宁波市江北区2012—2014年手足口病重复发病率及其影响因素

摘要

目的 了解宁波市江北区2012—2014年手足口病重复发病率、重复发病发生率,分析其影响因素,为手足口病防控工作提供科学依据.方法 2012—2014年江北区手足口病数据来自中国疾病监测信息系统,接种资料来自宁波市免疫规划信息系统,筛选多次感染的病例,采用描述流行病学的方法进行分析.结果 宁波市江北区2012—2014年重复发病发生率为5.40%,手足口病患者发病月龄中位数单次发病为33.77(20.03,47.83)月,重复发病为38.26(22.05,54.75)月,第一次发病为23.93(15.87,36.87)月;重复发病的时间间隔中位数为10.27(5.23,16.06)月.3~岁组的重复发病发生率最高(χ2=37.51,P<0.001).职业分布主要以散居儿童和幼托儿童为主.性别为女性是手足口病重复发病的保护因素(OR=0.73,95%CI:0.57~0.92),职业为幼托儿童是手足口病重复发病的危险因素(OR=1.46,95%CI:1.16~1.84).重复发病病例所在街道7 d内罹患率中位数为10.36(9.29,11.44)/10万,对照组街道同期罹患率中位数为8.95(8.16,9.74)/10万,两者间比较,差异有统计学意义(Z=-2.68,P<0.001).重复发病儿童(病例组)与对照组接种针次比较,差异无统计学意义(Z=-1.38,P=0.17).结论 宁波市江北区2012—2014年手足口病重复发病疫情较严重,应重点关注男童、幼托儿童等人群,减少其与患者接触,采取针对性防控措施.%Objective To investigate the incidence of recurrence and occurrence rate of recurrence of hand-foot-and-mouth disease (HFMD)in Jiangbei District of Ningbo City between 2012 and 2014,analyze the influencing fac-tors,and provide a scientific basis for the prevention and control of HFMD.Methods Data of HFMD in Jiangbei in 2012-2014 were collected from China Disease Surveillance Information System,immunization data were from Im-munization Programme Information System of Ningbo City,the recurrent infectious cases were selected and analyzed by descriptive epidemiological methods.Results The occurrence rate of recurrent HFMD in Jiangbei in 2012-2014 was 5.40% ,the median month of patients with single occurrence and recurrence of HFMD were 33.77(20.03, 47.83)and 38.26(22.05,54.75)months respectively,median month of patients with the initial occurrence were 23.93(15.87,36.87)months,median of time interval of recurrent HFMD was 10.27(5.23,16.06)months. The oc-currence rate of recurrence was the highest in 3- years old group(χ2= 37.51,P<0.001). Most were scattered chil-dren and children in child-care center. Female was a protective factor of recurrence of HFMD (OR,0.73[95% CI, 0.57-0.92]),while children in child-care center was a risk factor (OR,1 .46[95% CI,1 .16-1 .84]). The median attack rate of recurrence in HFMD group and control group in blocks within 7 days were 10.36(9.29,11.44)/100000 and 8.95(8.16,9.74)/100000 respectively,there was significant difference(Z= -2.68,P<0.001). In-oculation frequency between recurrent HFMD group and control group was not significantly different (Z= -1.38,P= 0.17).Conclusion The epidemic of recurrence of HFMD was serious in Jiangbei District of Ningbo City between 2012 and 2014,boys and children in child-care center should be paid attention,contacts with patients should be re-duced,and targeted prevention and control measures should be carried out.