Effect Study On Environmental Sanitation And Resident Behavior Factors To Hookworm Infection In A Rural Area Hainan

Objectives:The objective of the study is to understand the current status of hookworm infection in the high-prevalence area in Hainan province, to explore its influencing factors in terms of household environmental sanitation and individual behavior and to analyze its household clustering.Methods:Xinzhu township in Dingan county and Maoyang township in Wuzhishan county of Hainan were selected as the survey areas. The natural villages of high infection rate in two townships were selected as survey spots. Villagers who are more than10years old were investigated by the unity questionnaire and interview outline to obtain the data of personal health behavior and household and village environment.The modified Kato-Katz thick smear technique was used to examine eggs of hookworm. The salt water separation was used to examine larvae in the soil. EpiData3.1was used for data entry and SAS9.2was used to analyze the survey data. The survey data was analyzed by single factor and multi-factor unconditioned logistic regression analysis to find out factors and binomial distribution fitting theory to explore the family clustering.Results:1. This study has collected2011villagers’ excreta samples. The total hookworm infection rate was31.58%and the rate of slight infection was98.11%. In these samples, Li nationality had1000people, and its hookworm standardized infection rate was32.41%, Han nationality had1011people, and its hookworm standardized infection rate was31.08%. No statistical difference was found between two national standardized infections rates (χ2=0.4178, p>0.05)2. A total of635cases of hookworm infection were found in this study, and the male infection rate was26.69%, the female infection rate was36.59%. The female infection rate was higher than that in male (χ2=22.8017, P<0.05)3. In the study,90soil samples in20villages were collected and37.78%were detected with larvae.60soil samples were from fields and20.00%were detected with larvae;30soil samples were from the opened defecation and73.33%were detected with larvae. Statistical difference was found between two detection rates(χ2=24.2017, P<0.05)4. A total of835households were included in this study, the water supplies were adequate. The household sanitation status of the households was not as good as expected. Courtyard ground hardening households accounted for59.40%;62.87%of household had plants in courtyard and around the courtyard;45.63%of families didn’t have latrine; of those with latrines, the coverage rate of sanitary latrine was68.94%;55.73%of the households disposed feces with harmless treatment process5. Among all surveyed villagers,69.37%don’t know about hookworm diseases; among whom,90.80%engaged in labor, male accounted for45.65%, female accounted for45.15%, no statistical difference was found between above two rates, χ2=2.4606, P>0.05; among the labors, barefoot labors accounted for86.58%;34.01%of labors don’t have any protective measures in the fields; washing hands after labor work was perceived right behavior,46.44%of villagers do. To separate the different villagers by gender, male barefoot labors account for86.58%, female barefoot labors account for89.32%, statistical difference was found between two gender groups, χ2=11.6252, P<0.05;34.01%of male labors don’t have any protective measures in the fields, female rate was36.23%, statistical difference was found between the two, χ2=3.9831, P<0.05;48.37%of male labors did washing hands after labor work, female rate was44.49%, no statistical difference was found between the two gender groups,χ2=2.7524, P>0.05.6. Results of multi-factor unconditioned logistic regression analysis showed that age, sex, education, whether protective measures in the fields, washing hands after labor work, whether know hookworm diseases, whether has latrine in household and household total environmental sanitation all had statistically significant relationship with villagers’ hookworm infection, OR and its95%CI were1.234(1.155～1.318).1.340(1.072～1.673).1.503(1.262～1.789).3.572(2.691～4.741).1.988(1.497～2.639).1.251(1.087～1.439).2.428(1.919～3.073).1.226(1.015～1.481) respectively.7. Household clustering analysis of hookworm infection showed family clustering was existed in the hookworm infection,χ2=79.33, P<0.05.Conclusions:1. The hookworm infection of villagers was still at a higher lever, but most of them were slight infected. There was no difference between two nationalities in terms of hookworm infection.2. In the local area, the number of households without latrine is large, and the coverage rate of sanitary latrine was low.3. In the individual behavior factors, having protective measures in the fields or not and washing hands after labor work were influencing factors of villagers’ hookworm infection.4. The risk levels of influencing factors from high to low were that, having protective measures in the fields or not、having household latrine or not. washing hands after labor work、education、sex、whether know hookworm diseases. age and family total environmental sanitation.5. Family clustering was observed in the hookworm infection.