang benh chii tai 12 linh, thanh phd. Rieng tai rinh Ca Mau, 2 nam y^u la cho (90%), meo nuoi (5%) va con lai crdpng vat 2017 - 2018 lien tuc gan day da cd 5 ca tu vong do hoang da (5%). Theo uoc tinh ciia To chiic Y te The benh dai. Dac biet, nam 2018 cd 4 ca tuvong do bSnh gioi (WHO), hang nSm co khoang 55.000 - 70.000 dai (huyen Dam Doi 2 ca, huyen Tran Van Thdi 1 ca, ngutri ch^t vi b$nh dai, trong do hon 90% tu cac nucrc huy^n Cai Nude 1 ca). Do vay, viec tien hanh dieu tra dang phat trien b chau Phi va chau A. Trong nhung khao sat cpng dong v^ benh dai tai rinh Ca Mau la nam gan day, b6nh dai luon xay ra o \'iet Nam va gay mot trong nhirng yeu cau cSn thiet de cd bien phap hau qua nghiem trpng dcin tinh mang va kmh te cua toi uu nham xay dung chuong trinh phdng chdng con nguoi. O nuoc ta, de phong chong benh dai, benh dai cd hi^u qua va timg bude giam thilu, hen Chinh phu da ban hanh Nghi dinh 05/2007/ND-CP tdi loai trir benh dai tai dia ban tinh Ca Mau va ca ngay 09/01/2007 va Bo Nong nghiep va I^INT cung nirdc. da ban hanh Thong tu sd 48/2009 ngay 04/8/2009. Trong do. ni^i dung d^ cap den viec tiem phong dai Z- niQI DUNG VA PHUONG PHAP NGHBU CUU cho cho va di4u kien chan nuoi la khong de cho chay 2.1. Dia di^m vk thdi gian nghiSn cihi rong khap noi. Ngay 13/02/2017. Thu tuong Chinh phii da ban hanh Quyet dinh s6 193-QD-Trg phe Nghien ciiu dupe thuc hien tai Unh Ca Mau tir duyet Chuong trmh Qu6c gia khong che va M^n ten thang 10 nam 2018 d6n thang 4 nam 2019. loai trir benh dai giai doan 2017 - 2021. Tiep do, Thu 2.2. Ddi tupng nghiSn cihi tirong Chinh phii ban hanh Chi thi so 31/CT-TTg D^ tai nghien ciiu tren tat ca cac cho dupe nudi ngay 06/7/2017 yeu cau tat ca cac rinh, thanh pho dmmg tai 9 huyen va thanh phd thuoc Unh Ca Mau true thuoc Trung uong va cac 36. nganh tang cuong bao gdm nhom gidng chd ndi, nhom g,dng chd ngoai; phuong thuc nuoi tha va nuoi nhdt B6n canh do, cdn ti^n hanh khao sat true U^p doi vcii nguoi dan ' Bi,t mon Thii >. Khoa WMIL; nghi?p. Truong Dai hpc Can ve rinh hinh tiem phong. ty le ngu-n mdc benh va Tha Email; tnbich@ctu.edu.vn NONG NGHIEP VA PHAT TRIEN NONG THON - KY 1 - THANG 9/2019
  2. KHOA HOC CdNG NGHE nhgn ttnic cpng ddng ddi vdi benh dai tren dia ban thong qua didu txa hdi eiiu tai Chi cue Chan nuoi va tinh Ca Mau. Thii y tinh Ca Mau. Sd heu tdng dan chd va tinh hinh 2.3. Phiremg phip nghi&n cihi tiem phdng benh dai trdn chd giai doan tir nam 2015 - Cac sd lieu dupe su dung h-ong d^ tai bao gom 2018 dupe trinh bay trong bang 1. cac sd li^u so cap va thti cap, sii dung phuong phap Bang 1. Tinh hinh tifim phdng b§nh d$i trfin chd tir dieu tra hdi cuu va dieu tra cat ngang de tien hanh nam 2015 - 2018 tai tinh CA Mau nghidn ciiu. Cac sd Ueu sa cap dupe thu thap theo So lugng cho Tyle Nam dugrc hem •o phirong phap di^u tra cat ngang va phdng van true tiep. Sd lieu dupe thu thgp tir phong van true tiep tai phong (con) (%) cac huyen, thanh phd ed ngudi chet vi benh dai. 2015 217.238 2.850 1.31 Thdng tin khao sat dupe ghi nhan tiieo phieu di^u 2016 214.127 1.845 0.86 tra. Cac sd li§u thii cap dupe thu thap tir eac bao cao 2017 135.641 1.628 1,20 tdng ket cdng tac thu y tu nam 2015 - 2018 cua Chi 2018 204.588 17.422 8.52 cue Chan nudi va Thii y rinh Ca Mau va cua Trung Trung binh 192.898 5.936 3.08 lam Y id Du phdng tinh C^ Mau. Qua kdt qua bang 1 cho thay ty Ip tidm phdng Chitidukhio siti benh dai tren eho tai tinh Ca Mau bidn dpng qua cac Tong dan chd tir nam 2015 - 2018. nam, cao nhat vao nam 2018 (8,52%), gap 2,8 lan ty Id tiling binh va tiiap nhat vao nam 2016 (0,86%). Ty Ic Ty 16ri6mphong benh dai trdn chd rij nam 2015 trung binh tiem phdng benh dai Udn chd tir nam -2018. 2015 - 2018 tai tinh Ca Mau la 3,08%. Theo bao cao Tinh hinh bpnh dai ti-en chd bi nam 2015 - 2018. ciia Bd Ndng nghiep va PTNT- Bo Y td (2016), ty Id Ty 1^ ti^m phdng benh dai trdn ngudi do dpng tiem phdng benh dai trdn ehd trong ea nude nam vat can tir nam 2015-2018. 2015 la 42,90% va nam 2016 la 38,50%. Kdt qua ciia bao eao cung cho thay, Ca Mau la dia ban cd ty id Ty Id tidm phdng bdnh dai tren ngudi do dpng tiem phdng benh dai tren chd nam trong khoang v|lt can ttr nam 2015 - 2018 tiieo nhdm tudi. dudi 10% tdng dan chd. Didu nay eho thay, ty le tidm Ty le tidm phdng b$nh dai tren ngudi do ddng phdng benh dai tien chd tai Ca Mau edn kha khi^m vat can hi nam 2015 - 2018 tiieo gidi tinh. tdn so vdi ca nude. Ty Id tidm phdng bdnh dai tren ngudi do chd can Tir nam 2015 - 2017, ty Id tidm phdng bdnh dai tir nam 2015 - 2018 theo don vi hanh chinh. tren chd tai tinh Ca Mau it cd su bien ddng (dao Tinh hinh bdnh dai tien ngudi tir nam 2015 - ddng trong khoang 0,86-1,31%); cung ti-ong giai doan 2018. nay, toan tinh Ca Mau chi ghi nhan mot trudng hpp chd mac benh dai vao nam 2017. Tuy nhien, nam Ty le nhan thiic cua cdng ddng ve benh dai. 2018 tinh da ghi nhan 5 tiirdng hop ehd mac benh dai 2.4. Xuly sdlieu (Bang 2), didu nay gdp phdn vao viec can day manh Sir dung phuong phap nghien ciiu theo kieu didu tuyen truydn khuyen cao ngudi dan tang cudng tiem fra hdi euu, didu tra cat ngang va phan tich. Sd lieu phdng benh dai cho dan chd nuoi nham bao ve an khao sat se dupe tdng hpp va xii ly bang phan mdm toan cho siic khde dan chd va ca chii nudi. Cdng tae Microsoft Excel 2013. tiem phdng benh dai tren chd phu thudc true tiep vao y tinic tuan thu phap luat vd tiem phdng eho vat nudi 3. KET QUA VA THAO LUAN ciia ngudi dan. Do dd, neu mudn nang cao ty le tiem 3.1. Ty 1^ tidm phdng, ty Id chd mdc bdnh dai tii phdng benh dai tren chd can kdt hop cong tac van nam 2015 - 2018 t?i tinh C^ Mau ddng va tuyen truydn den timg hd dan, giiip nguoi 3.1.1. Tdngdanchd va ty le tiem phdng benh dai dan hidu duoe mirc dp nguy hiem cua benh dai. dong thdi cho tiiay su cdn thiet eua viee tiem phong bdnh tirnSni 2015 - 201S tai tinh Ca Mau dai eho dan chd nudi. Thudng xuyen to chirc tiem Trong thoi gian nghien ciiu ciia de tai, da ghi vaccine de phdng bdnh dai ti-en dan chd, meo la vide nhiin dupe sd lieu tdng dan chd va tinh hinh tiem lam thudng xuyen ciia nganh tiiu y, la mdt bien phap phdng bdnh dai tren chd giai doan tii nam 2015 • 2018 w-Aftfl^ «»-f>M«SRWA ©WAT TIPII'N N O N G THON - KY 1 -THANG 9/2019 93
  3. KHOA HOC CdNG NGHl phdng benh mang tinh quyet dinh nham ngan ngua nam gan day. Ket qua nghien ciiu ciia Tenzin va cs. sir truydn lay \iras d?i tii cho sang ngudi (Pham (2010). cho tiiSy mot dpt biing phat benh dai ldn a Hong Son va Nguydn Thj Ngcx- Hien, 2017). chd va cac ddng vat nudi khac xay ra a mien Ddng 3.1.2. Tinh hinh benh dai tren chd tunani 2015- Bhutan trong khoang thdi gian tii thang 5 nam 2005 201S tai tinh Ca Mau den tiiang 11 nam 2007. cd 106 tiTrdng hpp chd mac bdnh dai duoc ghi nhan trong giai doan nay (chidm Tinh hinh benh dai trdn cho tii nam 2015 - 2018 t\- le 41,00%). MOt nghien ciiu khac ciia Tenzin va cs. t^ tinh Ca Mau dupe trinh bay trong bang 2. (2011), cho tiiay tii nam 19% - 2009. tdng cOng cd BSng 2. Tmh hinh bdnh d^iti-enchd Mi 814 trudng hpp benh dai a chd va cac ddng v$t nudi nam 2015 - 2018 khac da dupe bao cao b Bhutan. Trong dd ty le bdnh Sd Iuong cho mSc d?i b-en chd chidm 39,00% (317/814 ca benh). Nam benh dai (con) 3.2. Tinh hinh tifim phdng vd ty 1$ b$nh d^i ti-en 2015 0 ngudi tir nam 2015 - 2018 t?i tinh Cd Mau 2016 0 2017 1 Qua kdt qua didu tra hdi cim t^i Trung tam Y td 2018 5 Du phdng tinh Ca Mau. da thu thap dupe cac sd lidu Tdng ve tinh hinh bdnh dai tren ngudi va tinh hinh tidm du 6 phdng bdnh daiti*enngudi tai tinh Ca Mau ti'ong giai Qua kdt qua bang 2 cho thay tii nam 2015-2016, do9n tii nam 2015-2018. tinh Ca Mau khdng ghi nhan tnrdng hpp chd mac 3.2.1. Ty le tidm phdng bdnh d^ tidn ngudi do bdnh dgi. Nam 2017, loan tinh Ca Mau ghi nhan dupe 1 tiirdng hpp chd mac bpnh dai. Tuy nhien, nam 2018 ddng v$t cdn lu nisni 2015 - 201S l^ tinh Ca Mau tinh hinh benh dai ti'dn chd tang ldn 5 trudng hpp Ket qud khao sat tinh hmh tiem phdng bdnh dgi dupe phat hidn. Day la mpt con sd dang dupe luu y, ti-en ngudi do dpng vat can tii nam 2015 - 2018 lai cho Ih^y tinh hinh bdnh dai tren dia ban dang didn tinh Ca Mau dupe trinh bay trong bang 3. bidn phiic t^p va cd xu hudng tang cao ti-ong nhirng Bdng 3. T^ le tiem phdng b^nh dai trdn ngudi do dpng v§t c ^ tii nam 2015 - 2018 Sd l u ^ g ngudi tidm phdng (ngudi) Ty 16 Udm Dia di^m 2015 2016 2017 2018 phdng (%) Phong kham Trung tam Y le Du phdng 1.050 1.356 1.808 2.474 32.62 Thanh phd Ca Mau 304 307 342 351 6.36 Huyta Thdi Binh 425 466 585 399 9,15 Huyen U Mmh 598 600 585 612 11,68 Huyen Tran Van Thdi 316 260 262 215 5.14 Huy^n cai Nude 149 180 314 408 5.13 Huy$n Phu Tan 0 0 1.183 90 6.21 Huyen Dlni Doi 879 1.270 346 1.681 20.37 Huyen Nam Can 207 95 132 175 2.97 Huy^n Ngoc Hi^n 0 0 0 76 0.37 Tdng 3.928 4.534 5.557 6.481 100,00 Qua ket qua bang 3 eho thay sd lupng ngiroi hue tiiudc Trung uong va cac Bp, nganh tang cudng tiem phdng benh dai tang dan qua cac nam: Nam cac bien phap cap bach phong chong bpnh dai ti-en 2015 loan tinh Ca Mau chi cd 3.928 nguoi tiem phdng loan qudc nham dat dupe muc tieu cua chuong ti-inh bdnh dgi. nam 2016 la 4.534 ngudi, nam 2017 la 5.557 qudc gia. Bp Y te da ban hanh Quydt dinh sd 1622 ngudi va nam 2018 la 6.481 ngudi. Didu nay phan anh ngay 08/05/2014, npi dung dd cap den' viec tuyen cdng tae tuyen truyen, giao due ve xu ly va phdng tiiiyen cho nhimg nguoi ed nguy co cao phoi nhidm chong benh dai tren dia ban tinh la co hieu qua. Thu voi virus dai thuc hien tiem phdng truoc nhm h'^ tuong Chinh phu ban hanh Chi thi sd 31/CT-TTg va nhiing ngudi bi phoi nhidm vm dpng vat bi b ' h ngay 06/7/2017 yeu cdu tat ca cac tinh, thanh phd dai hoac nghi mac benh dai thuc hien dieu t ' H 94 NONG NGHIEP VA PHAT TRIEN NONG THON - KY 1 - THANG 9/2019
  4. KHOA HOC CONG NGHE phdng bang vac xin. Ngudi dan chu yeu tap tiimg sinh sdng va tai nhung tnmg tam tiem phdng lon liem phdng bdnh dai tai phdng kham ciia Trung tam tren dia bdn tinh Ca Mau. Y te Du phdng tinh Ca Mau (32.62%), tidp den la 3.2.2. Tv Id ngudi tidm phdng bdnh dai do ddng huydn Dam Dm (20,37%), huydn U Minh (11,68%), vat cdn tiieo do tudi tu nSm 2015 -2018 tai tinh Ca huydn Thdi Bmh (9,15%). tiianh phd Ca Mau (6,36%), Mau huyen Phii Tdn (6,21%), huydn Tran Van Thai (5,14%), huydn Cai Nude (5,13%), huyen Nam Can Ty le ngudi tidm phdng benh dai do dpng vat cdn (2,97%) va tiiap nhat la a huydn Ngpc Hidn (0,37%). tiieo dp hidi tii nam 2015 - 2018 tai tinh Ca Mau dupe Ngudi ddn thudng chpn nhung dia diem tidm phdng trinh bay trong bang 4. bdnh sao cho thuan lpi vd giao thdng, gdn vdi noi Bdng 4. Ty le ngu6i tidm phdng benh dai theo dd tu6i tii nam 2015 - 2018 Sd luong ngudi tiem Dudi 15 tudi Tu 15 tudi trd len Nam phdng (ngudi) Sd luong (ngudi) Tyle(%) Sd luong (ngirdi) Tyl?(%) 2015 3.928 1.442 36.71 2.486 63,29 2016 4.534 1.586 34,98 2.948 65,02 2017 5.557 1.800 32,39 3.757 67,61 2018 6.481 1.949 30,07 4.532 69,93 Tdng 20.500 6.777 33,54 13.723 66,46 Qua kdt qua bang 4 cho thay ly Id ngudi tiem siic midn dich thap, kha nang phan khang cung nhu phdng benh dai tii 15 tudi trd len (66,46%) cao hon so tranh thoat Uong eac trudng hpp bi dpng vat tan vdi ty le ngudi tiem phdng benh dai dudi 15 tuoi cong khdng cao. Neu khdng tinh den nguy co hi dai (33,54%). Kdt qua ndy phii hpp vdi nghien eiiu eua thi miie dp nguy hiem khi bi ddng vgt hogc chd du Nguydn Thi Thanh Huong (2018), ti-ong sd 228.416 tan cdng cung rat eao va cd kha nang dan den tii ngudi di tiem vac xin phdng bdnh dai d-14 tinh d- khu vong. Tir day da dua ra nhan dinh can phai tich cue vue Trung du vd midn mii phia Bac ghi nhan sd tre tuyen truyen, giao due ve each thirc giir tre trdnh xa em dudi 15 tijoi ehidm ty le tii 28,60% den 42,10% vd cae mdi nguy hiem tir ddng vat ndi chung va chd du tdng sd cua ca khu vuc chidm tdi 33,40%, ngirdi tren ndi rieng. Ket qua nay cung phii hpp vdi nghidn ciiu 15 tiidi la 152.534 ngudi, chidm ty le 66,60% (giai cua Tenzin vd cs. (2012), tac gia cho rang tre em dudi doan tir ndm 2010 - 2015). Nghien ciru cua Salomao 15 tudi la ddi tupng de bi tan cong bdi nhirng con chd va cs. (2017), tae gia eho rang 37,90% tre em dudi 15 tha rdng tai Bhutan. tuoi bi ddng vat tan cdng tai Mozambique trong nam 3.2.3. Ty Id ngum tidm phong bdnh dai do ddng 2014. Thuc te, theo ghi nhan tai dia phuong thi ngudi vat cdn theo gidi tinh tir nam 2015-2018 tai tinh Ca tii duoi 15 tuoi mdi that su la ddi tuong chu ydu bi Mau ddng vat can. Trong giai doan khao sat ttr nam 2015 - 2018 cd den 6.777 truong hpp tre em hi dpng vat can. Ty le nguoi tiem phdng bdnh dgi do dong vat edn Binh qudn 1 thang cd 141,19 Ire bi dpng vat cdn, day theo gidi tinh tii nam 2015 - 2018 tgi tinh Ca Mau la eon sd r^t dang quan ngai. Tre em la ddi tupng cd dupe trinh bay trong bang 5. B ^ 5. Ty Id ngudi tidm phdng b^nh dai theo gidi tinh tu nam 2015 - 2018 Sd luong ngudi tiem Nam Nil Nam phdng (ngudi) Sd luong (ngudi) Ty le (%) Sd iuong (ngudi) Ty le (%) 2015 3.928 2.063 52,52 1.865 47,48 2016 4.534 2.446 53,95 2.088 46,05 2017 5.557 3.009 54,15 2.548 45,85 2018 6.481 3.583 55,28 2.898 44,72 Tdng 20.500 11.101 54,15 9.399 45,85 Qua kdt qua bang 5 eho thdy, ty Id tidm phdng su chenh lech vd y thiic va hieu biel ve benh dai theo bdnh dai d nam gidi Id 54,15% cao hon so vdi nii gidi gidi tinh. Bdi vi mot each ngdu nhidn, ca nam va nti (45,85%). Tuy nhien, khdng dii eo sd dd ket ludn cd deu cd kha nang bi dong vai cdn nhu nhau. Theo M A k i ^ M/^uicD \/A DUAT TDiFNi MONG THON - KY 1 - THANG 9/2019 95
  5. KHOA HOC CdNG N G H t Nguydn Thi Thanh Huong (2018). so lupng nguoi Tv Id ngudi tiem phdng bdnh dai do cho can tiem vac xin dai a 14 tinh khu vuc trung du va mien theo don vi hanh chinh tu nam 2015 - 2018 tai tinh Ca nu] phia Bdc phdn theo gidi tinh thi a tat ca cac tinh Mail duijc tiinh bay ti-ong bang 6. Ihi sd nam gioi tiem vdc xin dai nhieu hon nir gidi. Ty Qua kdt qua bang 6 cho thSy, t>- le ngudi tidm le nam/nii chung la 1.21 va ty le dao dpng theo cac phdng bdnh dai do chd can tai tinh Ca Mau la 1.68% tinh tir 1,11 ddn 1,40%. Dieu ndy cung tuong tu ket dan sd ciia tinh. Trong dd. ts' le tiem phdng cao nhat qua nghien ciiu ciia Nguydn Tien Dung vd cs. (2016), tai phdng kham cua Trung tam Y te Du phdng tinh tien hanh didu tra thuc trgng dieu tri du phdng bdnh Ca Mau (3.56%) va thap nhat tai huyen Ngpc Hien dai tai huyen Mai Son, tinh Son La nam 2014 ghi (0,1096). Ty 1? tidm phdng b$nh dai do chd can thay nhan trong sd 822 ngudi ddn dem vac xm phdng dgi ddi khac nhau theo mdi dia phuong va phu thudc vSo Ihi nam gidi chiem ty le 55,70%. Nguyen nhdn cd the nhieu ydu td. Ngudi dan tidm phdng bdnh dai do chd dupe giai thich rdng nam gidi trudng thanh pham vi can chu ydu tap trung d thanh phd Ca Mau cd thd hogt dpng nhidu va rpng hon nOr gidi cung nhu ban lien quan ddn vide day la dia diem tiem phdng Idn va tinh hidu dpng d tre nam mgnh hon nen nguy eo phoi uy tinh ciia tinh, ti-ang thidt bi va co sd vat chat hi^n nhidm vdi ddng vat la ngudn truydn benh dgi cao hon dai. vi txi UTing tam thujn tidn cho vide di chuydn cua nu gidi (Nguydn Thi Thanh Huong, 2018). Tuong tu. ngudi dan. Cac huydn Ngoc Hidn. Cai Nude va Tran nghidn ciiu ciia Tenzin va cs. (2012). nam gidi la ddi van Thdi la cac huy?n viing sau. vung xa. dan cu tupng dd bi tan cdng vd phoi nhidm vdi ddng vgt cdm thua thdt, do dd ngirdi dan it cd didu kien tidm phdng nhidm vdi bdnh dai. Trong 12 trudng hpp tir vong do bdnh dai do chd ciin so vdi cac vung khac trong tinh. bdnh dai a ngudi tai Bhutan (tii nam 2006 - 2011), cd 11 ti-irdng hpp Id nam gidi (92,00%). Salomao vd cs Bdnh dai cd thd lay nhidm tiirc tiep hr dpng vgt (2017), cho rang nam gidi Id doi tupng dd hi dpng vat sang ngudi va gay chdt ngudi vdi ty Id cao ndu khdng tdn cdng hon nu gidi, cd 469/819 trudng hpp nam dupe didu tri sau phoi nhidm kip thdi. Do dd, ngudi gidi hi dpng vgt can tai Mozambique nam 2014, dan c ^ canh giac va han che tidp xuc vol chd la, chiem ty Ip 57,30%. ddng thdi cdn phai tii-m phdng bdnh dai dinh ky cho dan chd nudi de dam bao cho cpng ddng. 3.2.4. Ty le ngudi tiem phdng benh dai do cho 3.2.5. Tinh hinh benh dai trCn ngudi tdnini 2015 cin tiieo don vj hinb chinh tu nam 2015 - 2018 tai - 2018 t$i tinh Ci Mau tinh a Mau Tinh hinh bfnh dai ti-dn ngudi tii nam 2015-2018 Bdng 6. i y 1$tidmphdng bdnh dgi do chd can theo tai tinh Ca Mau duoc trinh bay trong biing 7. don vi hdnh chinh bi ndm 2015 - 2018 Dan sd B ^ g 7. Tinh hinh bdnh dgi trdn ngudi ttr Sdluong Dia diera ngudi tiem (ngudi) Tyle nam 2015 - 2018 phdng (ngirdi) (*) Nam Sd luong ngudi mac benh dai (nguiri) Trung tam Yle 2015 0 Du phdng vaTP. 7.992 224.414 3.56 2016 0 ca Mau 2017 1 Huyen Thdi Binh 1875 135.966 1,38 2018 4 Huydn U Minh 2.395 102.897 2.33 ; Tdng 5 Huy^n Tran Van 0,55 1.053 190.081 Qua kdt qua bang 7 cho thay, trong giai doan tir Thdi 138.845 0.76 nam 2015 - 2018 toan tinh Ca Mau cd 5 ti-uimg hpp Huydn Cai Nuoc 1.051 1,22 phat hidn benh dai U-en ngudi. Rieng nam 2018 cd 4 Huydn Phu T;ui 1.273 104.193 trudng h(^ phat hi^n bdnh dai ti'en ngain (2 ca 6 Huven Dam Doi 4.17li 183.648 2,27 huydn Dam Doi, 1 ca d huyen Cai Nude va 1 ca d Huyen Nam Can 609 65.914 0,92 huydn Tran Van Thoi). Nam 2017, phat hi?n 1 trudng Huyen Ngoc 78.033 0,10 hcrp mac bdnh dai ti-en nguoi. Huyen Dam Doi la 76 Hien huydn cd nhieu tivong hgp ngudi dan mac bdnh dai Tdn.i: 20.500 1.223.191 1.68 nhal (2/4 ca vao nam 2018). Vi vay. cac nganh chiic NONG NGHIEP VA PHAT TRIEN NONG THON - KY 1 - THANG 9/2019
  6. KHOA HOC CONG NGHE ndng can nhanh chdng dua ra cdc bien phdp hpp ly Id 85,30% vd 73.30%. Ddy ciing la 2 dia ban phat hidn nham lam giam sd vu bi ddng vdt cdn trong dia nguoi ddn chet do benh dai, nen cong tdc tiiyen phuong ndy xudng. Tinh hinh bpnh tat vd mac cac Quydn dupe day manh ddn den cd nhidu ngudi dan tac nhdn truyen nhidm ndi chung cung nhu mdc nhdn thiic diing vd mire dp nguy hiem cua bdnh. bdnh dgi ndi rieng thay doi theo thdi gian la mpt Huyen U Minh cd ty- le nhan tiiuc tiidp nhal (54,50%). trong hai dac diem co ban cua bdnh truydn nhidm nhdn dinh ban ddu do huyen U Minh Id viing xdu. {Nguydn Thi Thanh Huong, 2018). Ket qua nghien vimg xa, ddn cu tiiua that, didu kien kinh td ban chd cuu cua Nguydn Thi Thanh Huong (2018) eho thay, ddn den khd khan ti-ong eong tac tuyen tinyen hon tiiucti-gngtinh hinh mdc benh dai d" cac tinh trung cac huyen trung tdm cua tinh. Huyen Cai Nuoc cd ly du vd midn mil phia Bdc ti-ong tiidi gian 2010 den Id ngudi dan nhdn tinic la 60,00% rat gan vdi miic 2015 ghi nhdn ty Id mde benh dai trung binh la nhdn thirc tiring binh todn tinh Id 69,80%. Cdi Nude 0,45/100.000 ddn. Mdt nghien ciiu khde eua Khazaei cung la huyen cd dieu kien tuong ddi khd khan, nen vd cs. (2014) cho tiiay, sd lieu giam sdt va tdng didu dii cd 1 ea hi vong do bdnh dai nhung cong tac tuyen tra tgi Iran tii 2/2011 den 2/2012 ghi nhdn ly le nguoi truyen, gido due vdn gap nhidu khd khSn. bi dgng vat cdn Id 423/100.000 dan. 3.3. K^t qua khdo sdt ty Id nhdn thiic ciia cpng Sd ngudi Sd nguiri cd ddng vd bdnh dai tgi tihh Cd Mau Tyld Dia diem dui?c phdng nhan thiic 3.3.1. Ty Id nhan tiiuc ciia cdng ddng vd benh dai van (nguiri) (ngudi) (%) t^ tinh Ca Mau Huyen Trdn Cae tieu chi danh gia nhan thiie ciia cdng ddng 34 29 85.30 van Thdi vd bdnh dai bao gdm: da timg nghe hoac biet vd Huydn U Mmh 22 12 54,50 bdnh dgi, bdnh dai la gi, loai dpng vat cam nhidm. Huyen Dam Tieu chuan danh gid ddi tu'ong cd nhdn thuc vd benh 30 21 73,30 Doi dai theo dinh nghia sau: la nhung ngudi cd bidt hoae Huyen Cai nghe ve benh dai, cd bidt hoac nghe vd loai ddng vat 20 12 60,00 Nude cam nhidm benh dai. Ty le nhan thiie ciia cpng ddng Tdng 106 74 69,80 vd benh dai lai tinh Ca Mau dupe trinh bay trong 3.3.2. Khao sat cdng ddng ve bdnh dai va tidm phdng benh dai cbo chd nam 2018 lai tinh Ca Mau Qua kdt qua bang 8 eho thay ty le ngudi cd nhan Ket qua khao sat cdng ddng ve benh dai vd tinh tiuic ve bpnh dai ehiem 69,80% h-en dia ban tinh Cd hinh tidm phdng benh dai cho chd nam 2018 tai tinh Mau. Huyen Tran Vdn Thdi va Dam Doi cd ty le nhan Cd Mau duoc trinh bdyti-ongbang 9. thlic cao nhat tiong 4 huyen dupe khao sal, ldn lupt Bdng 9. Kdt qua khao sdt cpng ddng vd bdnh dai va tidm phdng benh dgi cho chd ndm 2018 Chi tieu khao sdt Benh dai ti-uyen Cd tiem phdng Tiem phdng dai Bdnh dai gay chet Ket qua chu yeutiichd bdnh dai cho chd cho chd dimg lich ngudi Sd ho Ty Id (%) Tyld(%) Sdho Tyle(%) Sdhp Tyle(%) 94 88,60 75.50 64 60,40 75,50 Khdng dong y 12 11,40 26 24,50 42 26 24,50 Tdng 106 100,00 106 100,00 106 100,00 106 100,00 ua ket qua bang 9 cho tiidy 88,60% sd hp dupe ty le hp ed tiem phdng benh dai cho chd va ty le hd khao sdt clio rdng chd la nguon lay truydn bdnh dai tiem phdng benh dai dung lich eho chd, da nhan triK tiep eho eon ngudi. Day la nipt diem Ihuan Ipi dd dinh rang: Cd mpt bp phan ngudi dan chua cd nhdn vgn dpng ngudi dan Ueni phdng benh dai cho dan dinh dung ve tac dung cung nhu thdi gian bao hp ciia chd nudi tai hp gia dinh. 75.50% sd hd dupe khao sat vdc xin phdng benh dai cho ehd. Can tich cue tuyen cho biet dd tiem phdng benh dai eho chd. Ty Id vd truydn, gido due vd muc do quan trpng cua viec tiem nhdn thuc ve viec phai tiem phdng benh dai cho chd phdng va tiem phdng benh dai diing lich la mdt bien tiieo dung lich la 60,40%. Nhin vao tirong quan giiia phap phdng bdnh mang tinh quydt dinh nhdm ngan w n M o wrsHiFP VA PHAT TRIEN N O N G THON - KY 1 - THANG 9/2019 97
  7. KHOA HOC C 6 N 0 NGHt ngua su truyen lay virus dai tu chd sang ngudi (Pham Ket qua lihao sat cdng ddng vd dd tudi hi chd Hdng Son va Nguydn Thi Ngoc Hidn. 2017). can va each xur ly sau khi bi chd can nam 2018 t ^ 3.3.1 Khao sal cdng ddng ve do Bidi bi did can ^^'^ ^ a u duoc trinh bay trong bang 10. va each xdly sau khi bi chd dn nSm 2018 tai tinh Ca Mau B ^ I O . Kdt qua khao sAtc^ng ddng v^ do tudi bi chd can vaccich xir 1^ sau khi bj chd cjn nam 2018 Chi tieu khan sat Gia dinh co nguoi bi chd Trd em (
  8. KHOA HOC CONG NGHE can nam d vimg dau. Vi tri ciia vet cdn ed anh huong 4. Hatz, C. F.. KuenzU. E., and Funk, M.. (2012). rdt ldn tdi tiidi gian li benh, nhirng vdt thuong d gdn Rabies: relevance, prevention, and management in dau. cd vd ddu ngdn tay cd thoi gian ii bdnh ngdn hon travel medicine. Infectious Disease Clinics of North so vdi vdt can trdn than hoae chi dudi do ddy Id vung America. 26(3): 739-753. lap trung ciia cae ddu day than kinh va gan vdi ndo 5. Khazaei, S., Rezaeian, S., Soheylizad, bp (Gadekar va cs., 2014) ddn den tae dung ciia vdc M., Gholamaliee, B., (2014). Factors associated with xin trong trudng hpp nay khdng eao. Qua ket qua delay in post-exposure prophylaxis in bitten people. Iren cho thay dupe tam quan trpng eua viee xir ly Med. J. Islam. Repub. Iran. 28: 158-166. dpng vat gdy ra vet cdn diing each. Neu Irudng hpp N4 cd the theo doi tinh trgng siic khde eiia chd va 6. Nghi dmh Chinh phu (2007). Phdng. chdng phat hipn cac bieu hidn bat thudng (nghi dgi) thi cd benh dai d ddng vat. Sd; 05/2007/NE)-CP, ngdy ihd ddn bpnh vien yeu cdu truyen khdng huydt thanh 09/01/2007. Ha Ndi. va cd the dd khdi benh. Nhdt va theo d6i dpng vdt 7. Nguydn Thi Thanh Huong (2018). Thuc ti^g gdy ra vdt can khdng nhiing giiip ngudi dan cd phan benh dai d ngudi lgi cdc tinh trung du, midn niii phia ung chinh xdc nhat ti-ong trudng hpp xdu md cdn the Bdc va hidu qua can thiep truydn thdng thay doi hidn udch nhidm vdi cdng ddng. hdnh vi trong trudng hpc. Ludn an tien si y td cong cpng. Vien Ve sinh Dich te Trung uong. Hd Npi. 4.K!TLUAni 8. Nguydn Tien Dung, Nguydn Thu Yen, Ngd Ty le binh quan ehd dupe tiem phdng bdnh dai Van Toan, Tran Nhu Duong, Le Thi Hd, Dinh Thi lgi tinh Ca Mau la 3,08% ti'ong giai dogn tir nam 2015 - Thiiy Linh, Nguydn Thi San, Pham Thi Thu Huong 2018. Tre em dudi 15 tudi Id ddi tupng dd bi dpng vdt (2016). Thue trang dieu tri du phdng benh dai lai cdn vd il dupe tidm phdng benh dai (33,54%) so vdi huyen Mai Son, linh Son La ndm 2014. Tap chi Y hpc ngudi tir 15 tiioi ti-d Idn (66,46%). 87,40% ngudi dan Duphdng. 7(180): 81-87. tiem phdng bdnh dgi do ehd cdn, ty le tiem phdng benh dgi giira nam gidi vd nir gidi la tuong ddi ddng 9. Phgm Hdng Son vd Nguydn Thi Ngpc Hidn dt'ii (2017). Xde dinh tinh hinh dap img midn dieh dich thd vd cam nhidm virus dgi d chd nudi trdn dia bdn Qua kdt qua khao sat cdng ddng, ly le nhdn thuc thanh phd Hue bang phuong phap HI va SSDHI. Tap ve benh dgi cua ngudi dan la 69,80%. 88,60% ngudi chi Khoa hoc va Cdng nghd Nong nghiep. 1(1): 119- ddn ddng y rdng benh dai chii yeu dupe Idy truyen tii 129. chd. Ty le ngudi dupe khao sal ed tiem phdng benh dai cho chd dat 75,50%, song sd ngudi cd y thiic Uem 10. Gadekar, R. D., Domple, V. K, Inamdar, I. F., nhde lai tiieo dung lich chi dat 64,00%. Aswar. N. R. and Doibale, M. K., (2014). Same dog bite and different outcome in two cases - case report. Trong ndm 2018, todn tinh Ca Mau ed 4 Q-udng J. CUn. Diagn. Res. 8(6): JDOl-02. hpp ngudi tuvong do benh dgi tren tong sd 20.500 ea bj ehd edn vd cd 4 trudng hpp bi chd dgi edn ddu 11. Salomao, C , Nacima, A., Cuamba, L, Gujral, khong thd theo doi tinh trgng sire klide cua eon vat. L, Amiel, O., Baltazar, C, Cliff, J., Samo, G. E., (2017). Epidemiology, clinical features and nsk TAI UEU THAM KHAO factors for human rabies and animal biles dunng an 1. Bd Ndng nghiep va PTNT (2009). Thdng tu outbreak of rabies in Maputoand Malola cities, hudng ddn eac bien phap phdng, chdng bdnh dgi d- Mozambique. PLOS Neglected Tropical Diseases. dpng vat. Sd: 48/2009/Tr-BNNPTNT. ngay 11(7): 1-16. 04/08/2009. Hd Npi. 12. Song, M.,Tang. Q., Rayner, S.,Tao, X. 2. Bo Ndng nghidp va PTNT - Bd Y le (2016). Y.,Shen, XX, Uang, G. D., (2014). Factors Chuong trinh Qudc gia khdng ehe va tidn tdi loai tru influencing the number of rabies cases in children in benh dai giai dogn 2017 - 2021. Ha Ndi. China. Biomed. Envu-on. Sei. 27(8): 627-632. 3. Bp Y le (2014). Quydt dinh: Hudng ddn gidm 13. Tenzin, Navneet, K D., jambay, D. and sal, phdng chdng bdnh dai ti-en ngudi. Sd: 1622/QD- Michael, P. W.. (2010). Re-emergence of rabies in BYT, ngay 08/05/2014. Ha Ndi. dogs and other domestic animals in eastern Bhutan, M o w f i MGHIEP VA PHAT TRIEN N O N G THON - KY 1 - THANG 9/2019 99
  9. KHOA HOC CdNG N G H t 2005 - 2007. Epidemiolog\- and tofection. 139: 220- nen toi loai trir benh dai giai doan 2(117 - 2021, 225. So: 193/QD-TTg. ngay 13/02/2017. Ha Npi. 14, Tenzin. Navneet. K. D. and Michael, P. \V . 17. Tliu lirdiig Chinh phu (2017). Chi thi vi- vifc (2011), Patterns of rabies occurrence in Bhutan tang orong cac bitn phap cap bach phong, chdng between 1996 and 2009, Zoonoses and Public Health, benh dai, S6: 31/CT-TTg, ngay 06/07/2017, Ha Npi, 58:463471, j j ^^JJQ (2013). Expert ConsultaUon on Rabies, 15, Tenzin, Navneet. K, D„ Bir, D, R.. Changlob, World Health Organization Press. Switzerland Sangay T., Karma T . Pema U.. Karma S., iMichael (ii82pp). P.W.. (2012), Community-based smdy on knowledge. jg yousaf, M, Z„ Qasim. M„ Zia. S„ Khan, M., attitudes and percephon of rabies in Gelephu, South As|,faq, U, A, and Khan. S.. (2012). Rabies molecular - Central Bhutan. Intemahonal Health. 4:210-219. vu-plogy. diagnosis, prevenUon and treatment, 16, Thu tirong Chinh phii (2017), Quyet dinh ve Virology Journal, 21(9): 50-59, vi0c ph^ duy^t Chuong trinh quoc gia khong ch^ va INVESTIGATION OF COMMUNnY OF RABIES IN CA MAU PROVINCE Nguyen Le Nhat Truong, Tran Ngoc Bich, Le Quang Trung Summary Rabies is a zoonotic disease that has serious consequences for (on) human :md animal health, Tlie data used in this study included pnmary data and secondary data. Primary data collection tecliiiiques were done using in-depth interviews and direct observation in thefield.Secondiiry data obtained from retjorts from die competent authority. In this study, a cross - secUonal survey was earned out on local dogs in Ca Mau province from October, 1^018 to april, 2019, The respondents of this study were the owners of dogs and the local residenls in Ca Mau province. The study resulls showed that the iweraKc of rabies vaccmaUon rate in dog were 3,08%fi-om2015 to 2018, Children under 15 year^ old were being attacked by animals and they were lower rabies vaccinauon. Rabies vaccination rate in human by dogs attacked were 87.40%. 88.60% people agree witli rabies was transmitted by dogs. Tlie rate of human in the interview has vaccinated against rabies for own dogs that were 75.50%. Howe\er. the rate of human has booster injected for own dogs that were 64.00%. Keywords: Rabies, dogs, comnmnily. invesdgate, Ca Mau province. Ngu6i phSn b i ^ : PGS.TS. NguySn Van Thanh Ngay nhin bai: 10/6/2019 Ngay thOng qua phan bi^n: 11/7/2019 Ngiy duy^t dang: 18/7/2019 100 NONG NGHIEP VA PHATTRIEN NONG THON - KY 1 - THANG 9/2019
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