广西少数民族农村地区社区环境因素与食源性寄生虫感染关系的社会流行病学研究

Food borne parasitic disease is a serious public health problem in the world, especially in developing countries. Social epidemiology of parasitic diseases has been widely concerned. The rural minority area The community environmental factors of the rural minority area may have important effects on food borne parasitic infection, but which is very few studies. In this research, we will conduct a cross-sectional survey of 11 ethnic minority rural areas in Guangxi , using the methods of expert consultation, field investigation and multi-level model, to explore the relationship between adverse culture in the studied areas and food borne parasitic infection, and to examine the relationship of food borne parasitic infection with the other community environmental factors such as natural village economy, environmental sanitation, the proportion of captive livestock and poultry, the treatment method and use of human and animal excrement waste, fertilization and soil pollution status , the condition of water pollution and utilization, and the status of the personnel working in the zoonosis prevention and control in the administrative village and township, and to clarify the mechanism and pathway between them, and to explore the strategy of priority intervention, Finally, to propose the policy recommendations for the prevention and treatment of parasitic diseases in ethnic minority rural areas. Our research findings should be useful to shape the mode of social medical for the prevention and cure of parasitic disease, and to provide theoretical guidance and empirical support for the establishment of the parasitic disease prevention and control measures to integrate health into all policies. In addition, it is of great significance to improve the health awareness and to change unhealthy eating habits among minority residents.

食源性寄生虫病是全球特别是发展中国家严重的公共卫生问题。寄生虫病社会流行病学研究受到广泛关注。少数民族农村地区社区环境因素可能对食源性寄生虫感染有重要影响，但相关研究很少。本课题拟对广西11个少数民族农村地区进行横断面入户调查，采用专家咨询、现场调查和多水平模型等研究方法，探索不良文化与食源性寄生虫感染的关系，检查其它社区环境因素（如自然村经济状况、环境卫生、家畜家禽圈养比例、人畜粪便处理方式与用途、施肥与土壤污染状况、水源污染与水利用以及乡村人畜寄生虫病防治人员状况等）与食源性寄生虫感染的关系，阐明它们之间的影响机制及作用路径，探讨优先干预策略，提出社区环境因素干预为主的农村寄生虫病防治工作政策建议。相关成果可为形成现代寄生虫病的社会医学防治模式和实现“把健康融入所有政策”的寄生虫病防治措施制定提供理论指导和实证支持；此外，对提高少数民族居民的健康意识，改变不良饮食卫生习惯，有重要意义。

少数民族农村地区社区环境因素可能对食源性寄生虫感染（简称FPI）有重要影响，但相关研究很少。本项目系统地了解了广西壮族等7个少数民族农村地区（简称农村）FPI流行状况，证实了少数民族文化等因素与FPI流行关系，阐明了它们之间的机制，主要成果有：① 证明罹患FPI的农村居民的病理体征与教育水平低下有关。②FPI感染率较高；食用生或半熟鱼、虾、蟹等，大便后不经常洗手及不常在家庭厕所大便是引起FPI的重要因素；家庭有吃生或半熟的鱼、虾、蟹等习惯，家庭没有烧开水设备，家庭处理生食和熟食用具不分开及家庭没有保鲜膜或塑料袋是FPI的重要因素；自然村没有村卫生所、缺乏供水系统也是FPI的重要因素。③与FPI感染相关的卫生风险暴露患病率因民族而异。不经常剪指甲和户外土壤接触是各民族卫生风险暴露面临的最大挑战。卫生风险暴露在苗族中患病率很高，明显高于汉族。男性、已婚和未受过教育的居民或居住在建筑不佳的房屋或没有诊所的村庄的居民更有可能出现卫生风险暴露，但年龄≥60岁或家庭人均收入五分位数最低的居民不太可能出现卫生风险暴露。村干部比户主更了解现有与卫生风险暴露相关的国家和社区法规。几乎所有民族的村干部都认为村民对卫生风险暴露政策的遵从性很高。 ④ 居民食用生蔬菜的行为较为普遍，食用生鱼虾蟹次之，食用生肉最少。男性较女性更易食用生食；教育程度和婚姻对生食行为有影响；不同民族，生食行为不一样；年龄越大，越易食用生食。家庭对生食行为的影响较大。⑤ FPI总体知晓率偏低，其中低收入家庭、农民、老年人、苗族、低文化程度及腹泻患者等人群对FPI知晓率低于其它人群。⑥老年、未婚、苗族、受教育程度低、务农以及家庭收入低的户主，其FPI认知度较低。老年及FPI认知水平高的户主，其家庭成员FPI认知水平较其他家庭更高。.本研究对广西农村FPI防治，特别是相关的健康教育的政策和措施制定可提供科学依据。