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深圳市3 551例妊娠梅毒患者的性伴追踪情况及其影响因素分析
作者:吴肖冰 洪福昌 张春来 冯铁建 蓝丽娜 杨应周

摘要:

目的  分析深圳市妊娠梅毒患者的性伴追踪情况及其影响因素。方法  以深圳市各助产机构发现的18岁以上,深圳市各助产机构接受产前保健服务,按中华人民共和国卫生行业标准《梅毒诊断标准(WS 273-2007)》确诊为梅毒患者,确诊时间在2008年1月1日至2011年12月31日,以及愿意参加本研究的妊娠梅毒患者为研究对象,共3 551例。采用面对面访谈的方法填写结构化问卷,包括妊娠梅毒患者的一般人口学信息(年龄、文化水平、职业等)、实验室检测结果、疾病诊断、个人生活史、性伴通知意愿、性伴的追踪结果及实验室检测结果。采用多因素非条件logistic回归模型分析妊娠梅毒患者的性伴追踪情况的影响因素,计算OR(95%CI)值。结果  3 551例妊娠梅毒患者的年龄为(28.72±5.21)岁,最大49岁,最小18岁。3 551例妊娠梅毒患者中,2 550例患者的性伴到产前门诊进行梅毒检测,性伴追踪率为71.81%,其中,妊娠梅毒患者性伴的梅毒患病率为27.88%(711例)。与高中及以下文化程度者相比,本科以上者完成性伴追踪的OR(95%CI)值为1.70(1.26~2.30);与已婚者相比,未婚或离婚者完成性伴追踪的OR(95%CI)值为0.57(0.45~0.71);与孕周≤27周者相比,28~ 36和>36周或临产者完成性伴追踪的OR(95%CI)值为0.73(0.56~0.94)和0.65(0.53~0.81);与隐性梅毒患者相比,梅毒足量治疗者完成性伴追踪的OR(95%CI)值为1.45(1.14~1.84);与规范治疗者相比,未治疗或不规范治疗者完成性伴追踪的OR(95%CI)值为0.31(0.24~0.39);与完成妊娠者相比,终止妊娠者完成性伴追踪的OR(95%CI)值为0.53(0.43~0.65);与仅恋爱1次者相比,恋爱≥2次者完成性伴追踪的OR(95%CI)值为1.24(1.05~1.46);与不愿意告知性伴者相比,愿意告知者完成性伴追踪的OR(95%CI)值为4.74(3.54~6.35)。结论  妊娠梅毒患者性伴追踪率较高;患者性伴追踪的完成情况受到患者文化程度、婚姻状况、孕周、疾病分期、治疗情况、妊娠结局、恋爱次数和性伴告知意愿的影响。

关键词:梅毒;孕妇;性伴告知;接触者追踪;横断面调查

Abstract:

Objective  To investigate the current status of contact tracing among pregnant women infected with syphilis and to analyze the associated factors from patients' perspective.Methods  Pregnant women who aged 18 years old, receiving prenatal care services in Shenzhen, diagnosed with syphilis according to national diagnostic criteria (WS 273-2007) from 2008 to 2011 were recruited and the total number was 3 551. Information of both pregnant women (including demographic information, laboratory results, syphilis diagnosis, and personal life history) and their partners (including results of partner tracing and laboratory examination) were collected with structured questionnaire by face-to-face interview. Multivariate non-conditional logistic regression model was applied to analyze the factors associated with partners' contract tracing. Odds ratio (OR) and its 95% confidential interval (95%CI) were calculated.Results  The average age was 28.72 among recruited 3 551 syphilis-infected pregnant women, with standard deviation of 5.21 and range of 18 to 40. Totally 2 550 partners attended antenatal clinics and received syphilis examination, with a contact tracing rate of 71.81%. The OR(95%CI) was 1.70(1.26-2.30) for pregnant women with college or above education when comparing with those with senior high school or below education. The OR(95%CI) was 0.57(0.45-0.71) for those unmarried or divorce when comparing with those married. The OR (95% CI) was 0.73(0.56-0.94) and 0.65(0.53-0.81) for those screened in 28-36 gestational weeks and those screened in >36 gestational weeks or right before delivery separately, when comparing with those screened in ≤27 gestational weeks. The OR (95% CI) was 1.45(1.14-1.84) for those having received sufficient treatment before pregnancy when comparing with those diagnosed with latent syphilis. The OR(95%CI) was 0.31 (0.24-0.39) for those having no treatment or not standardized treatment when comparing with those having standardized penicillin treatment. The OR(95%CI) was 0.53 (0.43-0.65) for those terminating the pregnancy when comparing with those giving birth to a baby. The OR(95%CI) was 1.24 (1.05-1.46) for those having two or more love histories when comparing with those having only one love history. The OR(95%CI) was 4.74 (3.54-6.35) for those intending to disclose the serostatus to their partner when comparing with those showing unwillingness to disclose the serostatus.Conclusion  The successful rate of contact tracing among pregnant women infected with syphilis was high. The implementation of contact tracing may be affected by many factors, including patients' education levels, marital status, gestational weeks of screening, stage of syphilis, treatment status, outcome of pregnancy, number of love histories, and willingness of serostatus disclosure.

Key words: Syphilis;Pregnant women;Partner notification;Contact tracing;Cross-section study

发表日期:2015/12

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2015.12.010.T001:表1 深圳市不同特征妊娠梅毒患者基本情况及性伴追踪情况比较

    10.3760/cma.j.issn.0253-9624.2015.12.010.T001:表1 深圳市不同特征妊娠梅毒患者基本情况及性伴追踪情况比较

  • 10.3760/cma.j.issn.0253-9624.2015.12.010.T002:表2 深圳市3 551例妊娠梅毒患者性伴追踪影响因素的多因素非条件二分类logistic回归模型分析

    10.3760/cma.j.issn.0253-9624.2015.12.010.T002:表2 深圳市3 551例妊娠梅毒患者性伴追踪影响因素的多因素非条件二分类logistic回归模型分析

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