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1, Cdi thifin ehdt tu'png tnjydn thfing glfio dgc vd vfi sinh ca nhan, vfi sinh mdi trudng vfi chdt lupng nydc va cac bifin phfip bdo vfi nhdm iam cho ngudi dan cd nhu edu su dgng nha[r]
(1)lii-n nhofii l.;i'Mii ntirm tu6i a&i c6n trd * Cac tripij c h d n g vfi x6t nghidm
Trong nghign cuu cua chung t6t, gSp tfing enzym gan va Bilirubin vdt ll Ifi nhu' sau ALT: tang 25,9%, AST tang 29,3%, GGT tflng 55,2%, Bilirubin todn phdn tang 10,3%
Theo nghi&n ciiu cua chung tdi tSng ALT, AST va Bilirubin toSn phdn \i dc tridu chung it gfip d bfinh nhan (36ng nhidm HIV - HCV, nhifin, ISng GGT lgi 1^ tn^u Chung khfl phd bidn (55,2%) Theo kdt qu^ nghi§n cuu ciia Kanxay Vernavong (2011), enzym gan AST va ALT tSng c6 lifin quan ddn tinh trgng l6n thu'ong cua gan Nghifin cu'u cho Ihdy ndng dO AST trung binh la 216,58 ± 32.20 (U/l), ALT IS 147,15 ± 21.01 (U/l) Ndng 30 enzym gan cao ho'n mirc binh thu'dng ddng nghla vdi tinh trgng gan dang b| ldn thuong gap ddng nhidm HIV - HCV Vd chde nSng 6^0 thai mgt d gan vdi Bilirubin toSn phdn \i 83,05 ± 12,23 (pmol/l) Bilirubin true lidp la 38,80 ± 5,59 (pmol/l), kdt qua x6l nghifim phan anh tinh trang vi6m gan va u' mat cd lidn quan vdi vi rul vidm gan C Nhu' vSy, kdl qua nghifin ciiii ciia \ic gia phan anh muc (56 Ion Ihuong gan d bfinh nhSn vi&m gan C tren benh nhfln HIV, khong gap tdn thu'ong suy chii'C nflng gan d bfinh nhfln viem gan C tren benh nhfln HIV
KET LUAN
Qua theo doi, dieu in 24 thang cho 198 bfinh nhan nhidm HIV lgi khoa Truydn nhifim - Bfinh vifin 103, td thflng 1/2007 den Ihflng 5/2012 Chiing tdi nhan thdy
- Ty le dong nhidm HCV d bfinh nhan nhiim HIV la 29,3%
Ty le dong nhidm HIV - HCV d benh nhfin nam gidl la 34,5%, cao han so vdi d n d g i d i la 15,1%
Ty le dong nhiem chich ma tiiy 40,0% cao hon so vdi nh6m quan hfi tinh due khOng an tofln 25,0%
- Kieu gen HCV chiem u'u the Ifl typ (87,9%), lyp chiem (12,1%), khdng gap cac kieu gen khac
- Ty le bfinh nhan e6 tnfiu chdng lfim sflng vd gan d nhom dong nhidm HIV - HCV la thdp (Vflng da, vang mflt, lidu vflng 13,8%, mfil moi 8,6%, chfln fln
6,9%, dau tdc hg su'dn phai 5,2%, budn nfin -d
3,4%, sp md 3,4%, gan to 3,4%) j Tflng ALT, AST vfl Bilirubin toan phdn Ifl tffl
chdng i! gap d nhdm ddng nhiem HIV - HCV, fl Iuvt Ifl 25,9%, 29.3% vfl 10,3% Tuy nhifin, tflng GQ lgi Ifl Irifiu chdng khfl phd bien (55.7%)
- Khdng cO su' khflc bidt c6 y nghTa thdng kfi j eflc IriOu chirng Iflm sflng, xd\ nghiem enzym gaj Bilirubin d nhdm cd vfl khdng ddng nhidm HCV
TAI LIEU THAM K H A O
1 BO Y td, Cue phbng chdng HIV/AH (04/03/2009), "Hudng din chin doin vi didu HIV/AIDS"
2 Bui Ogi (2008), -Vifim gan virus C", Vidm virul B vi D Nhfl xudi b^n y hoc Hfl NOi
3 H Tdn Dgl, Pham Th| Thu Thuy vfl c^ng (2005), "Kidu gen cua vifim gan sifiu vi C d \i Nam", Tgp chi Y Hgc TP Hd Chi Mmh Tap 10, S4 Irang 28 - 34
4 Nguydn Tidn Hda (2012) Ttnh trgng r)t)i HIV HBV HCV vi ydu td lidn quan & mdt sd nl nguy ca cao tgi Hi N6i 2008 - 2010 Luan an Tidni Y hoc Vifin vfi smh dich id trung u'ong Hfl NOi •
5 Andrew H Talal (2002), "The HCV and Hij Coinfected Patient What Have We Learned Abw Pathophysiology", Current Gastroenterology RepOfS 2002, 15-22 Current Science Inc ISSN 1522-8037J Blatt LM el al (2000), 'Assessment D hepatitis C virus RNA and genotype from 66^ patients with chronic hepatitis C in the United Slated J Viral Hepal 2000 May,7(3) 196-202
7 Cooper CL and others (2003 Hepatotoxicity associated with antiretroviral thera( containing dual versus single protease inhibitors individuals coinfected with hepatitis C and hurni immunodeficiency virus Clinical Infectious Diseaa 34(9) 1259-1263 May 1, 2002
8 Dl Martino V and others (2002), "H coinfection does not compromise liver histologic response to interferon therapy m patients with chrw hepatitis C", AIDS 16(3) 441-445 February 15, 200
THin: TRANG DIEU KIEN NHA VA VE SINH MOI TRlTOTNG HO GIA DINH TAI BA XA VUNG NONG THON TINH HAI OUITNG NAM 2012
NGO TH! NHU - Dai hgc Y ThAi Binh
T M TAT
Nghidn cuv dt ngang 1205 hd gia dinh vd •'Thgc trgng nhi & vi didu kidn vd sinh mdi tnrdng hd gia dinh tgi ba xi vung ndng thdn tinh Hai Dwong nim 2012" tu' thing Iddn thing 6/2012 kdt qui cho thiy: Nhi d ting chidm ty Id 59%; nhi d cip chidm ty 1$ 14,9% Nhi d c6 didn tich trdn lOm'/ngwdi chidm
ty Id 84.6% Trong dd xi Thanh Timg chidm ty 1^ c nhit li 7.8% V$l hdu chlnh tmng xiy dwng nhi mii bing bd tdng chiim ty Id 61.5% vi tudng fc3 ggch nung cd trdt vwg li 63.3% Cdn 22.2% ftfli dinh sw dung ram rg vi 12,4% sir dung than trz dun niu sinh hogt hing ngiy.Ty 1$ ngudi dii\ dung nwdc sgch li 47% nwdc miy; 33% nwdc gii
(2)khoan vi cdn 3,8% cdn sO' dijng nwdc sdng, go Ty Id cic ngudn nwdc dwgc gia dinh cho li hgp vd sinh chidm tir 49,8% ddn 57,4% Tj? Id hd gia dinh cd nhi tidu li 99.2%; vin cdn 30,3% nhi tidu khdng dim bio vd sinh
Td" khda: nhi &, vd sinh mdi trwdng
SUMMARY
A cross-sectiongi study among 1205 people about the condition of household and environmental hygiene at rural communes in Haiduong province fmm January to June 2012 showed that: concrete house condition accounted for 59 0%, level IV house condition accounted for 14.9% About 84.6% of all houses had areas of more than 10 m^/person in which Thanhtung communes accounted for highest proportion (97.8%) The main materials for construction were concrete (61.5%) and brick with mortar (63.3%) About 22.2% of all the household used rice stmw and 12.4% used coal in daily cooking Neariy haff of people (47%) used tap-water, about 33% of them used well-water There was still 3.8% of people used water in pool for daily activities About 49.7% to 57.4% of all the water soumes were considered as hygienic ones, finest of household (99.2%) had WC in which 30.3% WC were not hygienic
Keywords: household, environmental DAT VAN o e
6 nhidm mdi tru'dng nfing thdn dang la tinh trang chung d hdu hdt cdc ^ a phu'ang, nhdt ifi vOng ddng bdng, dat dai chfit h|p nfin ngudi dan dang ddi • mat vdi tinh trang nhiem mdi tru'dng nang nd S6 < lupng rac thdi sinh boat mdt tang lfin Ngudi i dan vdt rac thai k h l p nffi nhu t d ven nha, du'dng , iang, ngd xdm ddn kfinh muang, ao hd Tai Vifit Nam, cd tdi ban 80% cae bfinh cd lien quan den ngudn nu'dc nhu tieu chay, thuang ban, ta, [y, giun J san, vifim gan Nguyfin nhfin chu ydu nhifim b i n f t d cfic chat hdu co va vi sinh vfit, qua dd tac dpng f tn^rc tidp ddn sue khde ngudi dfic bifit lfi ngu'di gia va tre em [13] Mdt vdn dd ddng ndi dd la tinh trang tdn tai nha vfi sinh khdng dam bao, hay khdng cd nha vfi sinh dfi tru-c tidp gfiy fl nhifim mdi tru'dng ndng thdn Tai Viet Nam, Tbeo bfio cao Chu'ong trinh nudc sgch vfi vfi sinh mdi tru'dng nfing thdn giai doan I 2005- 2010 chi ed 55% hfi gia dinh ndng thfin ed nha tieu dgt tifiu chudn vfi sinh cOa Bd Y td Thdp nhdt la vung Bdc Trung Bd (34%) vi cao nbdt la midn ddng Nam Bfi (69%), Trong dd myc tifiu chinh vd vfi sinh eua chuong trinh nfiy la phdn ddu ddn nam 2015 "cd 65% s6 hfi gia dinh, 100% tardng hpc va trgm y td ed nha tifiu hp'p vfi sinh Phdn ldn ngudi dfin chu'a thdy hdt moi nguy hai mfii tru'dng bj fi nhidm, suy 'Ithofii Ttnh trang thidu J thdc vd vfi sinh lfim cho mfii ^'trudng cfing nhidm hen
fi Giai quydt tdt vdn dd nba d va 6\ku kifin vfi sinh 3mditnrdngxung quanh se ban chd du'pctinh trgng P^hifim mdi tnrdng, gidm ty Ifi mdc vfi d§n tdi Moan mfit s6 bfinh darig lifin quan nhdm nfing cao tinh
trgng sdc khde cfing ddng dfin cu", cai thifin mdi tru'dng sdng Xudt phat t d y nghTa thi,i'c tifin dd chCing tfii tidn hfinh nghifin cdu dd tfii' "Thirc trying dieu kidn nhi & vi v$ sinh mdi trwdng hd gia dinh tai ba xi vung ndng thdn tinh HAi Duxmg nim 2012" D O I T U - Q N G V A PHU-aNG P H A P NGHIEN CU'U Ddi lu'Q'ng nghifin c d u : Hd gia dinh Tgi cac hfi ehiing tfli tidn bflnh didu tra va quan sdt vd Didu kifin nha d, md hinh nhfi tifiu va tinh trgng vfi sinh, ngudn nu'dc, rfic thdi
2 Oja bfin nghifin c u u
Nghifin cdu du'pc tidn hdnh tgi xa vCing ndng thfln Tinh Hi\ Duong d6 la: Xa Cdm Phiic thu$e huyfin cdm Giflng, xfl Thanh TCing thuOc huyfin Thanh Mifin vfl xa Phuang Hu'ng thudc huyfin Gia Ldc
3 Thdi gian nghifin c u u : Nghifin cdu dupe thu'c hifin t d thang_1/2012 ddn thang 6/2012
4.Thidt kfi nghifin c d u : Nghifin cdu djch td hpc mfl ta dua trfin cudc didu tra cdt ngang
5 C d mdu vfi chpn mfiu
- Chgn miu: Chii djnh chpn xfl dd ifl Cdm Phuc thufie huyfin Cdm Gidng, xa Thanh Tung thuflc huyfin Thanh Mifin vfi xa Phu'ang Hu'ng thuflc huyfin Gia Lfle, Day la cfic xa dgi difin cho viing ndng thfln tinh hai Duang T d eae xfl dS du'ac chon, tidn hanh chpn ddi lu'O'ng nghifin cdu theo phuang phdp chon ngiu nhifin bdng cflch bdc tham chon ngdu nhien mdt hfl gia dinh, sau dd tidn hanh 6iku tra theo phuang phap "cdng lidn cdng" cho Qkn du c_d mdu nghifin cdu
- Cd m i u ; Ap dung tinh cd mfiu
n = ^(a!2) ' .P^-P)
Du'a vao cflng thde tren tinh n=400 Vay ea mau can cho nghifin cdu la 1205 Hfi gia dinh
6 Phu'ang phfip, ky thufit thu th^p sd li^u Quan sat true tidp vfl sd dung bang kiim da xay dM'ng sdn dd xac dinh cac ydu to nguy ca d nhifim nguon nu'dc, tinb trgng vfi sinh nhfl tifiu, thu gom va xu ly rac, nha d (difin tich xSy dyng, cay xanh, ngudn nang lu'png sd dgng dun ndu, )
7 Tjfiu chudn ddnh gid
Dua theo tifiu chuln quy dinh tgi Quydt djnh 08/2005/QB-BYT va 09/2005/QD-BYT
Didu kifin vfi sinh nha d dya vao tifiu chudn c h i t lypng vfi sinh mfli trudng nydc, nhfi tifiu, thu va x d Yj rac, thidt kd xay dyng va yfiu cdu vfi sinh theo qui djnh hifin bfinb [0], [2]
8 PhSn tich vfi x u ly s6 li^u
cac phidu didu tra (Snh lupng, sau thu thfip ddu dup'C ifim sgch trude nhfip vao may tlnb bdng phdn mdm Epi DATA Phan tich s6 Iifiu bdng phdn mdm SPSS 16.0
Cfic s6 lieu dypc trinh bay dudi dang bang vfi bidu dd
Sy dgng cfic test tbdng kfi phfin tfch s6 Iifiu
(3)K^T QUA NGHIEN ClifU VA B A N L U A N Bdng 1, Cfic loai hinh nha d tgi cac xS didu tra L09i hinii nhS 0' Nhd Nhd Idnq Nhd t^ng trp T6ng C i m Phuc
S i 35 212 148 401 8.7 52,9 36,9 1,5 100 T h a n h
T u n g
SL 166 174 35 401 % 9,0 38,9 43,3 8,8 100 P h i f o n g
H u n g
SL 238 9 403 % 14,9 59,0 24,5 1,6 100 C h u n g
SL 131 606 421 47 701 % 10,9 50,2 34.9 3,9 58,2
Ty Ifi ehung ca xa nhd tdng chidm cao nhdt Id 50,2% vdn cfln 10,9% nha cdp Nha d cua ngudi dan chu ydu la nha tdng va tdng chidm ty Ifi t d 38,9% ddn 59% ddi vdi nhfi d xfiy tdng vfi td 24,5% ddn 43,3% vdi nha xay tdng va ed sy khae gida cfic xa theo Chung tdi la hpp ii* bdi IS kmh td cua m6i xa la cd sy chfinh Ifieh Tuy nhifin, d cd xfi vdn cdn chidm 10,9% hd gia dinh cd nha cdp 4; didu cOng hoan toan phCi hpp vdi didu kifin kmh td eua eac xS
Bdng Difin tich nhfi d d dja bfin nghifin cdu
D[$n t i c w ngirdri
<10 m ' >10
e l m Phuc ( n = ) ( )
SL 355 % 11,5 88.5 T h a n h
T a n g ( n = ) ( )
SL 392 % 2.2 97.8 P h i / o n g
H i f n g (n=403) (3) SL 103 300 % 25.6 74.4 T i n g (n=1205) SL 156 867 % 15.4 84.6 p (1.2vi3)<0,05
Difin tich nhfi d cua cfic hfl gia dinh t u lOm^/ngu'di trd lfin cbidm ty Ifi eao (84,6%); xfi nghifin edu cho tbdy xS Thanh Tung cbidm ty Ifi cao nbdt ifi 97,8% va thdp nhdt la xa Phyang Hyng chidm t^ Ifi 74,4% S y khfic bifit cd nghTa tbdng kfi vdi p<0,05
Bang Cfic loai vfit Iifiu chlnh s d dung lfim tudng nha
Loai v$t ll$U
TLffrng d i t t r i t
vdch
B& tdng
G a c h x l G a c h khdng nung, c d trdt v & a G c h n u n g c d t r i t v D a
e l m Phiic (n=401) SL 180 208 % 0,6 44.9 1.2 1.5 61,9 T h a n h
TCing (n=401) SL 12 20
2 3
% 3,0 16,7 17,2 4,9 58,2 P H i f ng (n=403) S I
0 12 387 % 1,0 2.9 96.1 T d n g (n=1205) SL 14 247 38 828 % 1.4 24,0 7,6 3,7 63,3
Hdu net nna a oeu awgc xay ue long ^z*^,u7bJ va ggch (63,3%) ddm bdo yfiu edu chde chdn nhung khS nfing chdng ndng cho nha d d^c bifit vd milia hfi rdt hgn chd
Bang c a c logi vfit Iifiu chinh sd dung lfim mdi nba Loai vdt li$u G5 Fibre XI mang N B I
luldi b i n g Khac
e l m PhUc (n=401) SL 34 76 288 % 0,5 8.6 18,9 71.9 0.2
T h a n h T u n g ( n = ) S I
4 150 % 1.0 8.9 37,4 52.1 0.6 P Hi^ng (n=403) SL 0 314 17 % 1.0 16,7 77.9 ,
Tfing J ( n = U
SL 74 294 810 21 %i m 7,2 J 28,71' 8'fl 2:0* cac logi v$t Iifiu cbinb duprc ngudi dfin sd dyr^ ifim mai nha chd ydu la mai bdng chidm 61,5%; m | ngdi chidm ty Ifi 28,7%; cac logi khac chidm t? 1$ thdp Trong xfi nghifin cdu, xfi Phuang Hung c6 If
lfi nha mai bdng cao nhdt (77,9%) '-^ Bdng Ngudn nfing lyprng chinh su dyng duft
ndu ^ Loai v | t
il«U
D i $ n Binh g a
Bioqa D I u hoa T h a n c d c icai
C i j i , r o m
d m P h u c (n=401) S L 318 11 16 % 1,5 79.3 2,7 0.7 3.9 11,9 T h a n h
T i i n g ( n = ) S L 128 103 6 % 19.7 31.9 5,0 1,2
2 ,
16.4 P H l / n g (n=403) S L
2
% 1,2 23,8 0,5 2,0 72.5 T i n g t (n=1205)J SL 90 542 33 127 405 » 8,7 S « 3,2; 0,8
"7? '1
!3
c a c hfi gia dinh s u dgng ga dun ndu 52,8%; nhifin, d xfi C i m phdc t9 ifi cao^MH chidm 79,3% vfi xS Phyang Hung chf cd ^ song t^ Ifi ngudi ddn s d di,jng cui va ram rg dd dun ndu chidm 72,5%, cdc nguyfin Iifiu khdc It dypc sur dgng nbu v$y It nhidu cOng gfiy dnb hydng d d n ^ khde ngudi
Bfing Ngudn nu'dc dang sd dung chlnh N g u d n
n i ^ d c
N i / d c mSv N i f d c m i f a G i l n q k h a i G i ^ n g khoan S d n g , sudi
a o h d e l m PhOc (n=401) SL 167 72 152 %
4 18,0 38.0
1,0 T h a n h T u n g ( n = ) SL 21 2 % 57 ? ,
0,5 P- H i / n g (n=403) SL 164 2 12 165 %
4 5,5 41
9,9 T i n g (n=1206) SL 563 158 39 399 46 % 47,0 13,0 3,2 33,0 3,S K & q u i Cho thily 93% c i c hO gia Oinh c6 iJCi nu«c dCing sinh hogt; ngu6n nu-iic chlnh du'^c sii dyng Id nu-c^c m^y chi^m 47%; 66 xS TTianh r a n g c h i j m t) 1$ cao nhSt 67,8%, xS Phtrang Hwi§ chi c6 40,6%, Hxftrc gifeng khoan cOng duyc sfr dyng chiSm 33,0%; c4c ngu6n nirdc khSc It Surge sO dgrg,
(4)TJ1${%)
60-DC Phiic (1) DT, TOng (2)_
• P Hiyng (3) C Phuc(1) T Tling {2)_ P Hipng
IUtl>ci3d nguy
ca RSt cao
Cao Trung
binh ThSp
Cim Phuc (n=401} SL 12 60 180 149
% 3.0 15.0 44.8 37.2
Thanh TUng (n=401) SL
9 73 161 158
% 2.3 18.2 40,1 39,4
P Hirng (n=403) SL 10 81 193 119
% 2,5 20,1 47.9 29,5
Ting (n=1205) SL 31 214 534 426
%
2,6 17.7 44.3 35.4 lyidc dp nguy co d nhidm cac ngudn nu'dc tgi xa Nguy co d nhifim mdc dd trung binh chung d xa chidm t^ le cao nhdt 44,3%; dd xa Phycng Hyng chidm ty Ifi cao nhdt 47,9% Nguy ca nhidm thdp ehidm 35,4%; dd xfi Thanh TCing cao nhdt chidm 39,4% v a n cdn 17,7% nguy CCT d nhifim mdc dfi eao va 2,6% nguy eo d nhidm mdc dd rdt cao Kdt qud nghifin cdu eua ehung tfii so vdi cae nghifin cdu khfic d tinh Thai Binh va Ha Nfii la thdp hon [12] Theo chCing tfii, kdt nhu vfiy la ph£j hpp bdi ie dd la kdt qua thye td cua nfing thdn Vifit Nam vd nude sach sinh hoat, cd sy khae gida cac xa ndng thdn eua cac dja pbucng nude
Hdu hdt cfic hp gia dinb ddu cd nhfi tifiu, cbidm t f Ifi 99,2%; nhifin v l n cdn mfit s6 bfi khdng cd nha tifiu ehidm t^ le 0,8% Kdt qua nfiy ifi cao ban rdt nhidu so vdi nhidu noi khu vyc Tuy nhifin kdt qud nghifin cuu cua chCing tdi tyo'ng du'ong vdi kdt qud nghifin edu eOa Vi Vfin Thuydt (2009) [18] vd tf lfi hfi gia dinh cd nhfi tifiu Kdt qui nfiy cung phdn anh mfit thye td la quan nifim cda ngydi dfin midn Bdc coi nha vfi sinb la mfit phdn khdng thd thidu cua gia dinb, nd vda lfi nai chda dyng cac chdt thdi cda cfic thanb vien gia dinh, nhyng nd cQng gdp phdn cung cdp mdt ngudn dinb dudng cbo cfiy cua gia dinh
QC.phuc(l) QT.TiJng(2) P P.HLfng (3)
P,i.2.3)<0.05
Bidu dd Ty Ifi hfi gia dinh cd ngudn nu'dc chlnh dyp'c danh gia cam quan la hpp vfi smh Ty Ifi hfi gia dinh cd ngudn nude ehinh dupc danh gia cdm quan id hp-p vfi sinh ehidm t / Ifi cao nhdt d xa Thanh Tung la 57,4%; xa Cdm PhOc 56,1%, thdp nhdt la d xa Phuang Hyng 49,8% vdi p<0,05
sang Mdc dd nguy ca fi nhifim cdc ngudn nudc tai cac xa
C.phijc T.Tung P.Hu'ng (1) (2) (3)
K , P(i.2.3)<0.p5 Bifiu dd Ty Ifi nhd tifiu dat tifiu chudn vfi sinh vd
xfiy dyng d xS
D^t xdy d^rng D^t si> dung mt utu
Bidu dd Ty Ifi nha tifiu h$ gia dinh dgt tifiu chudn vfi sinh d xfi
Kdt qua bidu dd va cho thdy nha tifiu dgt tifiu chudn vfi sinh vd xfiy dyng d xfi Phuong Hu-ng chidm ty Ifi cao nhdt 94,8%; xfi Cdm Phuc 89,7%, thdp nhdt la xa Thanh Tung 69,1% vdi sy khac bifit cd y nghta thdng kfi Ty Ifi hfi gia dinh c6 nhfi tifiu dgt chudn vd sd dung d ca xfi la 70,1%
KfiT LUAN
- Nha d tang chidm ty Ifi 59%; nhfi d cdp chidm ty lfi 14,9%, Nha d cd difin tich trfin lOm^gu-di cbidm ty Ifi 84,6%, Trong dd xa Thanh Tung chidm ty Ifi cao nhdt lfi 97,8% Vfit Iifiu chinh xfiy dyng nha d la mai bdng bfi tdng chidm t / Ifi 61,5% vfi tydng bdng ggch nung cd trdt vQ'a lfi 63,3%
- Cdn 22,2% vfi 12,4% hd gia dinh sy dyng rom rg, than dun ndu, sinb hogt hdng
- Ty Ifi ngudi dan sd dyng nude sach la 47% nu'dc may, 33% nu'dc gidng khoan va cdn 3,8% cdn s u dyng nudc sdng, ao Tf Ifi cfic ngudn nude duvc gia dinh cho la hpp vfi sinh chidm t d 49,8% ddn 57,4%
- Ty Ifi hfi gia dinh cd nhfi tifiu la 99,2%; vdn cdn 30,3% nha tifiu khdng ddm bdo vfi smb
KHUYDN NGHI
1, Cdi thifin ehdt tu'png tnjydn thfing glfio dgc vd vfi sinh ca nhan, vfi sinh mdi trudng vfi chdt lupng nydc va cac bifin phfip bdo vfi nhdm iam cho ngudi dan cd nhu edu su dgng nha tifiu, s u dung nudc sgch va cdi thifin hfinh vi vfi sinh ca nhfin Elfic bifit lfi vd vai trd vfi yfiu cdu nha d hp'p vfi sinh
2 T u van dd ngudi dSn bidt Iya chpn logi nhfi tifiu pbCi hp'p vdi Adu kifin dia If cua Ct\a phuang vfi didu kifin kinh td cua gia dinh, d | c biet hydng ddn dd
(5)ho Xdy dunq, su' dyng va bSo quan nha tifiu ddm bdo cac tidu chudn vfi smh
T A I L I E U THAM K H A O
1 Hoang Anh (2009), Hd thdng v8n bin mdl vd bio vd mdl tmdng 2009 quy chuin lidu chuin Vidt Nam vd mdl trwdng, nxb Thdng kfi
2 Bd Y td (2005), Tidu chuin vd sinh nudc sgch vi tidu chudn vd smh ddi v&i cic logi nhi tidu Hd NOi-2005, tr 12-13
3 Cyc Qudn ly mfii trudng, Bfi Y td (2011), Hudng din vd sinh hd gia dinh Hfi NOi 2011
4 Nguydn Duy Dang (2006), Dinh gii hidu qui cgn thidp cii tgo xiy dgng, sd' dijng nhi tidu hgp vd sinh tinh Thii Binh Lufin vfin thgc s f Y hpc, Trydng Dgi hpc Y Thai Binh,
5 Trdn Thj Khuyfin (2004), Dinh gii mdt sd chl tidu vd chdt lugng nudc sinh hogt vi ydu td lidn qugn ddn chit Iwgng nudc tgi x8 thudc huydn Kidn Xwgng tinh Thii Binh Lufin van thgc sf Y bpc, Tru'dng Ogi hpc Y Thai Binh,
6 Phgm Trung Kifin, Nguydn Gia Khfinh (2010), Hidu qui chwang trinh cung cip nw&c sgch vd sinh mdl tm&ng ddi v&i sue khde bdnh t$t trd em dwdi tudi Igt x8 Hoing Tiy Kim Bing Hi Nam Tgp chl Y
hgc Thi/c hinh, s6 (3), Tr
7 Ngfl Thj Nhu (2008), Nghidn cCru mdt sd yiu chit Iwgng nw&c sinh hogt vi bdnh lidn quan &6x5 ndng thdn Ddng Hwng Thii Binh Hidu qui bidn phip can thidp Lufin an tidn s f y hpc, Hpc Vifin Qufin Y
8 Trdn Ddc Phu vfi CS (2010), Nghidn cOv m6i lidn quan giO-a vd sinh mdi trwdng, ngudn nwdc hd gia dinh vi hinh vi vd sinh chim sdc trd cOa bi m$ vdi tinh trgng dmh dudng cua trd dw&i tu& tgi Vi^ Nam Bao cao kdt qud dd tai cdp Bfi
9 UNICEFT Vifit Nam, Nwdc sgch, mdi tnj&ng vd vd sinh
http//www.unieef.orq/vietnam/vi/wes.blml NgSy truy cfip 5/8/2009
10 VO Khanh Vfin (2010), Thi/c trgng xiy difl)g sir dung nhi tidu hd gia dinh, xir 1^ phin ngwdi t^i m^t sd xi vOng ndng thOn Nam Djnh, Lufin vSn tiigc s f Y bpc, Trudng Dgi hpc Y Thfii Binh
11 Vi v a n Thuydt (2009), Nghidn cim nhin thtic, thii dd thwc hinh cua ngwdi din vd quin ly s&dijng phin ngwdi tgi Bi Thwdc, ttnh Thanh Hda Lufin v&i thgc s f Y bpc, Tnj'dng Dai hpc Y Thfii Binh
NGHIEN CUfU XAY DUNG MO HJNH CAN THIEP NHAM HAN CHE TAI BIEN DO LAN CHD NGITDAN KHANH HDA
PHUNG TH! THANH T l i \ VlfiN CHINH CHlfeV, T R A N T H | QUYNH CHI', Lt HONG MINH* , HOANG TI^N THANH' NGUYEN V A N T U Y S N ' , T H i i U LONG'
Vi^n Pasteur Nha Trang\ Vi^n Vd sinh Dich (S TAy Nguydn', Vidn Y hgc Biin Vi^t Nam', Bdnh vi^n 175 BO QuSc phdn^, B^nh vi^n Y hgc C6 truydn vA Phyc h6i chirc nSng KhAnh Hda' T6M TAT
Di/a trdn kdt qui didu tra vi nghidn cdu vd nguydn nhin tai bien l$n, md hinh bdnh tdt vi tai biin lin cua ngw din Khinh Hoi, nhdm tic gii di tiin hinh nghidn cuv can thidp trdn 200 ngw ddn Khinh Hoi: - Tnrd-c can thidp Kiin thwc vi thgc hinh cda ngw din vi an toin lin vi sd cip cdu tat ngn trdn bidn chidm tl Id thip (tip buin an toin lin 1,8%; sa cip cOv tai ngn trdn biin 33%) - Tidn hinh can thidp: Tip huin cho ngw din vd an toin lin vi so cip cuv tai ngn trdn bidn lin; dinh gii kidn thdc thi/c hinh vd an toin l$n vi so cip cOv tai ngn trdn bidn lin - Sau can thi^p: kidn thirc vi thi/c hinh cua now din vd an toin tin vi sa cdp cdu tai ngn trdn bien ting Idn: t$p huin an toin l$n 98,5%; bidt bing hwdng din l$n 98.5%; thudc bing hwdng din lin 98% cip ciru tai bidn l$n ngn nhin cdn tinh 98%, cip ciru tai biin l$n ngn nhin bit tinh 95%; sO- dgng binh oxy an toin 93%; so dp cOv tai ngn trdn bidn 96% Sau can thidp, l<idn thOc thi/c hinh vd an toin lin vi so cip cdu tai n$n trdn biin cOa ngw din ting idn rO rdt, v&i p<0,005
• CAc tic gii dS dd xuit m6 hinh can thi$p
nhim hgn chd tai bidn l$n cho ngtr dSn tOiinfi HoA MO hinh di/a trdn cic vin bin vi chl thj cOa 6$ Y td vi Bd Ndng nghidp - Phit triin ndng thdn UBND tinh Khinh Hda iXn cic S&, Ban, Nginh lidn quan iM •Qudn ly an toin nghd lin bidn & Vidt Nam"
TOF khda: tai bien tin ngw din fOiinh Hoi SUMMARY
Research to set up the model of intervention to limit the diving accidents of Khanh Hoa's fishermen
Based on (be investigating and researching the cause of diving accidents, disease model and diving accidentst of Khanh Hoa's fishermen, conda(^nQ inten/ention studies on 200 fishennen Khanh Hoa • Before Intervention: The knowledge and practice of fishermen for safe diving and first aid accidents at sea have very low rate: training on safe diving (1.8%); fire( aid accidents at sea 33% - Cany out the intervention: safe diving tmining for fishermen: times and assessing knowledge about safe diving and first aid accidents at sea practices: times • After intervention: safety knowledge and practice of emergency diving accident and first aid accidents ei
http//www.unieef.orq/vietnam/vi/wes.blml N