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目的了解山西省某既往有偿献血地区人免疫缺陷病毒(H IV)感染率,并探索H IV感染的危险因素。方法选择山西省某县4个村所有18~64岁村民开展以社区为基础的横断面研究,采用标准化问卷收集研究对象的人口学、医疗史、危险行为等信息,采集静脉血用于检测H IV抗体。基于广义估计方程的logistic回归模型被用于分析H IV感染的危险因素。人群归因分值被用于测量危险因素在当地H IV感染发生中的公共卫生学意义。结果4个村中82.5%(3062/3711)的18~64岁村民参加本次调查,共发现40例H IV感染者,该地区H IV总的感染率为1.3%(40/3062),献血人群和非献血人群H IV感染率分别为4.1%(37/904)和0.1%(3/2158)。多因素分析发现,献全血(调整OR=13.25,95%CI:3.02~58.25)和献血浆(调整OR=87.85,95%CI:22.22~347.27)与该地村民感染H IV有关,二者累计的人群归因分值(PAF)为89.8%。03号村村民感染H IV的危险性高于04号村村民(调整OR=12.26,95%CI:1.46~103.00)。结论该地区H IV感染流行水平相对较低,引起村民H IV感染流行的主要因素是既往有偿献血(浆),未出现H IV从献血人群向非献血人群的明显蔓延。
Objective To understand the prevalence of human immunodeficiency virus (H IV) infection in a previously paid blood donation area in Shanxi Province and explore the risk factors for H IV infection. Methods A community-based cross-sectional study was conducted among all 18-64-year-old villagers from 4 villages in a county in Shanxi Province. A standardized questionnaire was used to collect demographics, medical history, and risk behaviors of the study subjects. Vein blood was collected for testing. IV antibody. A logistic regression model based on a generalized estimating equation was used to analyze risk factors for H IV infection. The population attribution score was used to measure the public health significance of risk factors in the occurrence of local H IV infection. Results Of the 4 villages, 82.5% (3062/3711) of 18-64-year-old villagers participated in the survey. A total of 40 patients with H IV infection were found. The overall H IV infection rate was 1.3% (40/3062). The H IV infection rates in the population and non-donor groups were 4.1% (37/904) and 0.1% (3/2158), respectively. Multivariate analysis showed that blood donation (adjusted OR=13.25, 95%CI:3.02~58.25) and plasma donation (adjusted OR=87.85, 95%CI:22.22~347.27) were related to the H IV infection in villagers in this area. The cumulative population attribution score (PAF) was 89.8%. The villager No. 03 had a higher risk of H IV infection than the villager No. 04 (adjusted OR=12.26, 95% CI: 1.46 to 103.00). Conclusion The prevalence of H IV infection in this area is relatively low, and the main cause of H IV infection in villagers is the previous paid blood donation (plasma). There is no obvious spread of H IV from blood donors to non-donor groups.