| Understanding the epidemic features of the acute viral hepatitis in Huangpu District and the medical staffs HBV (Hepatitis B Virus) and HCV (Hepatitis C Virus) infection rate and hepatitis KAP (Knowledge-Attitude-Practice) situation, to provide evidence for establishing the hepatitis preventive measures for the relevant medical staffs. The respective relations can be described, analyzed and discussed by methods of collecting the retrospective data combining with the field investigation. The research project consists of three parts.Ⅰ. The epidemic characteristic analysis of the acute viral hepatitis in Huangpu DistrictThe prevention suggestion was proposed through collecting the acute viral hepatitis epidemic data in Huangpu District from 1996 to 2005, describing the epidemic change trends, and analyzing effect factors. From 1996 to 2005, 3248 acute viral hepatitis cases who were from the registered residents in Huangpu District were reported, and the annual average incidence rate was 48.51 per 100,000. Overall the acute viral hepatitis incidence rate was on gradually downtrend from 1996 to 2005. Of the 3248 acute viral hepatitis cases, there were 234 HAV (Hepatitis A Virus) cases, 367 HBV cases, 25 HCV cases, 162 HEV (Hepatitis E Virus) cases and 2,460 unclassified hepatitis cases. Overall the acute HAV incidence rate remained steady, its incidence rate in 2002 reached 8.12 per 100,000 the highest, and then it decreased rapidly and its incidence rate in 2004 was 0.81 per 100,000. The acute HBV incidence rate was the highest in classified hepatitis; its incidence rate increased steadily from 1996 to 2000, reached 7.86 per 100,000 the highest in 2000 and from 2001 to 2005 its incidence rate pended from 3.20 per 100,000 to 7.04 per 100,000. The HBV accounted for 11.30% in the total constituent ratio and this proportion was the highest in classified hepatitis. The acute HCV incidence rate was the lowest in classified hepatitis, there were 25 cases in 10 years and annual incidence rate was always lowered than 1 per 100,000. The HCV accounted for 0.77% in the total constituent ratio of the acute viral hepatitis from 1999 to 2005. Overall the acute HEV incidence rate was on gradually increase and its highest incidence rate was 5.46 per 100,000 in 2002. The HEV proportion in the constituent ratio of the acute viral hepatitis was on gradually increase since 2002, and now it ranked the second type in the constituent ratio of the classified hepatitis. Although the preventive work of the acute viral hepatitis in Huangpu District has made great achievements, the prevention and control of the acute viral hepatitis were a long-term task, especially the problems such as the emerge of HBV and HEV, etc. In terms of controlling the acute viral hepatitis, the comprehensive controlling measures mainly prevention should be actively taken.Ⅱ. The investigation and analysis of HBV and HCV infection status of the medical staffs in Huangpu DistrictGroup by first-class hospital, second-class hospital and tertiary hospital, random drawn one hospital from each group and altogether drawn 511 medical staffs. HBV and HCV related indicators would be measured. According the HBV and HCV tested serum indicators to analyze the occupational infection situation of the HBV and HCV of the medical staffs in this district in terms of different groups. Of the 511 medical staffs, the numbers of HBV infection people were 267, the infection rate was 52.25%. Including the medical staffs in the tertiary hospital, second-class hospital and Community Health Service Center, the infection rates of HBV were 52.90%, 52.47% and 48.98% respectively, and there was no significant difference (P>0.05). In all the HBV testing indicators, the positive rate of the HBsAg was 3.52%, the positive rate of the anti-HBs HBV was 45.21%, the positive rate of the anti-HBc was 11.15%, the positive rate of the HBeAg was 0.20%, the positive rate of the anti-HBe was 11.74%. In the multi-positive of all HBV indicators, the positive proportion of HBsAg, HBeAg and anti-HBc (Great Three Positive) was 0.20% and the positive proportion of HBsAg, anti-HBe and anti-HBc (Small Three Positive) was 1.37%. According to the analysis of the HBV infection situation for the medical staffs in the different departments, the highest infection rate of the department was Infectious Department and the HBV infection rate was 72.09%; others were in sequence of Blood Dialysis Room, Surgical Department and Internal Medicine Department, the infection rates were 54.55%, 52.89% and 51.72% accordingly, and there was significant difference (P<0.05). According to the analysis of the HBV infection situation for the medical staffs with different job, the HBV infection rate of the nurses in the tertiary hospital was far more than of the doctors, the infection rate were 62.07% and 40.00%, and there was significant difference (P<0.05); the infection rate of the nurses and doctors in the Community Health Service Center was 66.7% and 43.75% accordingly, and also there was a great distance. The testing of anti-HCV for the medical staffs was negative totally. The prevention of HBV is comprehensive, which includes the patients isolation, the medical staffs self-protection, avoiding contact with pollutants, improving the immunological competence through vaccination, etc, then it can reduce the HBV occupational infection rate. The transmission route of HCV is the same as of HBV, and the prevention methods and measures for HBV are suitable for HCV as well.Ⅲ. The KAP (Knowledge-Attitude-Practice) investigation and analysis of the viral hepatitis of the medical staff in Huangpu DistrictGroup by third-class hospital, second-class hospital and tertiary hospital, select two hospitals from tertiary hospital, two hospitals from second-class hospital, three hospitals from first-class hospital and there were 1,046 people in those seven hospitals. Design the closed questionnaire and conduct the questionnaire survey to the medical staffs according to the knowledge such as harm, transmission route, preventive measures, etc. of the viral hepatitis, and the viral hepatitis preventive attitude, practice, etc problems. Under awareness rate of the hepatitis knowledge investigation, the repliers with total correction were 41 people, and the correction rate was only 3.92%; the general situation part of the hepatitis, 75.24% of them gave the total correct answers; the transmission route part of the hepatitis, 56.98% of them gave the total correct answers; the preventive measure part of the hepatitis, 10.23% of them gave the total correct answers and the correction rate of three parts of the hepatitis knowledge, there were all significant difference (P<0.05). According to the awareness rate of medical staffs' hepatitis knowledge in all classes hospital, 1.85% of them in tertiary hospital gave the total correct answers, 1.33% of them in second-class hospital gave the total correct answers, 19.15% of them in the Community Health Service Center gave the total correct answers and there was a significant difference (P<0.05). According to the awareness rate of the investigation and analysis of the medical staffs' hepatitis knowledge in the different departments, 2.99% of them in the Surgical Department gave a correct answer, 3.03% of them in the Infectious Department gave the total correct answers, nobody of them in the Blood Dialysis Room gave the total correct answers, 5.77% of them in the clinical laboratory Department gave the total correct answers, nobody of them in the Executive and Logistic Department gave the total correct answers, and there was no significant difference (P>0.05). According to the investigation and analysis of hepatitis knowledge awareness rate of all the professional medical staffs, 2.72% of them in the Clinical Group gave the total correct answers, 21.57% of them in the Preventative Group gave the total correct answers, 5.26% of them in the other groups gave the total correct answers and there was a significant difference (P<0.05). According to the investigation and analysis of hepatitis knowledge awareness rate of all the occupational medical staffs, 6.72% of them in the doctor's group gave the total correct answers, 0.97% of them in the nurse's group gave the total correct answers and there was a significant difference (P <0.05). In the investigation of the medical staffs' attitude to HBV vaccine, 95.79% of them felt necessary very much and necessary to inject vaccination. In the investigation of the medical staffs' attitude to the knowledge of preventing hepatitis, 97.89% of them were interested and a little interested. In the investigation of the medical staffs' inoculation HBV vaccine, 233 people expressed that they once inoculated HBV vaccine and the vaccination rate was 22.28%. In the investigation of the medical staffs acquiring hepatitis prevention knowledge, 61.47% of them expressed that they acquired relevant information through the professional books. Through the investigation of the medical staffs awareness rate for the hepatitis knowledge we found that they neglected the preventive measures for the hepatitis comparatively, but the preventive measures position in the hepatitis prevention was very important, so it was very necessary to improve the medical staffs' attention for the preventive measures. |
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