一起甲型病毒性肝炎流行病学调查分析  

Investigation of risk factors in a hepatitis A epidemic in Hubei Province

作　　者：赵明江[1] 吕桂阳[1] 钱足庶[2] 岳金亮[1] 刘公平[1] 赵克堤[2] 

机构地区：[1]湖北省疾病预防控制中心,武汉430079 [2]湖北省黄石市疾病预防控制中心

出　　处：《公共卫生与预防医学》2010年第2期34-38,共5页Journal of Public Health and Preventive Medicine

摘　　要：目的通过对湖北省某县甲肝流行病学特点进行分析,查找甲肝流行影响因素,为今后预防控制甲肝提供科学依据。方法采用描述流行病学及分析流行病学方法,对甲肝疫情和流行危险因素进行分析。结果此次甲肝流行持续时间长,从2009年1月至4月3日,共报告发病194例,无重症和死亡病例发生。疫情波及5个乡镇、76个村、78所中小学校及托幼机构,病例呈高度散发。男女性别比为2:1,2～14岁儿童占总病例数的88.66%,中小学生、散居及托幼儿童为主要发病对象。排除水源性和食源性爆发,疾病主要通过日常生活接触传播,病例组与对照组发病前一个月"不良饮食史"、"饮水习惯"、"学校就餐史"、"外出打工父母返回"无显著性差异,外出就餐方式中"聚餐"(χ2=7.428,P<0.01)、"摊点"(χ2=14.233,P<0.01),"洗手习惯"(χ2=9.905,P<0.01)有显著性差异,对该3个变量做多因素Logistic回归,仅"摊点"与发病有关(P<0.01),提示常在外面摊点就餐可能是造成疾病感染的危险因素。结论当地甲肝疫苗接种率不高、常年有甲肝散发病例发生、群众防病意识不强、儿童生活卫生习惯差、春节期间大量人口流动、疫情发生早期未严格落实各项防控措施是造成此次甲肝大面积流行的主要因素。Objective To identify the epidemiological factors of hepatitis A and provide evidence for its prevention and control in a county in Hubei province.Methods Descriptive and analytical epidemiological methods were used to analyze the characteristics and risk factors of hepatitis A.Results The epidemic of hepatitis A had a long duration and spread to a wide area.Most cases were primary and middle school students and also children from kindergartens.Male cases were more than female.Aged from two to fourteen years predominated in this epidemic.The epidemic was mainly transmitted by daily contact,food-borne and water-borne transmission might be excluded..Risk factors might be the behavior of students having meal in the poor hygienic restaurants.Conclusions The comprehensive influence of many factors such as：the low rate of vaccination,the frequent occurrence of sporadic cases,the poor awareness of disease prevention,the unhealthy habit of children,the frequent gathering during the Spring Festival and the lack of effective prevention measure at the onset of the epidemic.all the above factors lead to the wide spread of hepatitis A.Under the concern of the government and the joint efforts carried out by the related departments,after the implementation of vaccination for the susceptible people,and cutting off the transmission,the hepatitis A epidemic was under control.

关 键 词：甲肝 流行病学调查 病例对照研究 

分 类 号：R512.61[医药卫生—内科学]