基于症状监测系统的杭州市学校因病缺课特征分析  

Features of sick leave in schools in Hangzhou based on symptom monitoring system

作　　者：黄春萍[1] 王兵 吴彦[2] Huang Chunping;Wang Bing;Wu Yan(Tuberculosis Prevention and Control Institute,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,China;Infectious Diseases Prevention and Control Institute,Hangzhou Centerfor Disease Control and Prevention,Hangzhou 310021,China)

机构地区：[1]杭州市疾病预防控制中心结核病预防控制所,杭州310021 [2]杭州市疾病预防控制中心传染病预防控制所,杭州310021

出　　处：《国际流行病学传染病学杂志》2024年第2期110-115,共6页International Journal of Epidemiology and Infectious Disease

摘　　要：目的分析杭州市学校因病缺课的情况及常见特征,为学校疾病精准防控提供参考。方法收集并整理基于智能手机的"杭州市学校症状监测系统"监测信息2823145条,采用生态学研究方法,以学校为基本单位,对不同学校类型、不同地区因病缺课及发热、咳嗽、皮疹、红眼、腹泻、腮腺肿大、呕吐等7个常见症状进行单因素方差分析和多因素一般线性模型分析。结果杭州市全市学生请假中因病占比为65.78%(1868293/2840421),其中以咳嗽占比最大,为49.51%(924947/1868293),其次为发热28.78%(537630/1868293),红眼占比最低,仅0.41%(7591/1868293)。发热、红眼在冬春季高发,分别占比全年同类症状的48.03%(258961/539170)和64.48%(3193/4952),随气温升高呈下降趋势(Z_(发热)=-94.04,Z红眼=-18.10,均P<0.001),呕吐以冬季为主,占比全年报告的61.94%(77925/125813)。学校类型(F=181.15,P<0.001)、地区类型(F=8.56,P<0.001)以及二者的交互项(F=4.47,P<0.001)差异均有统计学意义。控制其他变量的情况下,因病缺课和7个常见症状均存在学校类型差异,发热、皮疹、腹泻、腮腺肿大和呕吐存在地区差异。一般线性模型边际估计结果显示,农村幼儿园因病缺课比例高于城市(64.89%vs.61.50%,F=8.24,P<0.001),农村中小学发热比例明显低于城市(小学:33.78%vs.43.09%,中学:25.68%vs.28.49%,F=17.58,P<0.001),农村中学皮疹比例显著高于城市(6.80%vs.4.68%,F=4.41,P=0.012),农村中小学腹泻比例显著高于城市(小学:4.06%vs.3.12%,中学:6.93%vs.4.94%,F=4.58,P=0.010)。结论小学生及农村地区学生应成为杭州市疾病监测与控制的重点人群,冬春季应重点做好流行性感冒、流行性结膜炎、诺如病毒感染等传染病监测预防工作,夏秋季农村地区应加强室内外防蚊灭虫等预防控制措施。Objective:To provide reference for precise prevention and control of diseases in schools through the analysis of sick leave and common features in schools in Hangzhou.Methods:A total of 2823145 monitoring records from Hangzhou School Symptom Monitoring System based on smartphones were collected and sorted out.Schools as the basic units were analyzed by ecological research method.School absence due to illness,7 common symptoms including fever,cough,rash,red eye,diarrhea,parotid gland swelling and vomiting among different types of schools and regions were analyzed by one-way ANOVA and general linear model multivariate analysis.Results:Among students on leave in Hangzhou,65.78%(1868293/2840421)took sick leave,with cough being the most common symptom,accounting for 49.51%(924947/1868293),followed by fever of 28.78%(537630/1868293),and red eyes being the least prevalent,accounting for 0.41%(7591/1868293).Fever and red eyes were more common in winter and spring,accounting for 48.03%(258961/539170)and 64.48%(3193/4952)of the similar symptoms reported throughout the year,respectively,showing a decreasing trend with rising temperatures(Z_(fever)=-94.04,Zred eyes=-18.10,both P<0.001).Vomiting was more common in winter,accounting for 61.94%(77925/125813)of reports throughout the year.School type(F=181.15,P<0.001),region type(F=8.56,P<0.001),and their interaction(F=4.47,P<0.001)were all statistically significant.Controlling for other variables,absence due to illness and 7 common symptoms were different in different school types,while fever,rash,diarrhea,parotid gland swelling,and vomiting showed regional differences.Marginal estimates of the general linear model showed that the proportion of sick leave in rural kindergartens was higher than that in urban ones(64.89%vs.61.50%,F=8.24,P<0.001),the proportion of fever in primary and middle schools were significantly lower in rural areas than those in urban areas(primary school:33.78%vs.43.09%,middle school:25.68%vs.28.49%,F=17.58,P<0.001),the proportion of rash in middle schools

关 键 词：学校 症状监测 因病缺课 大数据 多元一般线性模型分析 

分 类 号：R179[医药卫生—妇幼卫生保健] G478.2[医药卫生—公共卫生与预防医学]