高雄地區登革熱病媒蚊密度監測及民眾相關 知識、態度、行為之研究

Surveillace of Dengue Vectors and It`s Correlation with Knowledge、Attitude and Practice of Residents in Kaohsiung Area.

呂怡玲(Yi-Ling Lu)

指導教授 ： 白秀華

高雄醫學大學/健康科學院/公共衛生學研究所/碩士(2004年)

摘要

為瞭解登革熱病媒蚊密度及民眾相關之知識、態度及行為進行本研究，於2003年3月至2004年1月在高雄縣市以誘蚊產卵器進行病媒蚊密度監測並對當地民眾進行相關問卷調查。
病媒蚊密度監測結果發現誘蚊產卵指數在9月(77.4%)最高，1月(30.9%)最低。整年度的溫度變化與誘蚊產卵指數有顯著正相關(person’s r =0.4)(p<0.05)(表1)。
公共場所誘蚊產卵指數之比較，空地 (76.3%)、空屋 (72.3%)、公園 (68.1%)都顯著高於市場 (31.7%)，未來應特別加強這些公共場所的環境清潔及孳生源清除(表5及圖3-4)。
住宅誘蚊產卵指數的比較，空地附近住宅之誘蚊產卵指數(47.4%)顯著高於其他，應特別加強衛教空地附近之居民，使其瞭解登革熱防治的方法及重要性(表6)；另外在住宅室內室外誘蚊產卵指數的比較上，室外誘蚊產卵指數(47.7%)顯著高於室內(29.6%) (P<0.05)，應特別加強衛教居民做好室外環境之孳生源清除工作(表9)；另於公共場所誘蚊產卵指數(62.1%)亦顯著高於住宅誘蚊產卵指數(38.6%) (P<0.05)(表16)。
蚊種的調查發現以白線斑蚊(85%)居多，可能登革熱病媒蚊的孳生源為室外天然容器居多，未來須做進一步調查及研究 (表17)。
住家的住宅指數(0.4%)(表20)、容器指數(0.2%)(表21)，公共場所容器指數(0.1%)(表22)，都非常低，無法反應出當地病媒蚊密度。
民眾對登革熱病媒蚊認知之問卷調查結果，多數人誤認為登革熱病媒蚊最常於晚上叮咬人(66.5%)；態度及行為方面，多數人對登革熱有警覺性，願意清除登革熱病媒孳生源(87.4%)，但僅有47.5%的民眾能做到「清除孳生源」，應加強民眾防護措施及確實清除孳生源(表28-30)。
將受訪民眾分為公園、市場、空地、空屋附近民眾進行分析，結果發現空屋附近居民對登革熱相關之知識、態度、行為，均較其他地區好，而誘蚊產卵指數是四區中最低者(28.6%)，可見有正確的登革熱相關知識、態度及行為，確實其登革熱病媒蚊密度較低(P<0.05) (表6,28-30)。
整年度的溫度與雨量變化對誘蚊產卵指數有相關，Y=-21.448+3.010X1+0.002X2 ,(X1=溫度,X2=雨量,r=0.4, F=7.1 , P<0.05) ，可提供未來病媒蚊密度預測之參考。
在未來進行孳生源清除主要的清除重點應放在各地區公共場所，尤其是無人管理的空地及空屋，更需要定期的清掃。另外應加強公園、市場及空地附近居民在登革熱防治知識、態度及行為之衛教，進而降低登革熱病媒蚊密度，減少登革熱傳播的危險性。

關鍵字

知識 .態度.行為 ； 登革熱 ； 登革熱病媒

並列摘要

The purpose of this study is to survey the index of dengue vectors and understand residents’ knowledge、attitude and practice about dengue vector. An entomological survey was done from March 2003 to January 2004 in Kaohsiung city and county. The ovitrap index in September (77.4%) was higher than other month and the ovitrap index was only 30.9% in January. The different temperature had relate with the ovitrap index .( r=0.4)(p<0.05) The ovitrap index were observed in 76.3% of the open space、72.3% of antiquated house、68.1% of park both significantly higher than the market(31.7%). The ovitrap index of the household nearby the open space (47.4%) was significantly higher than the others. The outdoor ovitrap index (47.4%) was significantly higher than the indoor ovitrap index (29.6%) (P<0.05).The ovitrap index of the public place (62.1%) was significantly higher than the household (38.6%) (P<0.05).
The Aedes albopictus index was 85%.The key breeding sites for the dengue vector Aedes albopictus may be outdoor nature containers.
The house index(0.4%)、container index(0.2%)for household and the container index for public place can`t show the real vector index.
66.5% people misinterpreted that mosquito bites at night. Most people showed the vigilance of the dengue disease and agreed to tidy out the breeding sites (87.4%), but only 47.5% of residents did. Therefore, education should continue to emphasize the dengue prevention and breeding sites clearance. People who lived in the epidemical area had less entomological knowledge and correctly attitude about dengue vectors than the residents who lived around the epidemical area. For this reason, education should continue to emphasize entomological knowledge and correctly attitude to the residents who lived in the epidemical area. Besides, the residents who lived near by the antiquated house have moor correct knowledge、attitude and practice about dengue than other residents who lived nearby the open space、park and market. To compare the results of the ovitrap index, the index of household nearby the antiquated house (28.6%) was significantly less than the others. The result of the study indicate that the correctly knowledge、attitude and practice reduced the index of dengue vectors(P<0.05).
The temperature and the precipitation had relate with the ovitrap index. Y=-21.448+3.010X1 +0.002X2 .(X1= temperature,X2= precipitation,r=0.4, F=7.1 , P<0.05) This result can provide consultation for the ovitrap index forecast in the future. The education should continue to emphasize entomological knowledge and correctly attitude to the residents who lived in the epidemical area.

並列關鍵字

dengue vectors ； knowledge、attitude、practice ； dengue

參考文獻

1.台灣地區公共衛生發展史(一) ,1995.行政院衛生署

2.疫情報導,2002.行政院衛生署疾病管制局.19:

3. Whiteford LM,1997. The ethnoecology of dengue fever. Medical Anthropology Quarterly. 11:202-23.

4. Lloyd LS, Winch P, Ortega-Canto J, Kendall C,1994.The design of a community-based health education intervention for the control of Aedes aegypti. American Journal of Tropical Medicine & Hygiene. 50:401-11.

5. Donalisio MR, Alves MJ, Visockas A,2001. A survey of knowledge and attitudes in a population about dengue transmission--region of Campinas Sao Paulo, Brazil--1998. Revista Da Sociedade Brasileira de Medicina Tropical. 34:197-201.