结核病和行为危险因素:尼日利亚西北部的案例

A. Fada
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摘要

行为风险因素影响疾病的传播,特别是结核病等传染病的传播,其传播与几个因素有关,包括食用未经巴氏消毒的牛奶。在尼日利亚西北部就行为风险因素对疾病传播的作用进行的少数研究也没有定论。因此,本研究以调查设计和疾病生态学概念为框架,以这些因素为重点,调查了该地区肺结核的患病率。采用随机抽样方法收集富拉尼季节性迁徙路线上15个短程直接观察治疗中心的记录数据。对选定的461名患者进行了结构化问卷调查,并收集了有关行为风险因素的数据,包括“前往保健中心治疗结核病”、“吸烟”和“饮用未经巴氏消毒的牛奶”以及已知的疾病原因。采用简单线性回归和方差分析(ANOVA)分析资料,p<0.05。回归结果显示,在行为因素中,“曾经到健康中心治疗结核病”的贡献最大(贝塔值=0.853),其次是“曾经吸烟”(贝塔值=0.953);whist遗传(Beta=0.265)和上帝的意愿(Beta=0.229)被认为是结核病的主要原因。两组患者的行为差异无统计学意义[F (15,44)=1.397;p=0.191]和感知因素[F (19,130)=0.525, p=0.947]。结论是,行为因素不影响尼日利亚西北部结核病的流行。因此,需要认识到该地区结核病监测和控制中的其他因素。
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Tuberculosis and Behavioural Risk Factors: The Case of NorthWestern Nigeria
Behavioural risk factors affect the spread of diseases, particularly infectious diseases like tuberculosis (TB), the transmission which is associated with several factors, including consumption of unpasteurised milk. The few studies that have been conducted on the role of behavioural risk factors on disease transmission in North-western Nigeria are also inconclusive. This study, therefore, examined the prevalence of pulmonary TB in the region with a focus on these factors, using a survey design and the disease ecology concept as the framework. Random sampling was used to collect data from the records of 15 Directly Observed Therapy Short-course (DOTS) centres along Fulani route of seasonal migration. A structured questionnaire was administered to 461 selected patients, and data collected on behavioural risk factors included „visits to health centre to treat TB‟, „smoking‟ and „consumption of unpasteurized milk‟ as well as perceived causes of the disease. Simple Linear Regression and Analysis of Variance (ANOVA) were used to analyze data at p<0.05. Results of the regression showed „ever visited a health centre to treat TB‟ with the highest contribution (Beta=0.853), followed by „ever been a smoker‟ (Beta=0.953) for the behavioural factors; whist heredity (Beta=0.265) and God‟s wish (Beta=0.229) were perceived as the main causes of TB. There was no statistical significance of both the behavioural [F (15,44)=1.397; p=0.191] and perceived [F (19,130)=0.525, p=0.947] factors. It was concluded that behavioural factors do not affect the prevalence of TB in North-western Nigeria. Thus, cognizance needs to be taken of other factors in TB monitoring and control within the region.
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