贵州省平坝县伤寒副伤寒流行特征及危险因素研究  

Research on epidemiological features and risk factors of typhoid and paratyphoid fever in Pingba County, Guizhou Province

作　　者：姚光海[1] 唐光鹏[1] 陈学 田克诚[1] 张静[3] 孙军玲[3] 王子军[3] 蒋有琴[4] 赵启良 杜江平 陈少芬 黄艳[1] 黎明[1] 王定明[1] 

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550001 [2]贵州省平坝县疾病预防控制中心,贵州平坝561100 [3]中国疾病预防控制中心疾病控制与应急处理办公室,北京102206 [4]安顺市疾病预防控制中心,贵州安顺561000

出　　处：《现代预防医学》2014年第3期385-388,392,共5页Modern Preventive Medicine

基　　金：科技部公益性行业科研专项(200802025);贵州省“十一五”社会发展科技项目(黔科合S字【2007】1037)

摘　　要：目的探讨平坝县伤寒、副伤寒流行特征及发病危险因素,为采取针对性干预措施提供依据。方法采用描述性流行病学方法分析平坝县2005-2008年伤寒副伤寒疫情特征,对暴发或聚集性病例采取现场回顾性病例对照调查,对村(居)民个人习惯和环境相关因素采用现况调查。结果平坝县伤寒副伤寒全年均有病例报告,6-10月为发病高峰;发病以青壮年为主,学生和农民居多;甲型副伤寒沙门菌为流行优势菌型。暴发主要危险因素为饮用水被污染;病前2周喝生水(OR=6.42,χ2=11.28,P<0.01)聚集性甲型副伤寒病例的危险因素与每周喝水大于15次以上有统计学联系(OR=10.55,χ2=4.71,P<0.05);饭前偶尔或不洗手(OR=2.81,χ2=3.92,P<0.05)为散发病例的危险因素。现况调查农村饮用水存在安全隐患,蓄水池无消毒设施,改厕率低(9.11%),多数厕所粪便未无害化处理;城区餐饮店食品卫生合格率偏低,人群伤寒副伤寒防治知识知晓率为22.61%,66.56%喝生水。结论平坝县伤寒副伤寒传染源广泛存在,应严格管理传染源,加强饮用水和食品卫生管理,针对个人卫生习惯和就医行为开展健康教育,才能有效控制伤寒副伤寒的流行或暴发。Objective To probe the epidemiological features and risk factors of typhoid fever and paratyphoid fever in Pingba County, Guizhou Provinceial Pingba Count, and provide evidences for developing its prevention measures. Methods The descriptive epi- demiology was used to analyze epidemiological characteristics of typhoid and paratyphoid fever during 2005-2008 in Pingba Coun- ty, where a field retrospective case-control study on the outbreak and clustered cases and a prevalence study on villagers/inhabi- tants＇ personal habits and environment-related factors were performed. Results The cases of typhoid and paratyphoid fever would take place in tbe whole year with a peak from June to October in Pingba County. All stages of age were subject to this disease with the highest morbidity occurring in youth and adults. Farmers and students were the main targets. Salmonella paratyphoid A was the most dominant bacteria. According to the field survey, polluted drinking water was the main risk factor of the outbreak. Drinking raw water before falling ill two weeks （OR=6.42, ~2_ 11.28, P〈0.01） was the risk factor of the clustered cases. There was a statistical correlation between drinking fifteen times a week and clustered cases （OR=10.55, ~=4.71, P〈0.05）. And occasionally or not wash- ing hand before meals （0R=2.81, ~=3.92, P〈0.05） was the risk factor of sporadic cases. Cross-section survey found that the rural drinking water existed potential safety hazard and there were no sterilizing facilities for reservoir, along with low-rate work of sani- tary toilets （9.11%）, Excrements from most toilets weren＇t treated to be harmlessness. Eating and drinking establishments in urban areas were disqualified in hygier, e. With regards to the population＇s awareness, attitude and behavior towards typhoid and paraty- phoid fever, which displayed thai： only 22.61% persons acquired the knowledge of typhoid and paratyphoid fever, and 66.56% persons drank uncoiled water. Conclusion There are wide infective sources of

关 键 词：伤寒 副伤寒 危险因素 病例-对照研究 

分 类 号：R181.3[医药卫生—流行病学]