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標題: | 臺灣某軍事單位登革熱防治成效探討 The Effectiveness of Dengue Fever Control in a Military Unit |
作者: | Yi-Wei Huang 黃奕維 |
指導教授: | 蔡坤憲(Kun-Hsien Tsai) |
關鍵字: | 登革熱,登革熱防治,軍隊,防治成效,病媒蚊, dengue fever,disease control,military,effectiveness,vector, |
出版年 : | 2020 |
學位: | 碩士 |
摘要: | 研究背景與目的: 登革熱為目前全球最重要蟲媒傳染病之一,而登革熱的控制主要依靠媒介控制和中斷傳播途徑。幼蟲防治和成蟲滅蚊是媒介控制的兩個關鍵點。幼蟲的防治主要包含孳生源的清除、社區動員和環境管理。成蚊的防治主要使用空間噴灑、室內殘留噴灑和物理防治。每年約有5千萬至5.28億人被感染,約造成1至2萬人死亡。 國軍營區因資訊保密需求及訓練的特殊性,成為一個封閉且群居式的工作環境,面對傳染性疾病比一般工作環境或住家有更高的風險,若造成群聚感染,將使國軍戰力削減,影響國軍保衛國家之使命,故探討登革熱防治成效,及國軍營區的型態與特質對於登革熱防治之優、劣勢,並評估本部官兵與一般民眾之疾病發生率,是否有顯著差異,期望研究之成果供國軍各部隊參考,以達防疫之果效。 研究材料與方法: 本研究以描述性統計、相對危險度、卡方檢定及費雪精確性檢定進行分析。研究資料取自衛生福利部疾病管制署法定傳染病通報系統本土登革熱通報及陽性病例以及本部下轄營區發生之個案,範圍為2012年1 月1日至2016年12月31日為止。 研究結果: 以2012年至2016年全台灣確診登革熱個案數與本研究之國軍單位進行分析,2012年及2016年本部無確診個案,且多數營區無確診個案發生,2015年全年度43832人確診,發生率為0.187%,而本部確診3人,發生率為0.057%,一般民眾相對於本部官兵的相對風險值為3.2484,其差異達到統計上的顯著水準(p<0.05)。 結論與建議: 本研究發現,當疫情處於嚴峻的狀態時,營區的個案數並不受影響,2015年時全台灣43832人確診為近10年最多例,而營區共確診3人,相對風險值為3.2484,其差異達到統計上的顯著水準(p<0.05),研究期間2012至2016年間無營內感染之個案發生,此外,本研究亦發現登革熱個案皆發生於無醫療人員之獨立營區,代表獨立營區無法確實完成防疫工作,需倚賴軍醫人員之介入,然而現行之人員編制致使軍醫人員無法逐一前往各營區進行防疫視察,因此,應針對獨立營區擬定個別性防治計畫及督導模式,才能從根本解決體制上的不足。最後在居住地的部分,確實與登革熱個案有相關性,且經疫調發現,所有個案皆居住於南部,故應加強宣導南部疫情,使官兵注意自身防疫,非必要不前往,如必須前往須注意自身防護,以避免將病毒帶回營區,造成營區內傳染事件。 Dengue fever is a mosquito-borne viral infectious disease with the fastest spreading around the world. At present, dengue fever control mainly depends on vector control and interruption of transmission routes. Larvae control and adult mosquito control are the two key points of vector control. Larvae control is based on container manipulation, container treatment, community campaigns and environmental management. Adult mosquito control is based on space spraying, indoor residual spraying and physical methods. It causes 10,000 to 20,000 deaths every year. The military is a closed environment, and the crowd have intensive contact which result in a high risk of clustering of infection. If the prevention and control plan can be improved through research, it can be implemented in the whole army as a key measure for dengue prevention. This study uses descriptive statistics, relative risk, chi-square test and Fisher's exact test for analysis. The research data is taken from the local dengue fever notification and positive disease notification system of the CDC and the cases that occurred in the camps under the Ministry on January 2012 to December 2016. The analysis results showed that there were no confirmed cases in 2012 and 2016, and most of the camps had no confirmed cases. In 2015, 43,832 people were diagnosed, with an incidence rate of 0.187%, while 3 people were diagnosed in the camp with an incidence rate of 0.057%. The relative risk of the officers and soldiers in this camp is 3.2484, and the difference has reached a statistically significant level (p<0.05). This study found that when the epidemic is in a severe state, the number of cases in this department is not affected. In 2015, 43,832 people in Taiwan were diagnosed with the most cases in the past 10 years, and 3 people were diagnosed in this department, with a relative risk of 3.2484. The difference has reached a statistically significant level (p<0.05). It was also found that dengue fever cases occurred in independent camps without medical personnel. This means that independent camps cannot reliably complete the epidemic prevention work and need to rely on the intervention of military medical personnel. However, the current staffing makes it impossible for military medical personnel to go to each camp for epidemic prevention inspections. Only by formulating individual prevention and control plans and supervision models for independent camps can the system's shortcomings be solved fundamentally. Finally, the part of the place of residence is indeed related to the dengue fever case, and the epidemic investigation found that all the cases are living in the south area. Therefore, we should strengthen the publicity of the epidemic in the south, so that soldiers should pay attention to their own epidemic prevention to avoid bringing the virus back to the camp area and causing infection. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/71171 |
DOI: | 10.6342/NTU202004059 |
全文授權: | 有償授權 |
顯示於系所單位: | 公共衛生碩士學位學程 |
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