中越边境村庄感染性腹泻暴发疫情危险因素研究  

Study on the high risk factor of an infectious diarrhea outbreak in a Sino-Vietnamese border village

作　　者：徐世民[1] 谢志春[1] 谢艺红[2] 何为涛[2] 谢镇国[2] 谭毅[2] 朱建国[3] 

机构地区：[1]广西医科大学公共卫生学院,南宁530021 [2]广西壮族自治区疾病预防控制中心,南宁530028 [3]湖南师范大学,长沙410081

出　　处：《应用预防医学》2013年第5期272-275,共4页Applied Preventive Medicine

摘　　要：目的开展现场调查研究分析和确认中越边境广西大新县某屯一起感染性腹泻暴发疫情特征及其流行危险因素,为防控提供依据。方法建立病例定义并开展病例主动搜索,采用描述性流行病学的方法掌握病例的三间分布特征;采用病例对照研究方法,对调查对象的接触史、生活习惯、饮食习惯等因素进行分析,探讨暴露流行危险因素;采集部分病例的粪便、肛拭子及该屯的相关水样等进行实验室病原学和卫生学检测。结果 2012年10月8日至11月1日,该屯出现37例感染性腹泻病例,罹患率为31.90%,男性和女性的罹患率分别为29.82%和33.90%;发病具有明显的家庭聚集性;病例对照研究提示饭前是否洗手、便后是否洗手、厕所类型及是否使用蓄水池等情况是发病的危险因素;该村无集中供水、蓄水池未清洗消毒、水质卫生学检测指标不合格。结论依据病例的临床表现和流行病学特征,引起该起感染性腹泻疫情的危险因素有饭前是否洗手、便后是否洗手、厕所类型及是否使用蓄水池。由此推测该村人群因饮用不洁水源感染并通过粪口途径传播的;致病原为诺如病毒感染的可能性较大;防控上应改善当地卫生条件,加强卫生宣教,增强居民的卫生防病意识。Objective To Study on the characteristics and high risk factors of an infectious diarrhea outbreak in a Sino-Vietnamese border village located in Guangxi Region in order to provide evidence for prevention and control measures. Methods Case definition was established and active case searching was done, in combining with descriptive epidemic methods to determine the three distribution characters of cases. A case control study was carried out, case contact history, living habits, and dieting habit were analyzed to investigate epidemic high risk factors. Feces and anal swab and water was sampled and tested. Results From October 8th to December 1st of 2012, 37 diarrhea cases occurred, with an attack rate 31.90%. For male and female, the attack rate was 29.82% and 33.90% respectively. There was an obvious familial aggregation. According to case control study results, high risk factors included if washing hands before meal and after using toilet, type of toilet and if using the impounding reservoir.Centralized water supply was not available in the village, impounding reservoir was not sterilized routinely and the quality of water was not reached hygiene criterion.Conclusion According to the clinical symptoms and epidemiological characteristics of cases, high risk factors were non-hand-washing before meals and after using toilet, toilet type and if a reservoir was used, villagers were infected mainly because of drinking impure water and transmitted by fecal-oral route The pathogenic agent is more likely to be norovirus. Improving the local health conditions and strengthening health education to local residents, and enhancing their awareness of health and disease are the powerful prevention measures.

关 键 词：感染性腹泻 暴发 危险因素 

分 类 号：R516.101[医药卫生—内科学]