[논문]대한민국 사슴농가 종사자의 라임병 혈청유병률 및 위험요인

딜라람 아지리아; 조재학; 유석주; 박지혁

doi:10.5393/jamch.2019.44.2.082

대한민국 사슴농가 종사자의 라임병 혈청유병률 및 위험요인
Seroprevalence and risk factors of Lyme disease among Korean deer farmers 원문보기

農村醫學·地域保健 = Journal of agricultural medicine & community health, v.44 no.2, 2019년, pp.82 - 89

딜라람 아지리아 (동국대학교 의과대학 예방의학교실) , 조재학 (동국대학교 의과대학 예방의학교실) , 유석주 (동국대학교 의과대학 예방의학교실) , 박지혁 (동국대학교 의과대학 예방의학교실)

초록
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목적 : 이번 연구는 인수공통감염병의 고위험군인 사슴농가 종사자를 대상으로 라임병의 감염 실태 파악 및 위험요인 분석을 위해 수행하였다. 대상 및 방법 : 전국 시 군 지역의 사슴농가를 중심으로 516명에 대해 설문조사 및 혈청검사를 실시하였다. 라임병 진단방법은 IFA(Indirect Immunofluorescence antibody Assay, 간접면역형광항체법)와 IFA검사의 높은 위양성률을 보완하기 위해 ELISA 검사 그리고 Western Blot 법을 이용하였다. 결과 : 전국 사슴농가 종사자 516명의 라임병 최종 혈청 유병률은 2.3%이었으며, 엘크 (Cervus Canadensis)만을 기르는 사슴 농가 종사자의 라임병 혈청유병률이 3.6%로 다른 종류의 사슴을 키우는 사슴 농가 종사자보다 라임병 발병 위험이 통계적으로 유의하게 높았다(p = 0.033). 결론 : 국내 사슴농가 종사자들이 인수공통감염병인 라임병에 노출되어 있음을 확인하였고, 키우는 사슴의 종류나 작업 행태, 보호복 착용 여부 등에 따라 라임병 노출의 가능성이 다름을 확인할 수 있었다.

Abstract ▼ AI-Helper

This study was undertaken to determine the seroprevalence and risk factors associated with contracting Lyme disease (LD) among Korean deer farmers. This cross-sectional study devised questionnaire that addressed farm activities, was devised and the blood samples of 516 Korean deer farmers were tested. LD seroprevalence was determined by Western blot test. Fisher's exact test, the chi-squared test, and the chi-squared test for trend analysis were performed to assess the risk associated with LD. Of total 516 study participants recruited, only 12 (2.3%) were seropositive for LD. The result of the study revealed that only deer farmers raising Elk (Cervus Canadensis) were found to be at significantly higher risk of contracting LD than other deer farmers (p=0.033). In addition, a male sex, an age of < 40 years, and those that had raised deer for < 19 years had higher rates of LD infection than their counterparts. Similarly, those that managed livestock sheds, fed deer, processed industry and prepared compost had higher rates of LD infection. In terms of protective factors, those who did not use protective measures such as wear glasses and masks, or protective gloves and aprons, and those that did not disinfect work instruments and did not shower after work had higher rates of LD than those that used protective measures. In conclusion, preventive health strategies should take into account the profiles of deer farmers at greater risk based on considerations of personal, type of work, and the use of personal protective measures.

주제어

표/그림 (3)

표 Table 1. Personal Profle of the deer raisers associated with Lyme disease infection, South Korea, 2009
표 Table 2. Work-related factors of the deer raisers associated with Lyme Disease infection, South Korea, 2009
표 Table 3. Personal protective measures and work-hygiene factors of deer farmers and the risks of Lyme disease infection, South Korea, 2009

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문제 정의

However, risk reduction strategies must be derived using evidence-based information about the disease and its associated risk factors. Given the above background, we undertook this cross-sectional study to determine the seroprevalence and the risk factors of contracting Lyme disease in a cohort of Korean deer farmers.
This study was undertaken to determine the seroprevalence and risk factors associated with contracting Lyme disease (LD) among Korean deer farmers. This cross-sectional study devised questionnaire that addressed farm activities, was devised and the blood samples of 516 Korean deer farmers were tested.

제안 방법

A face-to-face interview was conducted with each participant in a livestock veterinary service laboratory or the Public Health and Environment Research Institute using a structured questionnaire. The research team consisted of 3–4 members, that is, a medical doctor, a nurse, and one or two interviewers.
KL, JHC and SYJ conceptualized the study. DA and SYJ analyzed the data and wrote the manuscript (with important contributions from JHP and JHC). All authors participated in the writing and the revision of the manuscript and in the analysis and interpretation of results.
Some limitations of the present study require consideration. First, although we analyzed relations between different farm activities and LD seropositivity, numbers of detected positive cases were too small to allow us to calculate odds ratios. Second, the selfreport information used may have introduced bias.

대상 데이터

The research team consisted of 3–4 members, that is, a medical doctor, a nurse, and one or two interviewers.
This study was undertaken to determine the seroprevalence and risk factors associated with contracting Lyme disease (LD) among Korean deer farmers. This cross-sectional study devised questionnaire that addressed farm activities, was devised and the blood samples of 516 Korean deer farmers were tested. LD seroprevalence was determined by Western blot test.

이론/모형

Initially, samples were screened for LD seropositivity using an immunofluorescence assay (IFA) or an enzyme-linked immunosorbent assay (ELISA). Diagnoses were using a Western blot test (20). Serum titers for IgG or IgM of >1:16 by IFA or of ≥1: 24 by ELISA were considered positive for LD.

성능/효과

Similarly, a working duration of <19 years was associated with a higher infection rate. A significant difference was observed between LD infection rates by type of deer raised and the rate was highest for those raising Elk (Cervus Canadensis) (3.7%; n=¹³⁸⁾ followed by those raising Beautiful spotted deer (Axis Axis) and ElK (Cervus Canadensis) (2.9%; n=138) (p=0.033).
In terms of protective factors, those who did not use protective measures such as wear glasses and masks, or protective gloves and aprons, and those that did not disinfect work instruments and did not shower after work had higher rates of LD than those that used protective measures. In conclusion, preventive health strategies should take into account the profiles of deer farmers at greater risk based on considerations of personal, type of work, and the use of personal protective measures.
Lyme disease (LD) is one of the most prevalent zoonoses worldwide and is caused by several genospecies of the spirochete Borrelia burgdorferi sensu lato complex. Of these genospecies, five human-pathogenic genospecies have been identified, namely, B. burgdorferi sensu stricto, B. afzelii, B. garinii, B. bavariensis, and B. spielmanii(1, 2). Human LD infections exhibit a wide variety of clinical manifestations from early phase erythema migrans, multiple erythema migrans, early neuroborreliosis, acute arthritis and carditis to neuro-borreliosis (meningo-radiculitis, meningitis or meningoencephalitis), Lyme arthritis, and/or borrelia lymphocytoma, which develops several weeks after infection (3-6).
3%) were seropositive for LD. The result of the study revealed that only deer farmers raising Elk (Cervus Canadensis) were found to be at significantly higher risk of contracting LD than other deer farmers (p=0.033). In addition, a male sex, an age of < 40 years, and those that had raised deer for < 19 years had higher rates of LD infection than their counterparts.

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