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강화도 학교인구의 폐흡충 감염에 대한 고찰

Other Titles
 (A) study on paragonimus westermani infection among school population in Gangwha area 
Authors
 한경민 
Issue Date
1982
Description
의학과/석사
Abstract
[한글] 폐흡충은 한국에 만연되고 있는 풍토병 중의 하나로서 小林(1921)의 객담검사와 Walton & Chyu(1959)에 의한 피내반응 조사이래 전국에서 지역적으로 조사 보고되어 왔다. 최근에 이르러 주민의 피내반응 양성률과 중간숙주의 서식이 점차 감소되는 경향을 보이고 있 는데 이는 경제 수준의 향상, 농약 사용의 증가로 인한 중간숙주의 사별, 수리시설의 확대로 인한 수량의 감소 및 보건계몽의 효과 등에 원인이 있다고 보여진다. 경기도 강화군에 있어서 조사된 바에 의하면 폐흡충 만연지역으로 알려졌지만 본도 외곽도서지역으로는 교동도(면)의 국민학생과 주민을 대상으로 조사(尹 등, 1965)된 이래 아직 조사된 바가 없다. 이에 저자는 외곽도서인 교동도 및 삼산도(면)국민학생과 중 ·고생 2,380명을 대상으로 피내반응 검사에 의한 양성률과 중간숙주를 조사하였으며, 또한 초 ·중 ·고생 1 ,302명을 대상으로 설문지에 의한 식습성 및 폐흡충에 대한 보건지식을 조사하여 다음과 같은 결과를 얻었다. 1. 지역별 폐흡충감염 양성률은 교동면이 1,845명중 152명(8.2%)이 양성이었고, 삼산면은 637명중 21명(3.3%)이 양성이었다. 남녀별로는5.8%와 8.2%로 여학생이 다소 높은 양성률이었다. 2.학년별로는 국교생 5.0%(973명중 49명), 중학생 6.2%(962명중 62명) 및 고등학생 6.9%(445명중 53명)로 고학년일수록 양성률이 높았다. 3. 피내반응 양성자 164명중 3명에서만 객담내 충란이 검출됐으며, 분변에서는 검출되지 않았다. 4. 중간숙주로서 가재를 교동면에서 28마리, 삼산면에서 12마리 채집하여「메타셀카리아」 감염여부를 조사하였으나 검출되지 않았다. 5. 대조군으로 본도내 국민학교 2개교를 선정하여 6학년생을 조사한 결과 내가국민학생의 4.8%와 하점국민학생에서는 양성자를 볼 수가 없어 과거(尹등, 1965)보다 현저하게 감소되었음을 알았다. 6. 식습성 조사에 의한 중간숙주(가재)를 생식한 학생은 1.2%(1,274명중 15명)였으며, 익혀서 먹은 학생은 27.0%(988명 중 266명)였다. 7. 폐흡충에 대한 보건지식 조사에서는 「제 2중간숙주」와 「예방」에 대한 물음에서 28.2%와 26.3%의 정답률을 보였다. 이상의 결과로서 강화도 학교 인구의 폐흡충감염은 최근 현저하게 감소되는 경향을 보이고 있으나 본도 외곽도서의 일부 지역에서는 아직 양성률이 타지역 보다 다소 높게 나타나는 것을 알 수 있어 이들이 어떤 경로로 감염되었는지 앞으로 철저한 역학적 면에서 의 원인 규명과 국민보건 향상을 위한 계몽사업, 치료사업 등이 진행되어야 할 것으로 사려되는 바이다. A Study on Paragonimus westermani Infection among school Population in Gangwha Area Kyung Min Han Department of Medical Science The Graduate school Yonsei University (Directed by Prof. Keun Tae Lee, M.D.) Paragonimus westermani is one of the most popular endemic parasitic diseases in Korea. The nation-wide prevalence survey were carried out by Gobayashi (1921) with sputum examination and by Walton and Chyu (1959) with the intradermal skin test respectively. Recent studies showed the decline of positive rate in intradermal skin test of the local inhabitants and also showed the less distribution of intermediate host. The fact seemed that caused by economic improvement of village people, decrease of intermediate host by increasing use of pesticides, becoming lower water level at streams and rivers and better irrigation and finally by better community health education etc. Gangwha area of Gyeonggi-Do was found out as an endemic area of Paragonimus westermani through some studies in the past, however, in the vicinity area of Gangwha, the study in Kyodong island(myon) was carried out in 1965 by Yun et al. Therefore author carried out the intradermal skin test for 2,380 students of primary, middle and high school in Kyodong island and Samsan island. Additionally, the auther surveyed on health knowledge about P. wgstermani and food habit for 1,302 students of primary, middle & highschool. The results showed as follows : 1. The positive rate of intradermal testfor paragonimus westermeni infection stowed positive in 152 among 1,845 students(8.2%) in Kyodong island, and 21 among 637 students(3.3%) in Samsan island respectively. In sex distribution, girls showed higher(8.2%) than boys(5.8%). 2. According to grade levels, 49 among 973 students(5.0%) in primary school, 62 among 962 students(6.2%) in middle school and 53 among 445 students(6.9%) in high school showed positive rate. This showed the higher grade the higher positive rate. 3. Among these total 164 positive cases in the! intradermal skin test, only in 3 cases eggs were found in sputum and none of egg was found in stool. 4. Finding out the intermediate host, only 28 crayfishes from Kyodong Island and 12 from Samsan Island were collected and examined for metacercaria infection, however, none of metacercaria was found. 5. As a control group, 2 primary schools from the main island were selected. In these schools from the sixth grade students stowed positive rate of 4.8% in Naega Primary School and 0% in Hajeom Primary School respectively. Those results showed much decrease than studies carried out in the past. 6. The survey for food habit stowed that 15 among 1,274 students (1.2%) had experiences of eating raw intermediate host (crayfish)and 266 among 988 students (27.0%) ate cooked. 7. The questionnair survey about health knowledge for Paragonimus westermani showed correct answer 28.2% about second intermediate host and 26.3% about preventive measures respectively.
[영문] Paragonimus westermani is one of the most popular endemic parasitic diseases in Korea. The nation-wide prevalence survey were carried out by Gobayashi (1921) with sputum examination and by Walton and Chyu (1959) with the intradermal skin test respectively. Recent studies showed the decline of positive rate in intradermal skin test of the local inhabitants and also showed the less distribution of intermediate host. The fact seemed that caused by economic improvement of village people, decrease of intermediate host by increasing use of pesticides, becoming lower water level at streams and rivers and better irrigation and finally by better community health education etc. Gangwha area of Gyeonggi-Do was found out as an endemic area of Paragonimus westermani through some studies in the past, however, in the vicinity area of Gangwha, the study in Kyodong island(myon) was carried out in 1965 by Yun et al. Therefore author carried out the intradermal skin test for 2,380 students of primary, middle and high school in Kyodong island and Samsan island. Additionally, the auther surveyed on health knowledge about P. wgstermani and food habit for 1,302 students of primary, middle & highschool. The results showed as follows : 1. The positive rate of intradermal testfor paragonimus westermeni infection stowed positive in 152 among 1,845 students(8.2%) in Kyodong island, and 21 among 637 students(3.3%) in Samsan island respectively. In sex distribution, girls showed higher(8.2%) than boys(5.8%). 2. According to grade levels, 49 among 973 students(5.0%) in primary school, 62 among 962 students(6.2%) in middle school and 53 among 445 students(6.9%) in high school showed positive rate. This showed the higher grade the higher positive rate. 3. Among these total 164 positive cases in the! intradermal skin test, only in 3 cases eggs were found in sputum and none of egg was found in stool. 4. Finding out the intermediate host, only 28 crayfishes from Kyodong Island and 12 from Samsan Island were collected and examined for metacercaria infection, however, none of metacercaria was found. 5. As a control group, 2 primary schools from the main island were selected. In these schools from the sixth grade students stowed positive rate of 4.8% in Naega Primary School and 0% in Hajeom Primary School respectively. Those results showed much decrease than studies carried out in the past. 6. The survey for food habit stowed that 15 among 1,274 students (1.2%) had experiences of eating raw intermediate host (crayfish)and 266 among 988 students (27.0%) ate cooked. 7. The questionnair survey about health knowledge for Paragonimus westermani showed correct answer 28.2% about second intermediate host and 26.3% about preventive measures respectively.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/117293
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2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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