浙江省温州市<8月龄婴儿麻疹流行特征及危险因素分析  

Epidemiology of measles in infants aged < 8 months and related risk factors in Wenzhou,Zhejiang

作　　者：李万仓[1] 王志刚[1] 孙肖瑜[1] 陈玲萍[1] 郑晓春[1] 林献丹[1] 

机构地区：[1]温州市疾病预防控制中心,浙江温州325001

出　　处：《疾病监测》2014年第4期294-297,共4页Disease Surveillance

摘　　要：目的了解浙江省温州市〈8月龄婴儿麻疹高发的原因，为探讨降低小月龄婴儿麻疹发病免疫策略提供依据。方法采用描述性流行病学方法，分析温州市2009—2013年〈8月龄350例婴儿麻疹的分布特征；以麻疹确诊病例为病例组，非麻疹病例为对照组，用logistic回归分析法研究危险因素；对血清抗体浓度检测并进行，检验。结果温州市2009—2013年年均麻疹发病率为83．05／10万，〈8月龄婴儿麻疹病例占总病例数的35．79％，主要集中在6～8月龄。与发病前7—21天去医院就诊相比，无医院就诊史的OR值为0．68（95％CI：0．49—0．94）；与外地户籍比，本地户籍人口〈8月龄麻疹发生的OR值为0．53（95％CI：0．39—0．72）；居住在现住址≤3月龄麻疹发生的OR值为1．53（95％CI：1．07～2．18）。新生儿和6月龄婴儿的平均抗体浓度分别为214．94IU／L和86．38IU／L，麻疹血清抗体浓度显示健康婴儿6月龄时仅有18．07％的免疫保护力。结论〈8月龄婴儿麻疹抗体浓度较低是麻疹发病的易感人群，院内感染和流动人口是发病的危险因素。建议对育龄妇女婚前接种含麻疹成分的疫苗，以提高母传麻疹抗体的水平。同时加强流动人口管理和院内感染控制工作。Objective To understand the reason for the high incidence of measles in infants aged 〈 8 months in Wenzhou, Zhejiang province, and provide evidence for the development of measles immunization strategy to reduce the incidence of measles in young infants. Methods Descriptive epidemiological analysis was conducted on the 350 measles cases in infants aged 〈 8 months in Wenzhou reported to national measles surveillance information management system during 2009 -2013. Frequency matching case control study was conducted （case group： measles cases reported through surveillance system,control group： non measles cases）. Logistic regression analysis was done to identify risk factors, and the serum antibody level to measles virus was detected. Results The average annual incidence rate of measles was 83.05/lakh during 2009-2013 in Wenzhou, the cases in infants aged 〈 8 months accounted for 35.79% of the total and were mainly distributed in age group 6 - 8 months. The OR for infants receiving no medical care 7 days before the onset was 0. 68 （95% CI： 0. 49-0. 94）. Compared with the infants in floating population, the OR was 0. 53 （95% CI： 0. 39-0. 72） for local infants aged 〈8 months and 1.53 （95% CI： 1.07-2. 18） for local infants aged 〈3 months. The detection of serum measles antibody level in healthy infants indicated that the mean antibody level was 214.94 IU/L for the newborns and 86. 38 IU/L for infants aged 6 months, and over 80% of infants in Wenzhou might be susceptible to measles at the age of 6 months,. Conclusion Infants aged 〈 8 months are at risk to be affected by measles due to low antibody level among them and other risky factors, such as nosocominal infection and being floating population. The reproductive women are recommended to receive MCV vaccination before marriage to increase maternal measles antibody level. It is necessary to strength the management of floating population and control of nosocominal infection.

关 键 词：婴儿麻疹 危险因素 流行特征 抗体浓度 

分 类 号：R511.1[医药卫生—内科学]