2012-2019年南宁市手足口病重症病例流行病学特征及危险因素分析  

Epidemiological characteristics and risk factors of HFMD severe cases in Nanning,2012-2019

作　　者：黄礼庆 陆婉珠 刘虹兰 何小玲 刘创善 HUANG Li-qing;LU Wan-zhu;LIU Hong-lan;HE Xiao-ling;LIU Chuang-shan(Xingning Center for Disease Control and Prevention,Nanning,Guangxi 530001,China)

机构地区：[1]广西南宁市兴宁区疾病预防控制中心,广西南宁530001

出　　处：《现代预防医学》2020年第19期3479-3482,3548,共5页Modern Preventive Medicine

摘　　要：目的分析南宁市手足口病重症病例流行病学特征及危险因素,为制定防控策略提供参考。方法收集2012-2019年南宁市手足口病定点医院重症病例资料,采用描述性流行病学方法进行分析。结果2012-2019年三家定点医院共报告手足口病重症病例1963例,死亡20例,重症率和重症死亡率分别为3.03%和1.02%,重症率和重症死亡率均呈下降趋势(χ^2趋势=162.55,P<0.001;χ^2趋势=16.09,P<0.001);重症主要发生在3岁以下儿童(83.24%),职业分布以散居儿童为主(88.84%),男性重症率高于女性(χ^2=16.88,P<0.001);发病时间集中在4-7月,农村重症率高于城市(χ^2=245.81,P<0.001);死亡病例主要在农村(85.00%);EV71型所占比例呈下降趋势(χ^2趋势)=125.58,P<0.001;多因素logistics分析显示:男性、0~3岁、散居儿童、居住农村、发病-就诊时间间隔≥2d是重症手足口病的危险因素;初诊在个体诊所/村卫生室、最后入院重症级别为重症Ⅲ期及以上、EV71型感染是死亡的危险因素。结论南宁市手足口病重症率和重症死亡率呈下降趋势,加强健康教育和EV71疫苗接种、及时到定点医院就诊是预防手足口病重症和死亡的关键。Objective To analyze the epidemiological characteristics and risk factors of severe cases of hand foot mouth disease in Nanning city and to provide reference for formulating preventing and controlling strategies.Methods The data of severe cases of HFMD in the designated hospitals of Nanning in the period of 2012-2019 were collected and analyzed by the descriptive epidemiological method.Results From 2012 to 2019,1963 severe cases(20 deaths)of HFMD were reported in three designated hospitals.The severe rate and the severe mortality rate were 3.03%and 1.02%respectively,both of which showed a downward trend(χ^2 t rend=162.55,P<0.001;χ^2 t rend=16.09,P<0.001).Children aged less than 3 years old had the highest risk for severe disease(83.24%).According to the distribution of HFMD severe cases by occupation,children living at home are most easy to be infected(88.84%).The incidence rate of severe cases in male was higher than that in female(χ^2=16.88,P<0.001).The peak time of incidence is from April to July.The severe cases fatality rate in rural areas was higher than that in urban areas(χ^2=245.81,P<0.001).Death cases mainly came from rural areas(85.00%).In terms of etiology,the proportion of EV71 decreased(χ^2 t rend=125.58,P<0.001).Multifactor logistics analysis results were as follows.Male,0~<3 years old,children living at home and in urban areas,time span between onset and treatment in or longer than 2 dayswere the risk factors of severe HFMD.The first visit in private clinics,the final diagnosis with severe stage III or more severe and EV71 positivity were the risk factors of death.Conclusion The severe rate and the severe mortality rate of HFMD in Nanning were both on the decline.The keys to reduce the incidence of HFMD severity and mortality are to strengthen health education,vaccinate against EV71 and go to designated hospitals in time.

关 键 词：手足口病 重症 流行病学 危险因素 

分 类 号：R181.3[医药卫生—流行病学] R725.1[医药卫生—公共卫生与预防医学]