Case-based Brucellosis Investigation And Key Population Intervention Effect Research

Objective:To analyze the epidemiological characteristics of patients with brucellosis,and the clinical manifestations of different incidence forms and patients with different contact history in the national monitoring points of Xinjiang Production and Construction Corps(Corps).So as to provide reference for early diagnosis of brucellosis,and reduction of misdiagnosis and missed diagnosis in the epidemic areas of the Corps;Analyzed the influencing factors of the awareness rate of brucellosis prevention and control knowledge among key populations before intervention,and to evaluate the effectiveness of the awareness rate of brucellosis prevention knowledge before and after health education.In order to provide suggestions for relevant training for the epidemic areas of the Corps;Based on the evaluation of the correct rate of protective behavior and the use rate of protective equipment before and after behavioral intervention,it provides an important basis for formulating effective intervention measures and prevention and control strategies at the current stage of the Corps.Methods:The second division,the sixth division,the ninth division and the tenth division of the national-level brucellosis surveillance points in the Corps area were selected as the research site.According to the epidemic situation,past epidemiological data and monitoring work of each division,stratified random cluster sampling method was used to extract the intervention and the control group field.Before and after health education and behavioral intervention in the intervention group,a unified structured questionnaire was used to conduct a centralized investigation the key population of the intervention group and the control group.The effect of intervention was understood by comparing the changes in knowledge and behavior of prevention and treatment before and after intervention.Using SPSS17.0 statistical software,the results were evaluated from the aspects of basic information characteristics,knowledge of prevention and treatment of brucellosis,changes in protective behavior of brucellosis and use of protective equipment for brucellosis.Results :(1)The majority of brucellosis patients in surveillance sites were male,mainly concentrated in 40-49 years old.The national,occupational and cultural levels were mainly Han,farmer and herdsman,junior middle school and below.The brucellosis could occur every month throughout the year,with a peak of 5-7 months,showing a seasonal periodicity;The clinical manifestations were mainly fatigue,muscle and joint pain,hyperhidrosis and fever;Patients with acute and chronic brucellosis had symptoms of hyperhidrosis,fatigue and muscle and joint pain higher than the subacute phase(all P<0.0167),and the chronic phase was more prone to lymphadenopathy than the acute phase(P<0.0167).Brucellosis patients who contacted sheep and cattle and sheep had symptoms of hyperhidrosis,fatigue and muscle and joint pain that were higher than those exposed to cattle and cattle-free sheep(all P<0.0083);Patients with exposure to cattle developed symptoms of muscle and joint pain that were lower than those without cattle and sheep(P<0.0083).(2)Before health education,multivariate logistic regression analysis showed that gender,age,nationality,occupation and education level were the main factors influencing the awareness rate of brucellosis prevention and control knowledge.After intervention,the individual and overall awareness rate of prevention and control of key populations in the intervention group increased by 7.18%,10.21%,6.90%,4.49%,11.95%,10.34%,7.72%,6.94%,7.52%,11.87% and 8.44%,respectively,compared with the control group(all P<0.01);In addition,the individual and overall awareness rates of brucellosis in the key population of the intervention group were increased by 9.08%,10.14%,11.71%,6.04%,9.25%,11.54%,8.49%,10.94%,7.76%,11.80% and 9.67%(all P<0.01)compared with those before the intervention.(3)After behavioral intervention,there was no significant difference in the correct rate of intervention group between the “population of humans and animals” and “no drinking of raw milk”(all P>0.05),and the correct rate of protection of other brucellosis was higher than that of the control group(all P<0.01);The use rate of protective equipment for brucellosis increased by 15.14%,5.62%,3.51%,3.85%,5.09%,4.66% and 5.75%,respectively,compared with the control group(all P<0.01).Before and after the intervention,the correct rate of key populations of intervention group in the “no drinking raw milk” and “quarantine when purchasing livestock” increased by only 0.53% and 1.64%,the difference was not statistically significant(all P>0.05),the rest of the correct rate of brucellosis protection behavior was higher than that before intervention(all P<0.01);In addition to "wearing a hat"(P>0.05),the utilization rate of other protective equipment increased by 15.55%,10.89%,3.19%,4.79%,3.50% and 6.29%,respectively(all P<0.05).Conclusion:(1)The Han nationality,male,young and middle-aged,farmers and herdsmen,low cultural level accounted for a large proportion of brucellosis patients in surveillance sites,and May to July is the season with high incidence of brucellosis.The clinical manifestations of acute and chronic brucellosis patients are fatigue,muscle and joint pain and hyperhidrosis.And patients with brucellosis who contact sheep and contact cattle and sheep are more prone to fever,excessive sweating,fatigue,and muscle and joint pain.(2)Although health education can improve the awareness rate of brucellosis prevention and control knowledge among key population,it is vulnerable to factors such as gender,age,nationality,occupation and cultural level.Therefore,health education should be further strengthened for women,older people,ethnic minorities,farmers and herdsmen,and key population with low cultural level.(3)Through health education and behavioral intervention for key populations of the intervention group,the awareness rate of brucellosis prevention and control knowledge,the correct rate of protective behavior and the use rate of protective equipment can be significantly improved,which provides a reference for the intervention and prevention work in the Corps areas where brucellosis is prevalent.