上海市黄浦区幼托机构手足口病相关因素调查  

Investigation on related factors of hand-foot-mouth disease in preschools institutions in Huangpu District of Shanghai

作　　者：韩颖俊[1] 王怡珺[1] 毛宇明[1] 王曙[1] 郦佳莹[1] 沈福杰[1] 陆璐[1] 王侃[2] 王旭虹 HAN Ying-jun;WANG Yi-jun;MAO Yu-ming;WANG Shu;LI Jia-ying;SHEN Fu-jie;LU Lu;WANG Kan;WANG Xu-hong(Acute Infectious Disease Control Section,Huangpu Center for Disease Control and Prevention.,Shanghai,200023,China;School of Public Health,Shanghai Jiao Tong University,Shanghai,200025,China;Huangpu District Semi Sung Garden Community Health Service Center,Shanghai,200011,China)

机构地区：[1]上海市黄浦区疾病预防控制中心急性传染病防治科,上海200023 [2]上海交通大学公共卫生学院,上海200025 [3]上海市黄浦区半淞园社区卫生服务中心,上海200011

出　　处：《职业与健康》2018年第16期2244-2249,共6页Occupation and Health

基　　金：2015年黄浦区卫生计生系统科研项目(HKW201554)

摘　　要：目的手足口病是一种通过多种肠道病毒引起的常见传染病,以婴幼儿发病为主。本研究旨在采用病例对照研究方法,调查手足口病相关的发病危险因素,从而为疾病的预防控制和卫生部门的有关政策制定提供科学依据。方法采用多阶段分层抽样,根据2015年9月—2018年3月上海市黄浦区手足口病疫情暴发的区域分布特征,以街道为1级单位,按比例将调查所需的病例数分配至辖区内所有街道。再以街道内的社区卫生服务中心作为调查点,从所辖范围内随机选取幼托机构收集足够的病例组。对照组是从病例所在班级随机选择未患病的年龄相差±3月,且性别相同的儿童。对于病例组和对照组进行研究时,先采用单因素χ~2检验,在α=0.05的水准下筛选出可疑的影响因素,对其进行量化后,设为自变量,并以患病与否为应变量进行非条件logistic回归分析。结果单因素分析所得的结果显示,儿童主要养育人为父母(χ~2=11.774,P<0.01),照看人的教育程度高低(χ~2=20.149,P<0.01),儿童平时如厕所用卫生用具(抽水马桶、痰盂等)(χ~2=8.443,P<0.01),家庭中饲养宠物的情况(猫或狗)(χ~2=15.655,P<0.01),儿童上下学乘坐校车(χ~2=8.578,P<0.01),儿童有吮吸手指习惯(χ~2=5.507,P<0.05),家中大人有咀嚼喂食儿童的习惯(χ~2=11.437,P<0.01),在病例组和对照组之间差异有统计学意义。多因素分析结果显示,照看人受教育程度较低、上下学乘坐校车是危险因素,而家中不饲养猫狗等宠物为保护因素。结论儿童在家时的主要照看人对于儿童养成健康卫生习惯,从而减少患病风险等有着重大的意义。家中宠物的饲养(猫或狗)也存在致病隐患,应加强宠物的卫生清洁,避免儿童与之过于亲密的接触玩耍。应加强对幼托机构校车的清洁消毒工作,定期抽检,注意乘坐人数以及乘车儿童的健康状况,避免出现传播流行。部分儿童家长仍存在�[Objective]The hand-foot-mouth disease（HFMD） is an acute infectious disease of young children,which is caused by various enterovirus. The purpose of this study is to investigate the risk factors related to HFMD by case-control study,so as to provide a scientific basis for relevant departments to formulate the policy. [Methods] By using the multi-stage stratified sampling method,according to the regional distribution characteristics of HFMD outbreak in Huangpu District in recent 3 years,the number of cases required in the study was allocated to all streets in the district in proportion by taking the street as level-one unit. The the community health service center in the street was selected as the the investigation point,to randomly collect enough cases from the preschools institutions in the area. The children in the control group were collected from the same class of the case,and who were the same sex of the case and the difference of age was not more than three months with the case. The suspicious influencing factors were screened by single factor χ^2 test while α=0.05,and then were set as the independent variable after the quantification,and non-conditional logistic regression analysis was carried out with the illness as the dependent variable. [Results] Results obtained from single factor analysis should that the parents are the primary caregivers of children（χ^2=11.774,P〈0.01）,education level of caregivers（χ^2=20.149,P〈0.01）,sanitary appliances for children（such as flush toilet,spittoon）（χ^2=8.443,P〈0.01）,keeping pets in the family（cat or dog）（χ^2=15.655,P〈0.01）,children ride the school bus（χ^2=8.578,P〈0.01）,children have the habit of sucking fingers（χ^2=5.507,P〈0.01） and adults have the habit of chewing feeding children（χ^2=11.437,P〈0.01） were the suspicious influencing factors,and there were significant differences between the case group and the control group. Multivariate analysis showed that the low education level of the caregivers and child

关 键 词：手足口病 危险因素 病例对照研究 

分 类 号：R181.3[医药卫生—流行病学]