广西2015—2020年腹泻患者诺如病毒流行特征及相关因素分析  

Analysis of epidemic characteristics and related factors of norovirus in diarrhea patients in Guangxi,2015-2020

作　　者：钟延旭[1] 黄兆勇[1] 蒋玉艳[1] 谭冬梅[1] 石萌萌[1] 潘玉立 黄立嵘[1] 姚雪婷[1] ZHONG Yan-xu;HUANG Zhao-yong;JIANG Yu-yan;TAN Dong-mei;SHI Meng-meng;PAN Yu-li;HUANG Li-rong;YAO Xue-ting(Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530000,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁广西530000

出　　处：《中国热带医学》2023年第2期146-150,共5页China Tropical Medicine

基　　金：广西医药卫生课题(No.Z20180985,No.Z20180990)。

摘　　要：目的分析2015—2020年广西诺如病毒流行特征及变化趋势,为诺如病毒监测和防控提供科学依据。方法通过全国食源性疾病监测报告系统收集广西11家食源性疾病哨点医院2015—2020年监测数据,采用R4.0.3软件进行描述和统计分析,包括流行曲线、卡方检验、趋势卡方检验等方法,诺如病毒相关因素采取Logistic回归分析,分别计算OR值及95%置信区间,统计检验水准为P<0.05。结果共检出1008例诺如病毒病例,阳性检出率12.75%(1008/7903),<5岁儿童(OR=1.43,95%CI:1.13~1.82)及>20~45岁(OR=1.45,95%CI:1.13~1.87)为高风险人群,病例以秋季(OR=1.29,95%CI:1.08~1.53)高发,夏季低发(OR=0.67,95%CI:0.55~0.80),旅游地区(桂林市)为高发地区(OR=1.41,95%CI:1.10~1.80)。水产品(OR=1.40,95%CI:1.03~1.91)、肉类和乳类制品(OR=1.31,95%CI:1.06~1.61)是诺如病毒感染风险食品。新冠肺炎疫情防控措施可导致诺如病毒发生下降61%(OR=0.39,95%CI:0.31~0.49),诺如病毒检出率总体呈下降趋势(趋势χ^(2)=85.33,P<0.001)。此外,就诊时间延长可导致诺如病毒检出率下降19%~23%(OR_(24~48 h)=0.81,95%CI:0.70~0.95;OR_(>48 h)=0.77,95%CI:0.63~0.93)。结论广西诺如病毒流行具有季节性和地域性,近6年腹泻患者检出率呈下降趋势。低龄儿童是高发人群,海产品的摄入增加诺如病毒发生风险,新冠肺炎疫情防控措施大幅度降低诺如病毒发生概率。今后应加强对海产品等重点食品的监测,同时重点筛查早期就诊病例,提高诺如病毒监测水平,确保人群健康。Objective To analyze the epidemiological characteristics and related factors of norovirus in Guangxi from2015 to 2020,and to provide scientific recommendations for norovirus prevention and control.Methods The foodborne diseases surveillance data were collected from 11 sentinel hospitals through the National Foodborne Disease Monitoring and Reporting System from 2015 to 2020.R software with version 4.0.3 was used for descriptive and statistical analysis,including epidemic curve,chi-square test,and trend chi-square and so on.Logistic regression was used to analyze norovirus-related factors,OR values and 95%confidence intervals were calculated respectively with the statistical test level of P<0.05.Results There were 1008 norovirus cases detected,with a detection rate of 12.75%(1008/7903).Children with age less than 5 years(OR=1.43,95%CI:1.13-1.82)and patients at age 20-45(OR=1.45,95%CI:1.13-1.87)were high risk population.The detection rate was higher in autumn(OR=1.29,95%CI:1.08-1.53)but lower in summer(OR=0.67,95%CI:0.55-0.80).In addition,the tourist area(Guilin City)presented a higher detection rate than other areas(OR=1.41,95%CI:1.10-1.80).Aquatic products(OR=1.40,95%CI:1.03-1.91),meat and dairy products(OR=1.31,95%CI:1.06-1.61)were high-risk foods for norovirus infection.The prevention and control policies of COVID-19 can reduce the possibility of norovirus by 61%(OR=0.39,95%CI:0.31-0.49)showed a declining trend(Trendχ^(2)=85.33,P<0.001).In addition,prolonged visit time can lead to19%-23%decrease in the detection rate of norovirus(OR_(24-48 hours)=0.81,95%CI:0.70-0.95;OR_(>48 hours)=0.77,95%CI:0.63-0.93).Conclusions The epidemic of norovirus presented seasonal and regional distribution in Guangxi with a declining detection rate trend in diarrhea patients during recent 6 years.Young children were high-risk population in infection norovirus.The intake of seafood can increase the risk of norovirus infection.The prevention and control policies of COVID-19 can sharply decrease the possibility of infection norovirus.

关 键 词：诺如病毒 流行特征 影响因素 数据分析 

分 类 号：R181[医药卫生—流行病学]