Y HOC VIET NAM THANG 2 SO 2/2014

TAI LIEU THAM KHAO 1. Bo Y te (2012), Chien lUpc quoc gia ve an toan

ve sinh thu'c pham giai doan 2011-2020 va tam nhin2O30/Ha Noi.

2. Cue An toan thu'c pham (2012), Bao cao tong ket chu'dng trinh myc tieu quoc gia ve sinh an toan thiTc pham nam 2011 va trie'n khai ke hoach nam 2012, Ha Noi.

i.. Bui Vi The (2013), Thffc trang an toan ve smh thiTc pham, cdng tac quan ly va kien thffc, thyc hanh cua nhan dan tai cac bep an tap the huyen Thiiy Nguyen, Hai Phong nam 2012, Luan van tot nghiep bac si chuyen khoa I I , trUdng dai hoc Y khoa Hai Phdng, Hai Phong.

3. Pham Duy Tuyen (2010), thu'c trang an toan ve sinh thffc pham va cong tac quan ly mpt so cO sd

dich vu an uong cong cpng tren dia ban thanh pho Hai Du'dng nam 2010, Luan vSn thac sJ y te Cprjg dong, trudng dai hpc Y khoa Hai Phong, Hai Phong^ Nguyen Thj Van (2012), thffc trang an toan ve smh thyc pham, kien thffc, thai dp ciia ngu'di phuc vu tai nha hang an udng quan Le Chan, Hai Phong nam 2012, luan van thac sT y te Cong dong, tru'dng dai hoc Y khoa Hai Phdng, Hai Phong. Donkor ES (2009), Application of the WHO five keys of food safety to improve handling praaesof food vendors in apoor resource community in Gha na. East Afr J Puplic Health.2009 Aug,6(2): 148-51. Hislop N, Shaw K (2009), " Food safety knowledge retenbon stady " , J Food Prat, 72(2): 431-5.

CAC YEU TO NGUY Ca NHIEM GIUN TRUYEN QUA DAT ^ PHU Nir TUOI SINH SAN TAI XA AN PHU - TINH PHU YEN

T 6 M TAT Oieu tra mo ta cat ngang thffc hien d khoang 410

phu nff trong dp tuoi sinh san tff is den 45 tren dia ban xa An Phil, thanh pho Tuy Hoa, tinh Phii Yen nham xac dinh cac yeu to nguy cd nhiem giun truyen qua dat d phy nff tudi sinh san tai diem nghien cffu tren.

Ket qua thu dUpc nguy cO nhiem giun 6 ngu'di khong biet nguyen nhan, tac hai va phong chdng cao gap 2,4 lan; 2,5 fan va 3,1 lan tu'dng ffng so vdi ngi/di biet nguyen nhan, tac hai va phong chong. SU khac biet nay co y nghia thong ke (p

Y HOC VIET NAM THANG 2 - SO 2/2014

pham yi de tai nay, chung tdi khao sat 3 loai chfnh lay nhiem sang ngffdi la giun dua (Ascaris lumbricoides), giun tdc (Tnchuris trichiura) va giun mdc (Necator americanus va Ancylostoma duodenale) [1 ] .

^ Theo To chffe Y te The gidi (WHO) ifdc tinh tren toan cau cd khoang 2 ty ngu'di d trong dien cd nguy cd bi mac benh giun truyen qua dat va cd khoang hOn 1 ty ngffdi thiTdng xuyen bi nhi lm benh. Cac loai giun truyen qua dat chii yeu la giun dua, giun tdc va giun mdc [2], 6 Viet Nam, theo danh gia ciia nganh y te nam 2011 trong sd hdn 86 trieu ngffdi dan Viet Nam, cd 67 trieu ngffdi (chiem den 90% dan sd) d 53/63 tinh, thanh pho sdng trong vung dich te cira benh giun ffuyen qua dat, dang Iffu y la phu nff trong dp tudi sinh san la nhdm mac cd nguy cd mac benh cao nhat vdi 19 trieu phy nff [3]. Phu nff trong dp tudi sinh san mac benh ve giun se gay thieu mau, giam phat trien the chat, anh hffdng den phat trien tri tue va cdn gay ra nhieu bien chffng nguy hiem khac . Oac biet, vdi phu nff nhiem giun mdc trong thdi ky mang thai de gay thieu mau, de non, tre thieu can, tham chi cd the lam tff vong ba me va tre sd sinh. Vi vay benh nhiem giun truyen qua dat nhat la nhiem giun mdc 6if(ic coi la mdt van de Idn, de dpa den sffc khde ciia phu nff d dp tudi sinh san, anh hffdng den thdi ky mang thai [4] . Oe tim hieu tinh trang nhiem giun truyen qua dat d phu nff trong dp tudi sinh san chiing tdi tien hanh de tai: "Mot sdyeu td nguy cd nhiem giun dua, giun toe, giun moc

dphu niT tudi sinh san tai xa An Phu, thanh phd Tuy Hoa, tinh Phu Yen".

II. )6l TU'PNG VA PHU'aNG PHAP NGHIEN CUU 2.1 Ooi t i r o n g , dja d iem va thd i g ian

nghien cu'u - Odi tffOng nghien cffu: la phu nff trong dd tud'i sinh san tff 15 den 45 tuoi - Gia diem nghien cffu: xa An Phu - thanh phd Tuy Hda - tinh Phii Yen - Thdi gian nghien cffu

2.2 Phu'dng phap nghien cf fu: - Thiet ke nghien cffu: md ta cat ngang - C8 mau: dffdc tfnh theo cdng thffc:

n 2-, , . /., P(I-P) d '

Trong do n: cd mau p; vi chffa cd dieu tra ve nhiem

giun dua, giun tdc, giun mdc ciia phu nff trong dp tud'i sinh san d thanh phd Tuy Hda nen chpn

p = 0,5 de cd cd mau Idn nhat d; dp chfnh xac mong mudn (hay

gpi la sai sd cho phep) 0,05 2(1-0/2) = 1,96 (he sd tin cay vdi mffc xac

suat 95%) Vay cd mau se la; n RJ 384 Cdng them 7% nhffng ngffdi tff choi va di

vang, trong nghien cffu nay chung tdi chpn cd mau la 410.

III. Kfr QUA NGHIEN ciru Bang 1. Tv le nhiem qiun truyen

Tinh trang

Hon nhan

Tinh tr^ng cd thai

Co chong Chu'a chonq

Co thai Chu^ CO thai

So XN 269 136 31 238

qua dat (n= S6(+)

% 84(31,2) 17(12,5) 7 (22,6) 77 (32,4)

405) Giun dua

38 (13,0) 10 (9,6) 2 (6,5)

36(15,1)

Giun toe

12 (3,7) 3(3,7) 1 (3,2) 11(4,6)

Giun moc (%) 50(15,6)

7(11) 5(16,1)

45 (18,9) Nh$n xet: O bang 1 ghi nhan ty le nhiem giun truyen qua dat d ddi tffdng cd chdng (31,2%), d nhdm chffa chong la 12,5%. Ty le nhiem giun truyen qua dat ciia ddi tffdng cd thai la 22,6% ft hdn d ddi tffdng chffa cd thai (32,6%), nhffng dang Iffu y la ty le nhiem giun mdcd phu nff cd thai chiem 16,1%.

Bang 2. Lien quan qiu^ kien thu'c va nhiem qiun (n Kien thii'c

Nguyen nhan

Tic hai

Khonq biet Biet

Khonq biet

Nhiem giun (101) 39 62 40

=405) Khong nhiem (304)

63 241 62

P OR

p < 0,01 OR=2,4 p < 0,01

Y HOC VIET NAM THANG 2 - SO 2/2014

Phong chong Biet

Khonq biet Biet

61 42 59

242 57 247

OR=2,5 p 0,05

p > 0,05 p < 0,01 0R=4,1

Nhan xet: Nguy cd nhiem giun d ngffdi khong thffdng xuyen rffa tay trffdc khi an cao gap 1,7 lan d ngffdi thffdng xuyen (p

Y HOC VIET NAM THANG 2 - SO 2/2014

nguyen nhan, tac hai va phdng chdng cao cap 2,4 lan;_2,5 lan va 3,1 I3n tffpng ffng so vdi ngffdi biet nguyen nhan, tac hai va phdng chdng. Sff khac biet cd y nghia thdng ke (p < 0,01).

Cd moi lien quan giffa thdi quen an rau sdng, udng nffdc la va nhiem giun. Nguy cp nhiem giun d ngffdi thffdng xuyen an rau sdng cao gap 3,8 lan d ngffdi khdng an hoac an khdng thffdng xuyen (p < 0,01). Nguy cd nhiem giun d ngu'di thffdng xuyen udng nffdc la cao gap 1,9 lan d ngffdi khdng uong hoac udng khdng thu'dng xuyen (p < 0,05).

^Cd mdi lien quan giffa^rffa tay trffdc khi an va nhiem giun. Nguy cd nhiem giun d ngffdi khdng thffdng xuyen rffa tay trffdc khi an cao gap 1,7 lan d ngffdi thffdng xuyen (p