CAJ | 학술논문

目的：分析中国东部3个省份农村地区成年人乙型肝炎歧视的现状及其影响因素。方法于2011—2012年采用概率比例规模（PPS）抽样方法，选取北京市、河北省、山东省的7个县22个村18岁以上居民作为调查对象，共9269名。采用自行设计的结构式调查问卷对其社会人口学特征、对乙型肝炎患者及乙型肝炎病毒（HBV）携带者的态度、乙型肝炎疫苗接种史进行入户调查。分析调查对象乙型肝炎歧视得分及其分布情况，并通过多因素logistic回归模型分析乙型肝炎歧视的影响因素。结果51.15%（4741名）的调查对象在与乙型肝炎患者或病毒携带者接触的过程中感到恐惧、担心自己被传染；分别有51.29%（4754名）、61.14%（5667名）、52.22%（4841名）的调查对象不愿意接受其礼物、与其一起吃饭、与其握手拥抱；有73.92%（6852名）的调查对象不愿意孩子与乙型肝炎患者或病毒携带者的孩子玩耍；86.68%（8034名）的调查对象不愿意孩子与乙型肝炎患者或病毒携带者结婚。所有调查对象中，完全无歧视（乙型肝炎歧视得分为0分）者仅占0.88%（82名），无歧视或轻度歧视者（0<得分≤5分）占23.70%（2197名），严重歧视者（得分≥6分）占76.30%（7072名）。多因素logistic回归模型分析结果显示，与农民相比，打工者、技术员、公职人员/村医发生严重乙型肝炎歧视的OR（95%CI）值分别为0.86(0.75～0.98)、0.77(0.67～0.87)、0.57(0.41～0.79)；与低收入组（人均<10000元/年）相比，高收入组（人均>40000元/年）发生严重乙型肝炎歧视的OR（95%CI）值为0.57(0.46～0.70)；严重歧视发生率仍随受教育程度的提高而下降，相比文盲组，高中以上教育水平组发生严重乙型肝炎歧视的OR（95%CI）值为0.64(0.51～0.80)；与自评健康水平非常好者相比，自评健康水平非常差者发生严重歧视的OR（95%CI）值为0.41(0.25～0.67)。结论我国东部3个省份农村成年人乙型肝炎歧视现象严重，消除乙型肝炎歧视迫在眉睫。农村地区消除乙型肝炎歧视工作的开展应重点针对农民、低收入者、受教育水平低者。目的：分析中國東部3箇省份農村地區成年人乙型肝炎歧視的現狀及其影響因素。方法于2011—2012年採用概率比例規模（PPS）抽樣方法，選取北京市、河北省、山東省的7箇縣22箇村18歲以上居民作為調查對象，共9269名。採用自行設計的結構式調查問捲對其社會人口學特徵、對乙型肝炎患者及乙型肝炎病毒（HBV）攜帶者的態度、乙型肝炎疫苗接種史進行入戶調查。分析調查對象乙型肝炎歧視得分及其分佈情況，併通過多因素logistic迴歸模型分析乙型肝炎歧視的影響因素。結果51.15%（4741名）的調查對象在與乙型肝炎患者或病毒攜帶者接觸的過程中感到恐懼、擔心自己被傳染；分彆有51.29%（4754名）、61.14%（5667名）、52.22%（4841名）的調查對象不願意接受其禮物、與其一起喫飯、與其握手擁抱；有73.92%（6852名）的調查對象不願意孩子與乙型肝炎患者或病毒攜帶者的孩子玩耍；86.68%（8034名）的調查對象不願意孩子與乙型肝炎患者或病毒攜帶者結婚。所有調查對象中，完全無歧視（乙型肝炎歧視得分為0分）者僅佔0.88%（82名），無歧視或輕度歧視者（0<得分≤5分）佔23.70%（2197名），嚴重歧視者（得分≥6分）佔76.30%（7072名）。多因素logistic迴歸模型分析結果顯示，與農民相比，打工者、技術員、公職人員/村醫髮生嚴重乙型肝炎歧視的OR（95%CI）值分彆為0.86(0.75～0.98)、0.77(0.67～0.87)、0.57(0.41～0.79)；與低收入組（人均<10000元/年）相比，高收入組（人均>40000元/年）髮生嚴重乙型肝炎歧視的OR（95%CI）值為0.57(0.46～0.70)；嚴重歧視髮生率仍隨受教育程度的提高而下降，相比文盲組，高中以上教育水平組髮生嚴重乙型肝炎歧視的OR（95%CI）值為0.64(0.51～0.80)；與自評健康水平非常好者相比，自評健康水平非常差者髮生嚴重歧視的OR（95%CI）值為0.41(0.25～0.67)。結論我國東部3箇省份農村成年人乙型肝炎歧視現象嚴重，消除乙型肝炎歧視迫在眉睫。農村地區消除乙型肝炎歧視工作的開展應重點針對農民、低收入者、受教育水平低者。
목적：분석중국동부3개성빈농촌지구성년인을형간염기시적현상급기영향인소。방법우2011—2012년채용개솔비례규모（PPS）추양방법，선취북경시、하북성、산동성적7개현22개촌18세이상거민작위조사대상，공9269명。채용자행설계적결구식조사문권대기사회인구학특정、대을형간염환자급을형간염병독（HBV）휴대자적태도、을형간염역묘접충사진행입호조사。분석조사대상을형간염기시득분급기분포정황，병통과다인소logistic회귀모형분석을형간염기시적영향인소。결과51.15%（4741명）적조사대상재여을형간염환자혹병독휴대자접촉적과정중감도공구、담심자기피전염；분별유51.29%（4754명）、61.14%（5667명）、52.22%（4841명）적조사대상불원의접수기례물、여기일기흘반、여기악수옹포；유73.92%（6852명）적조사대상불원의해자여을형간염환자혹병독휴대자적해자완사；86.68%（8034명）적조사대상불원의해자여을형간염환자혹병독휴대자결혼。소유조사대상중，완전무기시（을형간염기시득분위0분）자부점0.88%（82명），무기시혹경도기시자（0<득분≤5분）점23.70%（2197명），엄중기시자（득분≥6분）점76.30%（7072명）。다인소logistic회귀모형분석결과현시，여농민상비，타공자、기술원、공직인원/촌의발생엄중을형간염기시적OR（95%CI）치분별위0.86(0.75～0.98)、0.77(0.67～0.87)、0.57(0.41～0.79)；여저수입조（인균<10000원/년）상비，고수입조（인균>40000원/년）발생엄중을형간염기시적OR（95%CI）치위0.57(0.46～0.70)；엄중기시발생솔잉수수교육정도적제고이하강，상비문맹조，고중이상교육수평조발생엄중을형간염기시적OR（95%CI）치위0.64(0.51～0.80)；여자평건강수평비상호자상비，자평건강수평비상차자발생엄중기시적OR（95%CI）치위0.41(0.25～0.67)。결론아국동부3개성빈농촌성년인을형간염기시현상엄중，소제을형간염기시박재미첩。농촌지구소제을형간염기시공작적개전응중점침대농민、저수입자、수교육수평저자。
Objective To analyze the present situation and influencing factors of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces in China. Methods By using the method of probability proportionate to size (PPS),we involved a sample of 9 269 rural adults aged above 18 years old from 22 villages of 7 counties in Beijing, Hebei,Shandong in 2011 and 2012. We used a self-designed interview questionnaire with questions about the individual and household characteristics, attitudes toward hepatitis B patients and carriers, individual HBV vaccination history, etc. We analyzed the hepatitis B discrimination score and its distribution, and we also created a multinomial logistic regression model to analyze the influencing factors of discrimination. Results Of all the participants, 51.15%(4 741)were afraid of being infected with HBV when getting on with hepatitis B patients or carriers;51.29%(4 754), 61.14%(5 667)and 52.22%(4 841)of them were not willing to accept <br> gifts from hepatitis B patients or carriers, have dinner with them ,or hug and shake hands with them, respectively; 73.92%(6 852)were unwilling to their children's playing with kids whose parents were hepatitis B patients or carriers, and 86.68%(8 034)were unwilling to their children's marrying hepatitis B patients or carriers. Of all the participants, only 0.88%(82)were totally discrimination-free (discrimination score=0);mild or without discrimination (<0 discrimination score≤5) accounted for 23.70%(2 197/9 269);severe discrimination (discrimination score ≥6) accounted for 76.30%(7 072). The multiple multinomial logistic regression showed that migratory workers, other occupations like technician, civil servants and village doctors were less likely to show severe HBV-related discrimination compared with farmers, with OR (95%CI) 0.86 (0.75-0.98), 0.77 (0.67-0.87), 0.57 (0.41-0.79), respectively. Compared with the lowest income group (<10 000 RMB/year per person), and the highest income group (>40 000 RMB/year per person)had an OR (95%CI) of 0.57 (0.46-0.70). People with higher education tended to show less severe discrimination. The high education group had an OR (95%CI) of 0.64 (0.51-0.80) based on the low education group. And compared with people whose self-assessment of health status was very good, those who assessed their health status as very poor showed less severe discrimination, with an OR (95%CI) of 0.41 (0.25-0.67). Conclusion The situation of discrimination against hepatitis B patients and carriers among rural adults in three eastern provinces was serious. It is of great urgency to eliminate the discrimination. Work on eliminating hepatitis B discrimination should focus on farmers, people with low incomes, and people with low educational level.