南京市社区≥60岁女性生殖道感染及就医行为影响因素分析

doi:10.12183/j.scjpm.2020.0630

摘要/Abstract

摘要： 目的探讨城市社区老年妇女生殖道感染情况并分析影响其就医行为的相关因素。方法采用分层整群抽样法抽取南京市老年妇女进行生殖道感染及相关因素问卷调查并进行常规妇科检查,采用描述流行病学分析方法对该人群生殖道感染情况及就医行为进行分析,并采用单、多因素分析方法对就医行为影响因素进行分析。结果本研究共对3 270名南京市各社区≥60岁女性进行调查,年龄60~88岁,平均（68.78 ± 5.24）岁。文化程度以初中、高中/中专为主（2 092人,占64.0%）。1 897例在过去3个月内至少出现过1项生殖道感染相关症状,发生率为58.01%。916例诊断为生殖道感染,生殖道感染患病率为28.01%,就医率为59.93%（549/916）。多因素分析结果显示已婚（OR=1.253）、生育子女数≥2个（OR=2.765）、大专及以上文化程度（OR=3.056）、家庭年收入≥5万元（OR=2.428）、有生殖道感染史（OR=2.522）、有医保（OR=4.609）、生殖道感染知识得分越高（OR=4.477）的生殖道感染老年妇女就医可能性越高。结论生殖道感染在城市社区老年妇女中有较高的发病率,就医率较低,其就医行为主要受到文化程度、经济状况、生殖道感染知识了解程度等因素的影响。

关键词: 生殖道感染, 就医行为, 阴道炎, 老年妇女, 影响因素

Abstract: Objective To investigate the prevalence of reproductive tract infection （RTI） among elderly women in urban communities, and to analyze the related factors influencing their healthcare-seeking behaviors.Methods The stratified cluster sampling method was used to select elderly women in Nanjing for RTI and related factors questionnaire surveys and routine gynecological examinations. Descriptive epidemiological analysis was used to analyze the status of RTI and healthcare-seeking behaviors. Univariate and multivariate analysis were used to analyze the influencing factors of healthcare-seeking behavior.Results A total of 3 270 Nanjing community women ≥60 years old were surveyed, aged 60-88 years old, with an average age of （68.78 ± 5.24） years. The education level was mainly junior high school, high school/secondary specialized school （2 092, accounting for 64.0%）. Among them, 1 897 cases had at least one symptom related to RTI who in the past 3 months, the incidence rate was 58.01%; 916 cases were diagnosed as RTI, the prevalence rate was 28.01%, and the rate of healthcare-seeking was 59.93% （549/916）. Multivariate analysis showed that the elderly women with RTI were married （OR=1.253）, had more than 2 children （OR=2.765）, college education or above （OR=3.056）, annual family income ≥50 000 yuan （OR=2.428）, a history of RTI （OR=2.522）, medical insurance （OR=4.609）, and a higher score of knowledge of RTI （OR=4.477）, had higher possibility of healthcare-seeking.Conclusion RTI has a high incidence rate among elderly women in urban communities, and the rate of healthcare-seeking is low. Their healthcare-seeking behaviors are mainly affected by factors such as education level, economic status, and knowledge of RTI.

Key words: Reproductive tract infection, Healthcare-seeking behavior, Vaginitis, Elderly women, Influencing factor

中图分类号:

R711.3

于点, 田侃, 孙陈敏, 赵文敏, 葛燕飞, 李红美, 于翠婷. 南京市社区≥60岁女性生殖道感染及就医行为影响因素分析[J]. 华南预防医学, 2020, 46(6): 630-633.

YU Dian, TIAN Kan, SUN Chen-min, ZHAO Wen-min, GE Yan-fei, LI Hong-mei, YU Cui-ting. Reproductive tract infection and influencing factors of healthcare-seeking behavior of women aged over 60 in Nanjing[J]. South China Journal of Preventive Medicine, 2020, 46(6): 630-633.

参考文献

[1] 陈锐, 廖秦平. 重视中国女性生殖道感染及阴道微生态诊治[J]. 中华检验医学杂志, 2018,41(4):251-253.
[2] Shusmita R, Julia EM, Caitlyn T, et al.Evaluating implementation of the World Health Organization’s Strategic Approach to strengthening sexual and reproductive health policies and programs to address unintended pregnancy and unsafe abortion[J].Reprod Health, 2017, 14(1):153.
[3] 陈凤英. 我国女性生殖道感染诊治现状及研究进展[J].医学理论与实践,2015,28(21):2906-2907,2909.
[4] 谢幸,苟文丽.妇产科学[M]. 8版.人民卫生出版社,2013,116-118.
[5] 朱晔,魏俊秀,杨欣, 等.北京市社区中老年妇女泌尿生殖道及盆底功能障碍性疾病相关因素分析[J].中国妇产科临床杂志,2018,19(4):319-322.
[6] 孙晓明, 舒星宇, 宗占红, 等. 中国农村中老年女性人口生殖健康状况与服务需求分析[J]. 人口与发展, 2013, 19(3):63-71.
[7] 蓝家富. 防城港市2 292例女性宫颈HPV感染与基因分型分析[J].分子诊断与治疗杂志,2019,11(3):204-208.
[8] 易本喜,沈丽娟,石冰,等.上海市金山地区老中青年已婚女性阴道分泌物流行病学调查[J].山西医药杂志,2020,49(4):371-374.
[9] 杨桂华. 生殖道感染患者的健康教育需求调查与指导对策[J].河北医学,2015,21(7):1222-1224.
[10] 董春波, 樊利春, 窦倩如, 等. 海南省农村妇女生殖道感染现况调查[J]. 中国热带医学, 2020, 20(9): 822-825.
[11] 邹先梅,陶水英.深圳西部社区流动育龄妇女生殖道感染调查及干预[J].齐鲁护理杂志,2017,23(8):36-38.
[12] 韩淑霞, 马静文, 李晓雯,等. 妇科门诊患者生殖道病原体感染情况分析[J]. 中华医院感染学杂志, 2019, 29(9):1412-1415.
[13] Simpson SJ, Wiggins R, Fox JM, et al.Hepatitis B vaccination induces mucosal antibody responses in the female genital tract, indicating potential mechanisms of protection against infection[J]. Sex Transm Dis, 2019,46(5):e53-e56.
[14] 尚瑞彦, 王雅莉, 李红娟. 女性生殖道感染流行特征及相关因素调查[J]. 华南预防医学, 2019, 45(6):74-76.
[15] Mabvakure BM, Lambson BE, Ramdayal K, et al.Evidence for both intermittent and persistent compartmentalization of HIV-1 in the female genital tract[J]. J Virol, 2019,93(10):e00311-19.
[16] 周青雪, 董世雷, 陈旭, 等. 杭州某医院女性就诊者生殖道支原体感染及其与分泌物清洁度的相关性[J]. 国际流行病学传染病学杂志, 2019, 46(2):117-121.
[17] 鲁盛康, 蒋春红, 张亮. 湖北省城乡居民门诊就医选择影响因素分析[J]. 中华医院管理杂志, 2018, 34(1):76-79.
[18] 陈俐,朱玲,于辉兰, 等.生殖道感染病原菌分布及影响因素分析[J].中华医院感染学杂志,2018,28(6):915-917,925.
[19] 王琦. 攀枝花市240例已婚妇女妇科病情况及生殖道感染调查分析[J]. 中国妇幼保健, 2018, 33(18):163-166.
[20] 冯晨阳, 赖颖斯, 李瑞雪,等. 孟加拉国1999-2018年女性生殖健康状况变化趋势[J]. 中华流行病学杂志, 2020, 41(4):599-604.