• Title/Summary/Keyword: Schoolchildren

검색결과 149건 처리시간 0.024초

울산지역 초등학생의 알레르기비염 유병과 면역반응과의 상관성: 환자-대조군 연구 (Correlation between Allergic Rhinitis Prevalence and Immune Responses of Children in Ulsan: A Case-control Study)

  • 이지호;오인보;김아라;김민호;심창선;김양호
    • 한국환경보건학회지
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    • 제41권4호
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    • pp.249-258
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    • 2015
  • Objectives: This study aims to investigate the correlations between the prevalence of allergic rhinitis (AR) and cytokines among elementary school children in an industrial city, Ulsan, South Korea, and to identify major environmental risk factors associated with AR prevalence. Methods: We conducted a case-control study in June 2009 and February 2010 in order to evaluate the relationship between AR and related cytokines. Data on physician-treated prevalence over the past 12 months and potential risk factors for AR were compiled through a questionnaire from a survey of 339 schoolchildren living in different urban environments. Logistic regression analysis was carried out with propensity score matched data (n=180) to assess the influences of cytokines (IL-13, IL-33, IL-4 and IL-5) on AR prevalence and to determine which environmental factors affected AR. Results: In univariate analysis, the AR prevalence was influenced by family history of AR (mother and siblings), environmental factors (odor condition and irritated symptoms of air pollution), and indoor allergens (D. farinae and D. pteronyssinus). The t-test demonstrated that eosinophils, Immunoglobulin E (IgE), and interleukins (IL-13 and IL-5) were statistically significantly different according to treatment of allergic rhinitis over the preceeding 12 months. The results of the multiple logistic regression analysis showed that a statistically significant association between several factors (such as irritated symptoms of air pollution (OR 4.075, CI 1.735-9.568), IL-13 (OR 0.825, CI 0.734-0.928), odor condition (OR 2.409, CI 0.908-6.389), and AR history of siblings (OR 2.217, CI 0.999-4.921)) and the prevalence of AR was found after adjusting for confounders. Conclusion: These results suggest that AR prevalence is significantly associated with cytokine level, genetic background, and outdoor environmental factors. Although living in a polluted area and genetic background can contribute to an increased risk of childhood AR, cytokine level should be considered as an important factor in the treatment of AR in the last 12 months.

학령후기 아동의 사회불안에 미치는 영향요인 (Influencing Factors of Social Anxiety in Late School-aged Children)

  • 문소현;김형란;김정숙
    • 한국산학기술학회논문지
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    • 제20권6호
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    • pp.63-73
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    • 2019
  • 본 연구는 학령후기 아동의 사회불안 정도와 사회불안에 영향을 미치는 요인을 파악하기 위한 것이다. 설문지를 이용한 서술적 조사연구 방법으로 초등학교에 재학 중인 6학년 아동 278명을 연구대상자로 하였으며, 연구도구는 SASCA-K(Korean Social Anxiety Scale for children and adolescents, 사회불안 척도), SES(Self-esteem Scale, 자아존중감 척도), CAPS(Child and Adolescent Perfectionism Scale, 완벽주의 척도), DSRS-C(Depression Self-Rating Scale for Children, 아동우울 척도), IPPA-R(Inventory of Parent and Peer Attachment-Revised version부모 및 또래애착 척도)을 사용하였다. 수집된 자료는 SPSS WIN 23.0을 이용하여 기술통계, t-test, One-way ANOVA, Pearson correlation, stepwise multiple regression을 실시하였다. 연구결과 학령후기 아동의 사회 불안과 완벽주의, 우울은 긍정적인 상관관계가 있는 반면, 자아존중감, 애착안정성은 부정적인 상관관계가 있었다. 단계적 다중회귀 분석에서는 자아존중감, 자기 지향적 완벽주의, 우울, 부 애착 의사소통이 사회불안에 영향을 주는 요인으로 38% 설명하는 것으로 나타났으며, 사회불안에 가장 영향을 미치는 요인은 자아존중감으로 분석되었다. 학교, 가족, 지역사회의 통합적인 개입을 통해 학령후기 아동의 정신문제를 예방하고 중재하기 위해 건강교육, 상담 및 학교기반 보건교육 프로그램 확대가 필요하다.

초등학생의 또래거부와 괴롭힘 피해행동의 관련성: 학급 갈등규범의 조절효과 (The relationship between peer rejection and victimization in elementary school classrooms in South Korea: The moderating effect of conflict norms)

  • 심재량;박종효
    • 교육심리연구
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    • 제32권3호
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    • pp.549-569
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    • 2018
  • 본 연구는 또래거부와 괴롭힘 피해행동의 관계에 대한 학급 갈등규범의 조절효과를 살펴보는데 목적이 있다. 본 연구는 클래스넷 3차년도 데이터의 일부로서, 전국 소재 총 초등학교 7개교, 52개 학급의 4~6학년 학생 1,194명을 연구대상으로 하며, 또래지명 방식으로 측정한 또래거부, 괴롭힘 피해행동, 괴롭힘 가해행동, 교사-학생 갈등 변인을 활용하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 남학생이 여학생에 비해 괴롭힘 피해행동 수준이 높았으며, 또래거부와 괴롭힘 피해행동은 유의한 정적 관련성이 있었다. 둘째, 학급 갈등규범은 학급마다 유의한 차이가 있었고 괴롭힘 피해행동의 학급 차이도 유의하였다. 셋째, 다층분석 결과에 의하면, 또래거부가 많을수록, 괴롭힘 피해행동은 유의하게 증가하였다. 또한 갈등규범 수준이 높은 학급에서 괴롭힘 피해행동 수준도 높았다. 특히 또래거부와 괴롭힘 피해행동의 관계는 학급의 갈등규범 수준이 조절하였다. 즉, 갈등규범 수준이 낮은 학급에 비해, 갈등규범이 높은 학급에서 또래거부는 괴롭힘 피해행동 수준을 유의하게 증가시켰다. 본 연구결과를 토대로, 또래거부가 괴롭힘 피해행동으로 이어지는 과정에서 학급 갈등규범의 중요성을 확인하였고 담임교사의 역할에 대해 교육적 시사점을 논의하였다.

초등학교 학생을 대상으로 한 건강증진 프로그램의 효과 (Effect of Health Promotion Programs in Schoolchildren)

  • 유중선;강복수;이경수;김석범;최광해;김미경
    • 농촌의학ㆍ지역보건
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    • 제25권2호
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    • pp.397-411
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    • 2000
  • 초등학교 학생을 대상으로 1년간의 보건교육 interevntion을 제공하고 이에 의한 보건지식, 태도 및 건강증진행위의 변화의 정도를 분석하고, 비만 식이에 대한 지식과 태도, 실천 행위점수의 변화에 영향을 미치는 요인을 규명하고, 건강지식과 건강증진행위의 변화에 따른 건강수준의 변화정도을 분석하고자 시행하였다. 1999년 4월 경주시 도시지역 초등학교에 재학중인 3, 4학년 학생과 학부모 각 354명을 대상으로 사전조사를 시행한 결과 학생과 학부모 각각 301명이 응답하여 회수율은 85%였다. 301쌍 중에서 1년 후 2000년 4월 추적조사를 실시하였으며, 전학한 학생, 조사 당일 조퇴자, 복부지방 측정 누락자와 추적설문조사에서 학생과 어머니의 설문이 불완전한 대상자를 제외한 231쌍을 최종분석 대상으로 하였다. BMI를 기준으로 비만군과 정상체중군으로 구분하고 이에 따른 비만 식이에 대한 지식, 태도 및 실천행위점수와 복부비만율을 intervention 전후의 변화를 비교한 결과, 지식 점수의 변화는 정상체중군에서 유의하게 증가하였고, 태도점수는 비만군에서는 유의하게 증가하였으나 정상체중군에서는 유의하게 감소하였고(p<0.01), 실천행위 점수는 양군 모두에서 유의하게 증가하였다. 복부비만율은 비만군에서는 변동이 없었으나 정상체중군에서는 유의하게 증가하였다(p<0.01). Intervention 전후의 비만 식이에 대한 지식점수 변화는 사전조사 점수를 기준으로 3분위 한 후 1년 후 점수의 변화를 보면 l분위의 경우 intervention 전후의 지식점수변화가 2.4점 증가하였고, 2분위는 0.6점 증가하였고, 3분위는 0.6점 감소하여, 사전지식 점수가 낮을수록 건강증진프로그램에 의한 효과가 큰 것으로 나타났다. 비만 식이에 대한 실천행위점수는 세 군 모두에서 유의하게 증가하였고, 점수의 변화량은 1분위가 7.0점, 2분위가 4.4점, 3분위가 1.8점으로 세 군간에 유의한 차이가 있었다. 어머니의 교육수준이 대졸 이상군에 속하논 학생의 BMI증가가 고졸 이하군에 속하는 학생의 BMI 증가에 비하여 유의하게 높았고, 어머니의 연령이 30대인 학생군에서 비만 식이에 대한 실천행위점수 변화는 높았다. 어머니의 비만 식이에 대한 지식점수와 태도점수를 3분위로 구분하여 비교한 결과 태도점수 수준에 따른 학생의 지식점수변화는 유의한 차이가 있었다. 비만 식이에 대한 지식점수변화량에 영향을 미치는 요인분석을 위한 다중회귀분석에서는 학생변수로는 비만에 대한 심각성 인지도와 비만 식이에 대한 사전지식점수가 유의하게 영향을 미치는 변수였고, 어머니 변수 중에 자녀식습관지도 정도와 교육수준이 유의한 변수였다. 비만 식이에 대한 태도변화량에 영향을 미치는 요인분석을 위한 다중회귀분석에서는 학생변수로는 BMI 비만 식이에 대한 사전지식 정수와 비만 식이에 대한 사전 태도점수가 유의한 변수였으나, 어머니 변수는 태도점수 변화에는 영향을 미치지 못하는 것으로 나타났다. 비만 식이에 대한 실천행위점수변화에 영향을 미치는 요인분석을 위한 다중회귀분석에서는 학생변수로는 BMI와 비만 식이에 대한 사전 태도점수, 비만 식이에 대한 태도점수 변화량이 영향을 미치는 것으로 나타났다. 결론적으로 비만 식이에 대한 지식수준이 낮고, 건강 실천행위정도가 낮은 학생에서 intervention에 의한 효과가 크게 나타났다. 그러나 1년간의 보건교육과 운동 등의 건강증진 프로그램을 통한 intervention에 의해서는 BMI나 복부비만율 등의 건강수준의 변화에는 거의 영향을 미치지 못하는 것으로 나타나 장기적인 intervention이나 교육-대조군 연구활 통한 건강증진효과를 계량적으로 분석하는 것이 필요하다. 아동의 비만 식이 태도와 행위 변화에 어머니의 연령과 교육수준 등의 영향을 미치고, 어머니의 비만 식이에 대한 태도점수도 영향을 미치므로 어머니도 학생의 비만 식이의 관련된 교육 프로그램의 대상에 포함시켜야 한다.

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역기하학 렌즈의 유효성과 각막에 미치는영향 (The Efficacy and Effect of Reverse Geometry Contact Lens on Cornea)

  • 김광배;김영훈;박상배;선경호;정연홍
    • 한국안광학회지
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    • 제12권2호
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    • pp.1-12
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    • 2007
  • 본 연구는 학동기 아동에서 근시교정용 콘택트렌즈인 역기하학 콘택트렌즈(RGL, reverse geometry contact lens)에 대한 근시교정 효과 및 안전성을 평가하는데 있다. 본 연구에서는 2004년 3월부터 2005년 7월 사이에 근시굴절교정술을 목적으로 역기하학렌즈를 처방 받은 7세부터 18세사이의 학동기 환자 중 착용 후 3개월 이상 추적관찰이 가능했던 중등도 이하의 근시(-1.00~-5.00 D(Diopter))를 갖는 남녀 53명 106안을 연구대상으로 하였다. 렌즈처방을 위한 검사로는 세극동 현미경, BUT(Break Up Time), 직상검안경, 검영기, 나안시력, 최대 교정시력, 자동굴절검사, 각막곡률측정, 각막지형도검사를 착용 전과 착용 후 1일, 1주일, 2주일, 1개월, 2개월, 3개월 째 각각 시행하여 근시교정 효과와 합병증 발생 여부를 알아보았다. 그 결과는 다음과 같다. 렌즈 착용 전 평균 나안시력은 $0.0938{\pm}0.378$에서 착용 후 1일에 $0.3136{\pm}0.283$이었고, 1주에는 $0.7925{\pm}0.301$으로 급격한 시력향상을 보였으며 2주후부터는 약간씩이었지만 계속되는 추이를 보였다(p<0.01). 각막지형도검사 상 편심율은 역기하학 렌즈 착용 전 평균 $0.548{\pm}0.099$에서 착용 후 3개월에는 $-0.257{\pm}0.283$(t=2.321, p=0.022)으로 감소하였다. 렌즈 착용 후 1일부터 2개월 사이에 급격한 편심율 감소를 보였으며(p<0.01) 2개월 후부터는 약간의 감소를 보였다(p<0.05). 이상의 결과로부터 역기하학 렌즈는 중동도 이하의 근시를 가진 환자에 있어 일시적으로 굴절이상을 교정하고 근시진행을 조절하는데 매우 유용한 방법임을 알 수 있었다. 부작용은 상대적으로 미미하였으나 장기적으로 눈 건강에 미치는 영향에 관해서는 추가 연구가 더 필요하리라 생각된다. 렌즈의 처방은 편심율(eccentricity)과 각막지형도의 분포도를 고려한 주문제작 피팅법이 매우 높은 성공률을 보였다.

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국민학교 학동의 혈압에 관련된 요인분석 (Risk Factors in Relation to Blood Pressure in Schoolchildren)

  • 이동수;이경수;강복수
    • Journal of Yeungnam Medical Science
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    • 제10권2호
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    • pp.345-359
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    • 1993
  • 대구시내 1개 국민학교 4학년 284명(남아 144명, 여아 140명)을 대상으로, 1992년 5월에 일반적인 특성을 조사하였고, 체격, 체지방 및 혈압을 측정하였으며, 혈액의 생화학적 검사를 실시하여 혈압과 관련된 요인을 분석하였다. 대상자의 평균 수축기 혈압은 103.5mmHg였으며, 남아가 104.1mmHg, 여아가 102.9mmHg로 남아가 약간 높게 나타났으며, 평균 확장기 혈압은 67.1mmHg이고, 남아가 66.6mmHg, 여아가 67.5mmHg로 여아가 약간 높았다. 수축기 및 확장기 혈압을 종속변수로 총콜레스테롤, 고밀도 지단백 콜레스테롤, 저밀도 지단백 콜레스테롤, 중성지방, 총단백질, 요산, 혈당, R$\ddot{o}$hrer지수, 체지방 비율, 체지방 무게 및 제지방체중을 독립변수로 하여 상관관계와 중회귀분석을 실시하였다. 수축기 및 확장기혈압과 독립변수들과의 상관관계를 성별에 따라 분석한 결과 남아의 수축기혈압은 신장, 체중, R$\ddot{o}$hrer지수, 제지방 체중, 체지방 무게 및 중성지방과 유의한 상관관계가 있었으며(p<0.01). 여아의 수축기혈압은 신장, 체중, 제지방체중 및 요산과 유의한 상관관계가 있었다(p<0.01). 남아의 확장기혈압은 체중, R$\ddot{o}$hrer지수 및 제지방체중과 유의한 상관관계가 있었으며(p<0.01). 여아의 확장기혈압은 체중, 제지방체중(p<0.01), 신장, 체지방무게 및 총단백질(p<0.05)과 유의한 상관관계가 있었다. 수축기 혈압을 종속변수로 한 중회귀분석에서 남아는 R$\ddot{o}$hrer지수와 sodium이 유의한 변수였고, 여아는 요산, R$\ddot{o}$hrer지수 및 체지방 비율이 유의한 변수였다. 확장기 혈압에서 남아는 R$\ddot{o}$hrer지수가 유의한 변수였고, 여아는 총단백질이 유의한 변수였다. 이상의 결과로 보아 소아의 혈압에 영향을 미치는 인자로는 R$\ddot{o}$hrer지수, sodium, 요산, 총단백질 및 체지방 비율 이었고, 그 중 R$\ddot{o}$hrer지수가 가장 중요한 요인으로 인정되었다. 따라서 고혈압 발생을 예방하기 위해서는 비만, 식이 및 이와 관련된 생활양식의 개선과 이에 대한 보건교육이 요망된다.

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고 비시지 접종률 상태에서 초등학생들의 투베르쿨린 조사를 통한 감염률 추정 조사 (Tuberculin Survey to Estimate the Prevalence of Tuberculosis Infection of the Elementary Schoolchildren under High BCG Vaccination Coverage)

  • 김희진;오수연;이진범;박윤성;류우진
    • Tuberculosis and Respiratory Diseases
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    • 제65권4호
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    • pp.269-276
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    • 2008
  • 연구배경: 결핵 감염률은 결핵 실태를 파악하기 위한 기본 지표임에도 불구하고 1995년 전국실태조사를 마지막으로 실시되지 못하고 2000년 결핵정보감시체계로 대체되었다. 비시지 접종률이 높은 현 상황에서 무반흔자를 대상으로 한 감염률 조사는 실행이 어려우며 비시지 접종자를 대상으로 투베르쿨린 조사에 대한 비시지 영향 분석과 비시지 반흔과 상관없는 결핵 감염률 조사가 필요하다. 방 법: 2006년에 전국 초등학교 1학년생들을 대상으로 각 시도별 아동 수를 추계한 후 학교를 대상으로 단면조사 연구를 하였다. 총 대상자 수는 40개 학교의 5,148명이 비례할당법으로 선정, 조사되었다. 투베르쿨린 검사는 2단위의 PPD RT 23 0.1 ml를 좌측 전박에 피내 주사한 후 48~72시간 후에 가장 긴 횡직경을 측정하였다. 비시지 반흔에 대해서도 각각 조사하였다. 결 과: 비시지 무반흔자는 6.3%였다. 평균 경결 크기는 0 mm 반응자 1,882명(46.8%)를 포함하여 $3.7{\pm}4.4mm$ 였다. 결핵 감염률은 10 mm 이상을 양성 반응으로 했을때 10.9% (439명)였다. 연간결핵감염위험률은 평균 연령을 6세로 하여 1.91%였다. 결핵 감염률은 비시지 반흔유무에 따른 유의한 차이는 없었다[11.2% vs. 7.6% (OR:1.54, 95% CI: 0.98~2.43)]. 16 mm를 정점으로 한 거울영상법으로는 감염률과 연간결핵감염위험률이 각각 2.4%와 0.4%였다. 결 론: 결핵 감염률과 연간결핵감염위험률은 기존 방법으로 할 경우 높은 비시지 접종률로 인해 높게 나타났다. 결핵 감염률이 높지 않은 국가에서는 거울영상법이 두 지표를 추정하는데 보다 더 적합한 것으로 보인다.

가족발달단계에 따른 간호요구영역에 관한 연구 (Study of The Area of Nursing Need by the Family Developmental Stage)

  • 최부옥
    • 대한간호학회지
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    • 제7권2호
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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한국(韓國)에 있어서의 장내기생충감염(腸內寄生虫感染)의 현황(現況)과 추이(推移) (Current Status and Transition of the Prevalence of Intestinal Parasitic Infections in Korea)

  • 김동찬
    • 농촌의학ㆍ지역보건
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    • 제9권1호
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    • pp.83-108
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    • 1984
  • Out of a total of 58 species of helminthic and protozoan parasitic infections in Korea, so far 38 species were reported as intestinal parasites of man. Quite a few species of the intestinal parasitic infections have long been prevalent throughout the country and this has been a significant public health problem. In this paper, current status and transition of the intestinal parasitic infections in the past years were presented. Chronological reviewing of data show background and prospects of change in the prevalence of infections. In the national prevalence survey on parasitic infections conducted once every five years since 1971, stool examinations were done by both cellophane thick smear and brine flotation techniques. Every egg positive case of Ascaris lumbricoides and Clonorchis sinensis was further examined by Stoll's dilution egg counting technique. In 1981, perianal swab using adhesive cellulose tape was added for Enterobius infection. For protozoan cyst examination conducted by province and city in '81, fecal specimens were fixed in SAF solution and examined by the formalin-ether concentration technique. High prevalence of parasitic infection in ana before the 1960s can be easily understood from the data given by the Ministry of Health and Social Affairs in 1967. From a parasite control point of view, the 1960s was the preparatory period particularly for control of soil-transmitted helminthiasis. Several organizations which have contributed to parasite control were founded in this period and the prevention law of parasitic infections was passed in '66. In the '70s, overall prevalence rates of the common intestinal parasitic infections, which were highly prevalent in the past were turned into reduction phase for the first time. The '80s can be said to be an active control period of parasitic infections. Intestinal helminths According to the reports of the national prevalence survey on parasitic infections, the prevalence of helminthic infections was 84.3%(number of person examined:24,887) in '71, 63.2%(27,178) in '76, and 41.1%(35,018) in '81. By area, the prevalence rate in '81 was 35.1%(20,569) in urban areas and 49.6%(14,447) in rural areas. Intestinal nematodes Ascaris lumbricoides The prevalence of Ascaris infection has decreased significantly in recent years. Among students, the prevalence was 55.4%, in '69 and decreased to 4.7% in '83. In the national prevalence surveys, the prevalence decreased to 13.0% in '81 from 54.9% in '71. By area, the prevalence decreased to 8.5% in '81 from 46.4% in '71 in urban area and 19.4% in '81 from 59.6% in '71 in rural area. By age, the prevalence has become in recent years relatively even in all age groups, although higher prevalence used to be seen in young age groups of around 10 years old, particulary in the highly prevalent rural areas. By sex, the prevalence was higher in the female than in the male. Unfertilized egg positive rates among the ascariasis cases increased gradually up to 55.4% on the average in '81. The intensity of the infection was also significantly decreased. Trichuris trichiura Trichuris infection had also decreased to 23.4% in '81 from 65.4% in '71. By area, the decreasing tendency of the prevalence became faster in urban areas than in the rural areas. The prevalence in urban and rural areas in '71 was 69.7%, and 63.1% respectively and decreased to 19.5% and 29.0% respectively in '81. By age, the prevalence reached a peak at the 10-14 age group and showed relatively even distribution throughout all age groups. By sex, the prevalence was close in young age groups, but in the 30s or over age group, especially in rural area, the prevalence was significantly higher in the female than in the male. The prevalence has much fluctuated depending in the area. The prevalence in rural areas surveyed in the '80s shows a range between 20.9% and 73.7% by locality. It is anticipated that the prevalence of Trichuris infection will drop more rapidly, when mass treatment is conducted. Hookworms Hookworm infection by mostly Ancylostoma duodenale and a few by Necator americanus has decreased to a negligible levels in recent years. In the national prevalence surveys, the prevalence was 10.7% in '71, 2.2% in '76, and 0.5% in '81. The prevalence was higher in rural areas than in urban areas. Wide application of multi-specific anthelminthics in the ascariasis control programmes conducted in the past decade appear to have been effective against hookworm infection. Trichostrongylus orientalis As in the case with hookworm infection, the prevalence of Trichostrongylus infection has reached a negligible levels. In the national prevalence surveys, the prevalence was 7.7% in '71, 1.0% in '76 and 0.2% in '81. Enterobius vermicularis In the national prevalence survey in '81, the egg positive rate was 12.0%. Higher prevalence is expected when examined repeatedly. The prevalence rate was 10.3% in urban area and 14.6% in rural area. In recent surveys conducted in rural areas among schoolchildren, the prevalence was 32.4% in Gimhae Gun in '82 and 64.1% in Yeongyang Gun in '83. By age, the egg positive rate was higher in young age groups of around 10 and sharply decreased in age groups of around 20 and then somewhat increased again in middle age groups. By sex, the prevalence was higher in the female than in the male. Strongyloides stercoralis Strongyloides stercoralis infection has rarely been found in Korea. Three cases were reported in 1914. And 0.1-0.5% were found infected out of 2,642 persons examined at the prisoner-of-war camp on Geojedo in 1956. One case was reported in '54 and '82, respectively. Anisakis spp. No systematic survey has been conducted for anisakiasis In Korea. So far, only several cases have been found 1 case in Seoul in '71, 5 cases in Busan in '81 and 1 case in Busan in '84. Intestinal trematodes Metagonimus yokogawai In the national prevalence survey conducted in 1981, the egg positive rate was 1.24% on the average. High endemic areas are located in the southwestern part of Korea. The prevalence in Hadong Gun was 29.1% on the average in '79. In a survey conducted in 76, the prevalence was 44.0% in Gwangyang, 55.0% in Gogseung and 29.0% in Gurye. The infection is closely correlated with raw sweetfish consumption in these areas. Other intestinal trematodes A human case of Heterophyes heterophyes was reported in 1914. Several species were reported in the '80s : 17 cases of Fibricola seoulensis, 9 cases of Pygidiopsis summa, 8 cases of Heterophyes heterophyes nocens, 1case of Heterophyopsis continua, 2 cases of Stellantchasmus falcatus, 1 case of Stictodora sp., 1 case of Echinostoma hortense, and 4 cases of Echinochasmus japonicus. As the intermediate hosts, snakes and frogs play a role for F.seoulensis and fish for the rest of the species. Intestinal cestodes Taenia saginata and T. solium Egg positive rates in the national prevalence survey were 0.7% in '76 and 1.1% in '81. The prevalence in '81 was 0.6% in urban area and 1.8% in rural area. The proglottid positive rate in Jeju Do was 19.2% on the average. On Udo, Jeju Do in 1983, the egg positive rate among the inhabitants was 2.9%. Hymenolepis nana In the national prevalence survey, egg positive rates were 0.6% in '76 and 0.4% in '81. No difference was seen in the prevalence by area and sex. Hymenolepis diminuta Infected cases were reported : 3 in '64 and I in '66. Egg positive rate in '81 was 0.01% in the national prevalence survey. Diphylobothrium latum So far, about 30 cases have been reported. The cases have been reported more frequently in recent surveys. Mesocestoides sp. A case was reported from a hospitalized patient in Seoul in '67. Spirometra erinacei Two cases were reported in '84 following reidentification of the adult worms collected in '74. Intestinal protozoa Out of a total of 23 species of human protozoan infections in Korea, 13 species were reported as intestinal protozoa : Entamoeba histolytica, E coli, Endolimax nana, Iodamoeba b$\ddot{u}$tschlii, Dientamoeba fragilis, Giardia lamblia, Chilomastix mesnilii, Embadomonas sp., Enteromonas hominis, Trichomonas hominis, Isospora belli, I. Hominis(Sarcocystis hominis), and Balantidium coli. Since the first report on intestinal protozoan infections in 1925, there have been quite a few survey data on the prevalence of the infection. It was found reviewing the data chronologically that up to the early '70s the infection was prevalent around a 30-50%. After that, the protozoan cyst positive rate has shown the tendency of gradual decrease throughout the country. Protozoan cyst survey conducted in Seoul and several provinces in 1981 revealed infection rates of 8.9%(1,310) in Gangweondo, 10.7%(1,703) in Gyenggi Do, 11.7%(1,032) in Jeonra Buk Do, 9.1%(4,116) in Jeonra Nam Do, and 1.4%(5,275) in Seoul. Entamoeba histolytica In the survey conducted by province in '81, the cyst positive rate was 0.8% in Gangweon-do, 0.3% in Gyeonggi Do, 1.4% in both Jeonra Buk Do and Jeonra Nam Do, and 0.2% in Seoul. Giardia lamblia In the survey by province in '81, cyst positive rates were 2.2% in both Gyeonggi Do and Jeonra Buk Do, 1.9% in Jeonra Nam Do, 0.5% in Gangweon Do, and 0.9% in Seoul. Balantidium coli Two cases were reported. One in 1930 and the other in '74. Isospora belli and I. Hominis(Sarcocystis hominis) Isospora belli was reported : 1 case in '56 and 3 cases in '66. I. Hominis, recently identified to be synonymous with Sarcocystis hominis, was reported : 3 cases in '66. Other intestinal protozoa The protozoan parasites other than the above mentioned are generally treated as commensal, although some of them are considered to be pathogenic. The data of '81 show that about 10% of the inhabitants are still infected with protozoa.

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