上海口岸赴美移民生殖道沙眼衣原体及淋球菌感染监测及干预
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摘要
目的 了解上海口岸赴美移民人群对生殖道沙眼衣原体(CT)及淋球菌(NG)感染的认知情况和感染现状,探索有效的干预措施。方法 2016年10月—2017年10月在上海国际旅行卫生保健中心进行赴美移民体检的15周岁及以上申请人共4076人,随机抽取500人进行问卷调查;所有申请人均进行尿液样本CT及NG的PCR普查,CT阳性者采用阿奇霉素1g顿服治疗,NG阳性者采用头孢克肟400 mg+阿奇霉素1 g顿服,均采取直接督导治疗。研究数据采用SPSS 17.0进行统计分析。结果 NG知晓情况平均得分为1.12±0.62,以41~50岁及50岁以上中老年人群得分较高;CT知晓平均得分为0.66±0.65,各年龄知晓率差异无统计学意义。被调查者现有知识获取途径主要是电视网络(47.70%)和报刊书籍(34.73%),期望获取途径以电视网络(66.11%)和宣传材料(41.00%)为主,期望通过医生咨询获取知识的人数构成比(23.01%)明显多于现有情况(9.00%)。检出CT感染者127例(其中2例CT/NG双重感染),检出率3.12%,21~30岁检出率最高;多症状隐匿,且否认高危因素,发现8对配偶共同感染;126例(99.21%)完成治疗。检出NG阳感染者3例,检出率0.07%,多具有高危因素和临床症状,全部完成治疗。结论 中老年人对NG的知晓情况优于年轻人,CT的知晓情况远不如NG。人群获取性病知识的现有渠道以电视网络和宣传材料为主,期望增加医生咨询途径。赴美移民人群中NG感染检出率远低于CT,CT在无症状人群中隐性感染情况不容忽视,且移民人群对这一疾病的认识普遍不足,急需加强宣教、疾病筛查并制定干预措施。
Objective To investigate the cognition and infection status of genital Chlamydia Trachomatis(CT) and Neisseria gonorrhoeae(NG) among U.S. immigrants in Shanghai and to find out effective intervention strategies.Methods From October,2016 to October,2017,a total of 4 076 U.S. immigrants aged 15 or above applied for physical examination in Shanghai International Travel Healthcare Center. In which of them,500 questionnaires were sent out randomly. All the 4 076 urine samples were performed PCR tests for CT and NG screening. The treatment plan for CT positive case was Azithromycin 1 g orally in a single dose,and for NG case was Cefixime 400 mg orally plus Azithromycin 1 g orally in a single dose. The treatment was performed by direct observed therapy(DOT). The data was analyzed by software SPSS 17.0. Results The average score of NG knowledge was 1.12 ±0.62,the highest score was among middle and elderly people aged 41-50 or above 50. The average score of CT knowledge was 0.66±0.65,with no statistical difference among different age groups. The main current knowledge sources were televi-sion & internet(47.70%) and newspapers & books(34.73%). The expected knowledge sources were television and internet(66.11%),or pamphlets(41.00%). More people(23.01%) expect doctors' consultation than current(9.00%).The 127 cases of CT infection were detected(including 2 cases of CT and NG double infection). The detection rate was 3.12%,the highest score was among 21-30 years old. Most of the infections were asymptomatic and denied risk factors. 8 couples were noticed to be infected spontaneously. 126 cases(99.21%) finished DOT. There were 3 positive NG cases(2 double infection cases included) with a detection rate of 0.07%,most of them reported high risk factors and clinical symptom. All NG cases had finished DOT. Conclusion The knowledge of NG was better in middle aged and elderly people than in young immigrants. The knowledge of CT was much worse than that of NG. The expected access to knowledge included television,internet and publicity materials. The immigrants would like to accept doctors 'consultation as a source of knowledge. The NG detection rate among U.S. immigrants in Shanghai was lower than that of CT. Latent CT infection among asymptomatic population should not be neglected. The knowledge of CT was not widely known among these immigrants. Education,screening and intervention strategies should be considered.
Objective To investigate the cognition and infection status of genital Chlamydia Trachomatis(CT) and Neisseria gonorrhoeae(NG) among U.S. immigrants in Shanghai and to find out effective intervention strategies.Methods From October,2016 to October,2017,a total of 4 076 U.S. immigrants aged 15 or above applied for physical examination in Shanghai International Travel Healthcare Center. In which of them,500 questionnaires were sent out randomly. All the 4 076 urine samples were performed PCR tests for CT and NG screening. The treatment plan for CT positive case was Azithromycin 1 g orally in a single dose,and for NG case was Cefixime 400 mg orally plus Azithromycin 1 g orally in a single dose. The treatment was performed by direct observed therapy(DOT). The data was analyzed by software SPSS 17.0. Results The average score of NG knowledge was 1.12 ±0.62,the highest score was among middle and elderly people aged 41-50 or above 50. The average score of CT knowledge was 0.66±0.65,with no statistical difference among different age groups. The main current knowledge sources were televi-sion & internet(47.70%) and newspapers & books(34.73%). The expected knowledge sources were television and internet(66.11%),or pamphlets(41.00%). More people(23.01%) expect doctors' consultation than current(9.00%).The 127 cases of CT infection were detected(including 2 cases of CT and NG double infection). The detection rate was 3.12%,the highest score was among 21-30 years old. Most of the infections were asymptomatic and denied risk factors. 8 couples were noticed to be infected spontaneously. 126 cases(99.21%) finished DOT. There were 3 positive NG cases(2 double infection cases included) with a detection rate of 0.07%,most of them reported high risk factors and clinical symptom. All NG cases had finished DOT. Conclusion The knowledge of NG was better in middle aged and elderly people than in young immigrants. The knowledge of CT was much worse than that of NG. The expected access to knowledge included television,internet and publicity materials. The immigrants would like to accept doctors 'consultation as a source of knowledge. The NG detection rate among U.S. immigrants in Shanghai was lower than that of CT. Latent CT infection among asymptomatic population should not be neglected. The knowledge of CT was not widely known among these immigrants. Education,screening and intervention strategies should be considered.
引文
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[6]Centers for disease control and prevention:Chlamydia Treatment and Care[EB/OL].[2017-10-31].https://www.cdc.gov/std/chlamydia/treatment.htm.
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[8]中国疾病预防控制中心性病控制中心.梅毒、淋病、生殖器疱疹、生殖道沙眼衣原体感染诊疗指南(2014)[J].中华皮肤科杂志,2014,47(5):365-372.
[2]Wong WC,Zhao Y,Wong NS,et al.Prevalence and risk factors of chlamydia infection in Hong Kong:a population-based geospatial household survey and testing[J].PLo S One,2017,12(2):e0172561.
[3]Tanksley A,Cifu AS.Screening for Gonorrhea,Chlamydia,and Hepatitis B[J].JAMA,2016,315(12):1278.
[4]张琼英.女性生殖器淋病的诊断及治疗进展[J].中国实用妇科与产科杂志,1998,13(2):69-70.
[5]Centers for disease control and prevention:CDC Immigration Requirements:Technical Instructions for Gonorrhea for Panel Physicians[EB/OL].[2017-08-25].https://www.cdc.gov/immigrantrefugeehealth/exams/ti/panel/technical-instructions/panel-physicians/gonorrhea.html.
[6]Centers for disease control and prevention:Chlamydia Treatment and Care[EB/OL].[2017-10-31].https://www.cdc.gov/std/chlamydia/treatment.htm.
[7]卫生计生委.淋病诊断标准[EB/OL].[2007-04-17].http://www.nhfpc.gov.cn/zwgkzt/s9491/200704/38742.shtml.
[8]中国疾病预防控制中心性病控制中心.梅毒、淋病、生殖器疱疹、生殖道沙眼衣原体感染诊疗指南(2014)[J].中华皮肤科杂志,2014,47(5):365-372.