| Background:Our country is one of22high tuberculosis burden countries around the world, the number of tuberculosis cases every year ranking second in the world. At the same time, our country is also the world’s27multi-drug resistant tuberculosis epidemic one of the most serious countries. Tuberculosis is still one of the major infectious diseases in China, which is a serious threat to people’s health and life safety, restricting economic and social development in the rural area, especially in poor areas. We must rediscover the status of tuberculosis epidemic in our country, in order to carry out preventive and control work effectively, and reduce the epidemic situation of tuberculosis. The spread of pulmonary tuberculosis mainly through the respiratory tract, from infectious pulmonary tuberculosis patients, by coughing, sneezing, singing, speaking loudly and so on, discharges mycobacterium tuberculosis out of the body, polluting the air and articles in contact. Pulmonary tuberculosis patients produce waste daily, including the patient’s sputum, all of the items that patients throw away after contact or use, such as clothing, spittoons, produced in the process of the patients for treatment and pharmaceutical packaging, syringes, infusion sets, etc, may contain mycobacterium tuberculosis. Susceptible population inhalation of mycobacterium tuberculosis, or contact with contaminated waste, are susceptible to infection. Therefore, improve the cognitive level of pulmonary tuberculosis patients about pulmonary tuberculosis and patient waste, making them carry out the correct treatment of pulmonary tuberculosis patients of waste, and taking effective measures to prevent the spread of tuberculosis, can protect the health of patients, family members and close contacts, reduce the occurrence of tuberculosis effectively. It is a great significance for tuberculosis control.Objective:This study adopts self-made questionnaire, to research cognitive status and influencing factors towards pulmonary tuberculosis and patient waste in Shandong Province among the new pulmonary tuberculosis patients, put forward the coping strategies of cognitive level, and provide a reference strategy for tuberculosis control institutions.Data and Methods:This study was conducted in Shandong Province. And six counties were selected by layer-cluster random sampling. The details are as follows:at first, selecting one city was selected from western, central and eastern regions of Shandong Province from three municipal level cities, including Jinan, Linyi and Weihai. Secondly, all counties in each city were Ranked in accordance with the level of GDP per capita, and were classified as three categories, good, average and bad. At last, the Simple random sampling method was used to select two countries as the sample countries, including6counties, Changqing, Zhangqiu, Yishui, Junan,Rushan and Wendeng.The pulmonary tuberculosis patients in the6counties selected from January1st in2011to December31th2011were enrolled as subject. The data was collected by one-to-one questionnaire survey. A total of800pulmonary tuberculosis patients were investigated and720patients response effectively, with the effective rate of90%. In which,571patients were new pulmonary tuberculosis. Strict quality control measures were carried out to ensure the investigation quality. And the data were analyzed using SPSS17.0software.Main Results: (1) The cognitive status of new pulmonary tuberculosis patients about transmission route of pulmonary tuberculosis shows that, about50%pulmonary tuberculosis patients believe that the droplets spread is one of transmission way,16.5%pulmonary tuberculosis patients think dust spread is one transmission of pulmonary tuberculosis. However, only6.7%patients believe mother-to-fetus transmission is one transmission way of pulmonary tuberculosis, less than10%.(2) The Precision Rate of patients cognitive of Sputum and discarded Spittoon are both more higher than80%. The Precision Rate of patients cognitive of used masks, toilet paper, packaging, infusion sets and syringes are followed, more than70%. And the cognitive rate of pulmonary tuberculosis patients to clothes, awareness bedding, towels, handkerchiefs and cutlery is relatively low.(3) The multivariate Logistic regression analysis shows that, age groups and occupation are factors influencing cognitive level of patients with new tuberculosis to susceptible populations (P<0.05).And region, age and education level are three factors influencing cognitive level of patients with new tuberculosis to transmission(P <0.05). The cognitive level decrease with the increasing of the patient’s age. The higher the education is, the better patients’cognitive level to tuberculosis transmission routes is. Meanwhile, the cognitive levels are different among different regions. It shows a certain degree of spatial heterogeneity.(4) The multivariate Logistic regression analysis shows that, age is the factor that influence patient cognitive status of waste. Occupation and age are factors that influence patient cognitive status on the infectiousness of waste, in which age is a protective factor. The younger the patient is, the better the cognition is.(5) The cognition of71.5%patients to tuberculosis and waste are from personal experience and feelings,39.2%from the doctors,12.4%from interpersonal,11.4%from posters and other publicity columns,9.3%of newspapers, magazines and radio and television, and only5.8%from the Internet.(6) Analysis of patients’cognition to waste hazards shows that,74.6%of patients think that tuberculosis waste can transmitter diseases,34.9%of patients believe that the waste can pollute the environment,25.9%believe it affect public health,5.4%of patients think it is not dangerous, while9.3%patients are not clear.Conclusion and Suggestions:Conclusion:(1) Only32%patients believe the close contact people are susceptible,50%of patients believe that the droplet spread is a transmission way of tuberculosis. This indicates that the cognitive level of new tuberculosis patients to pulmonary tuberculosis is low and not comprehensive enough. More health education measures are needed.(2) Age, education, marital status, occupation, residence location, personality type and other factors are influencing factors for the cognitive level of pulmonary tuberculosis patients to tuberculosis and waste. We should consider various factors in the tuberculosis health education, to enhance the effect of health education.(3) The cognition of71.5%patients to pulmonary tuberculosis and patient waste are from personal experience and feelings,39.2%from the doctors. This indicates that the new pulmonary tuberculosis patients are lack of enough knowledge sources. So more measures are needed to broaden the communication channels and improve the information accessibility.Suggestions:(1) Grasp the mission points for tuberculosis patients, put the cognition of waste as an important content.(2)Health education should be carried out actively for tuberculosis patients, aimed at improving cognitive level of pulmonary tuberculosis and patient waste.(3)The supervisory work should be strengthened, towards the key crowd, aimed at promoting the formation of the correct life behavior way.(4)More active measures should be targeted to waste disposal, aimed at blocking the transmission of tuberculosis. |
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