中国媒介生物学及控制杂志  2020, Vol. 31 Issue (5): 619-622

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周冰, 曹殿起, 付慧英, 刘缘, 史文静, 彭素标
ZHOU Bing, CAO Dian-qi, FU Hui-ying, LIU Yuan, SHI Wen-jing, PENG Su-biao
北京市门头沟区常住居民动物伤害现况及影响因素调查
An investigation of current status and influencing factors of animal-induced injuries in permanent residents in Mentougou district, Beijing, China
中国媒介生物学及控制杂志, 2020, 31(5): 619-622
Chin J Vector Biol & Control, 2020, 31(5): 619-622
10.11853/j.issn.1003.8280.2020.05.024

文章历史

收稿日期: 2020-04-16
北京市门头沟区常住居民动物伤害现况及影响因素调查
周冰1 , 曹殿起1 , 付慧英1 , 刘缘1 , 史文静1 , 彭素标2     
1 北京市门头沟区疾病预防控制中心计划免疫科, 北京 102300;
2 北京市东城区疾病预防控制中心, 北京 100009
摘要: 目的 了解北京市门头沟区常住居民动物伤害现状,为制定动物相关传染病防控策略、减少动物伤害提供科学依据。方法 2018年2-8月,采取分层抽样的方式,随机抽取门头沟区3个乡镇,从3个乡镇中随机抽取620户家庭,每个家庭由1人参与调查,使用自主编制的调查问卷。统计分析使用SPSS 22.0软件,动物伤害现状采用描述性统计方法,率的比较采用χ2检验,影响因素分析采用logistic回归。结果 收回有效问卷596份,总有效率为96.13%。146人曾经被动物致伤,占24.50%。Logistic回归分析结果显示,家中饲养宠物、住平房、家中有儿童、外地户籍、收入低和文化程度低的人被动物致伤的比例更高。被动物致伤的146人中,135人被宠物致伤,占92.47%;11人被无主动物致伤,占7.53%;105人被犬致伤,占71.92%;40人被猫致伤,占27.40%。仅111人被动物致伤后接种了疫苗,占致伤总人数的76.03%。结论 门头沟区常住居民受动物伤害较频繁,且主要被宠物伤害。今后应采取提高宣传力度、加强动物管理、提高动物免疫率等综合防控措施来减少动物伤害。
关键词: 动物伤害    狂犬病    影响因素    对策    
An investigation of current status and influencing factors of animal-induced injuries in permanent residents in Mentougou district, Beijing, China
ZHOU Bing1 , CAO Dian-qi1 , FU Hui-ying1 , LIU Yuan1 , SHI Wen-jing1 , PENG Su-biao2     
1 Mentougou Center for Disease Control and Prevention of Beijing, Beijing 102300, China;
2 Dongcheng Center for Disease Control and Prevention of Beijing
Abstract: Objective To investigate the current status of animal-induced injuries in permanent residents in Mentougou district, Beijing, China, and to provide a scientific basis for formulating prevention and control strategies against animal-related infectious diseases and reducing animal-induced injuries. Methods From February to August 2018, stratified sampling was used to randomly select 620 persons from 620 households (one person from each household) in three townships randomly selected from Mentougou district. The selected persons were surveyed using a self-designed questionnaire. SPSS 22.0 software was used for statistical analysis, descriptive statistical method was used for describing the current status of animal-induced injuries, chi-square test was used for rate comparison, and logistic regression was used for analysis of influencing factors. Results A total of 596 usable questionnaires were collected, with an overall response rate of 96.13%. One hundred and forty-six people (24.50%) had animal-induced injuries. The logistic regression analysis showed that people were more likely to have animal-induced injuries if they had a pet at home, lived in a bungalow, had a child in the family, were non-native residents, had a low income, or had a low education level. Among the 146 people injured by animals, 135 (92.47%) were injured by pets and 11 (7.53%) by ownerless animals; 105 people (71.92%) were injured by dogs and 40 (27.40%) by cats. Only 111 people were vaccinated after injury, accounting for 76.03% of the total number of people injured. Conclusion It is very common for residents in Mentougou district to be injured by animals, particularly by pets. In the future, animal-induced injuries should be reduced by taking comprehensive prevention and control measures such as reinforcing education, strengthening pet management, and improving animal immunization rate.
Key words: Animal-induced injury    Rabies    Influencing factor    Countermeasure    

近年来动物伤人事件时有发生,其中宠物伤人事件也屡见不鲜[1-4]。门头沟区狂犬病暴露处置门诊每年接诊数千人,宠物伤害在动物伤人事件中占90%以上[5-6]。为了解门头沟区常住居民动物伤害现状、伤口处置情况,为制定动物相关传染病防控策略、减少动物伤害提供科学依据,我们于2018年2-8月对门头沟区居民开展了动物伤害现状调查,结果报告如下。

1 对象与方法 1.1 抽样方法

北京市门头沟区有13个乡镇办事处,按照山区、城区和城乡结合部分为3类,每类随机抽取1个镇,每镇随机抽取2个村(居),山区和城乡结合部每村(居)随机抽取100户,每个城镇村(居)随机抽取110户,共抽取样本620户。每户抽取1名成年人经其知情同意后参与调查。

1.2 动物伤害

动物伤害指曾被各种动物致伤、皮肤黏膜等有破损。宠物致伤指伤人动物为有主动物。

1.3 统计学分析

采用EpiData 3.2软件建立数据库,统计分析使用SPSS 22.0软件,用描述性统计方法描述动物伤害现状,率的比较采用χ2检验,多因素分析使用logistic回归。P<0.05为差异有统计学意义。

2 结果 2.1 基本情况

共发出问卷620份,收回有效问卷596份,有效率为96.13%(596/620)。被调查者中男性占38.42%(229/596),女性占61.58%(367/596)。其中本市户籍占84.73%(505/596),外地户籍占15.27%(91/596)。被调查户中宠物饲养率为35.57%(212/596)。

2.2 动物伤人情况

被调查的596人中,146人曾被动物致伤,占24.50%(146/596)(表 1)。29人致伤时间为1年以内,占被调查总人数的4.87%(29/596)。将是否被致伤作为因变量,将是否养宠物、性别、户籍、住房类型、家庭中是否有儿童、家庭人均年收入和文化程度为自变量进行logistic回归分析,变量赋值见表 2。结果显示,家中饲养宠物、住平房、家中有儿童、外地户籍、收入低和文化程度低的人被动物致伤的比例更高。见表 3

表 1 北京市门头沟区常住居民被动物致伤情况 Table 1 Animal- induced injuries in permanent residents in Mentougou district, Beijing, China
表 2 北京市门头沟区常住居民被动物致伤的影响因素及变量赋值 Table 2 Influencing factors and variable assignment for animal-induced injuries in permanent residents in Mentougou district, Beijing, China
表 3 北京市门头沟区常住居民被动物致伤的影响因素分析 Table 3 Analysis of influencing factors for animal-induced injuries in permanent residents in Mentougou district, Beijing, China
2.3 伤人动物来源和种类

被动物致伤的146人中,135人被宠物致伤,占92.47%(135/146)。其中65人被自己饲养的宠物致伤,占44.52%(65/146);70人被他人饲养宠物致伤,占47.95%(70/146);11人被无主动物致伤,占7.53%(11/146)。在伤人动物种类上,105人被犬致伤,占71.92%(105/146);40人被猫致伤,占27.40%(40/146);1人致伤动物为乌龟,占0.68%(1/146)。

2.4 动物致伤者的疫苗免疫情况及未免疫原因

仅111人被动物致伤后接种了疫苗,占致伤总人数的76.03%(111/146);23人认为伤口不严重,没必要接种疫苗,占致伤人数的15.76%(23/146);7人认为家里养的猫或者犬很干净,不带狂犬病病毒,占致伤人数的4.80%(7/146);2人认为自己免疫力好,不用接种疫苗,占1.37%(2/146);1人认为疫苗太贵,1人认为致伤动物打过疫苗不用接种,1人致伤动物为乌龟不用接种,各占0.68%(1/146)。

3 讨论

从调查结果看,被调查者有24.50%曾被动物致伤,且92.47%的伤者被宠物致伤,说明动物致伤在普通居民中非常常见,而宠物又是最主要的致伤动物,与狂犬病暴露处置门诊接诊情况相一致[5-9]。而门头沟区犬只免疫率仅75.00%左右,考虑到有流浪动物存在,尚不能认为犬只免疫率能达到阻断狂犬病流行的程度,因此被犬、猫等危险动物致伤的患者都应该进行狂犬病疫苗免疫接种,宠物致伤给门头沟区居民带来了很大的经济和社会负担。

狂犬病一旦发病,病死率几乎为100%,接种疫苗是预防该病最有效的办法[10-13]。但是被动物致伤的患者对狂犬病疫苗注射的重要性认识远远不够,仅76.03%的被致伤者接种过疫苗,相当多的人存在侥幸心理,以伤口不严重、家养的动物不脏、自己免疫力好等理由不接种疫苗,留下了很大的免疫空白,存在重大安全隐患。门头沟区出现过的2例狂犬病病例都是被自己家宠物犬咬伤且未接种疫苗[5-6],其他相关研究也表明,绝大部分人狂犬病病例没有疫苗免疫史[14-16]。世界卫生组织狂犬病专家咨询委员会建议[13],对于狂犬病病毒Ⅲ级暴露者,应在接种疫苗的同时对伤口周围浸润注射被动免疫制剂,而门头沟区Ⅲ级暴露患者的被动免疫制剂应用率仅为66.67%[5-6]

根据调查结果,家中饲养宠物、住平房、家中有儿童、外地户籍、收入较低和文化程度较低的人被动物致伤的比例更高,是狂犬病知识宣传的重点人群。我们提出以下建议:(1)加强宣传力度,提高宠物饲养者为宠物免疫接种的意识,提高普通群众对狂犬病的认识,提高群众对狂犬病疫苗接种和被动免疫制剂应用的正确认识。(2)加强动物管理,提高犬只免疫率,加强流浪动物管理。(3)转变狂犬病防控工作模式,由给人接种疫苗向增强动物免疫转变。

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