2008—2023年青海省西宁市手足口病再感染病例流行病学特征及危险因素分析  

Epidemiological characteristics and influential factors of hand,foot and mouth disease rein fection in Xining City,Qinghai Province,2008-2023

作　　者：李翠华 孙妍兰 史永凯[2] LI Cui-hua;SUN Yan-lan;SHI Yong-kai(Department of Public Health,Qinghai University Medical College,Xining,Qinghai 810001,China;不详)

机构地区：[1]青海大学医学院公共卫生系,青海西宁810001 [2]西宁市疾病预防控制中心

出　　处：《现代预防医学》2024年第24期4440-4447,共8页Modern Preventive Medicine

摘　　要：目的分析2008—2023年青海省西宁市手足口病再感染病例的流行病学特征、危险因素,为西宁市及青藏高原地区手足口病再感染防控提供科学依据。方法从中国疾病预防控制信息系统中导出2008年5月1日—2023年12月31日期间西宁市手足口病的病例信息,通过对数据进行筛选和整理,以形成手足口病再感染病例的数据库。采用描述性流行病学方法分析再感染病例流行病学特征;采用Kaplan-Meier法探究病例首次感染后的再感染累积风险;采用Cox比例风险回归模型对手足口病再感染风险进行单因素和多因素综合分析。结果2008—2023年西宁市手足口病再感染病例累计报告493人,再感染率为2.67%(493/18472),再感染累积发生风险为3.00%,486人(98.58%)感染2次,7人(1.42%)感染3次。Kaplan-Meier曲线显示,首次感染后30个月内,再感染风险随急剧增长,30个月内再感染的病例占74.44%。Cox比例风险回归模型分析结果显示,女性(HR=0.822,95%CI:0.684~0.988)相较于男性、≥3岁人群(HR=0.586,95%CI:0.445~0.771)相较于<3岁人群发生手足口病再感染风险小;幼托儿童(HR=5.551,95%CI:2.278~13.525)和散居儿童(HR=6.897,95%CI:2.769~17.184)相较于其他人群、城市地区(HR=1.531,95%CI:1.222~1.917)相较于农村地区发生手足口病再感染风险更大。结论西宁市手足口病的再感染较高,首次感染为肠道病毒71型(enterovirus 71,EV71)的<3岁城市地区男童、散居儿童再次感染手足口病的风险更高,应对上述人群采取干预措施,以降低手足口病再次感染的发生率。Objective To analyze the epidemiological characteristics,influential factors,and the risk of reinfection in patients with hand,foot and mouth disease(HFMD)in Xining,Qinghai,2008-2023,and to provide scientific evidence for preventing HFMD reinfection in Xining and Qinghai-Tibet plateau regions.Methods The incidence data of HFMD in Xining from May 1,2008 to December 31,2023 were collected from the China Information System for Disease Control and Prevention to establish a database of cases of HFMD reinfection by filtering and organizing.Descriptive epidemiological method was used to describe the epidemiological characteristics of the reinfection cases,and the Kaplan-Meier method was utilized to assess the cumulative hazard probability of HFMD reinfection after initial infection,and Cox proportional hazards regression model was employed to conduct a comprehensive analysis of the risk of HFMD reinfection through both univariate and multivariate perspectives.Results A total of 493 HFMD reinfection cases were reported in Xining 2008-2023,the reinfection incidence was 2.67%(493/18472),and the cumulative risk for the reinfection was 3.00%.486(98.58%)cases were infected twice,and 7 cases(1.42%)were infected three times.The Kaplan-Meier curve demonstrated that the cumulative risk of reinfection increased sharply within 30 months after the first infection,and with 74.44%of cases reinfected within 30 months.The Cox proportional hazards regression model analysis revealed that the risk of HFMD reinfection was lower in males compared to females(HR=0.822,95%CI:0.684-0.988),in children aged≥3 years compared to those aged<3 years(HR=0.586,95%CI:0.445-0.771).The risk of HFMD reinfection was higher in kindergarten children(HR=5.551,95%CI:2.278-13.525)and scattered children(HR=6.897,95%CI:2.769-17.184)compared to other population groups,and in children residing in urban areas(HR=1.531,95%CI:1.222-1.917)compared to those in rural areas.Conclusion The reinfection rate of HFMD is relatively high in Xining.People living in urban areas,i

关 键 词：手足口病 再感染 流行病学特征 影响因素 COX比例风险回归模型 

分 类 号：R211[医药卫生—中医学] R183.4