某幼儿园儿童手足口病发病危险因素的回顾性调查分析

摘要

To explore risk factors of hand-foot-mouth disease(HFMD) in western parts of Shenzheng city . Methods :Questionnaire survey was used to investigate the history of children with HFMD in past 3 years retrospective-ly in one nurseries and kindergartens in western parts of Shenzheng City .Univariate analysis and multi-logistic regres-sion analysis were used to analyze major risk factors of HFMD .Results:There were 79 HFMD cases in 363 study ob-jects with incidence of 72 .5/1 000 person-years ,Univariate analysis indicated that six exposure factors were related to the occurrence of HFMD ;Multivariate analysis showed that there were two protective factors and two risk factors con-cerned with the prevalence of HFMD ,and the factors were depicted as follow :non registered resident of Shenzheng city (OR=0 .55 ,95% CI:0 .32-0 .95) ,natural delivery (OR=0 .56 ,95% CI:0 .33~0 .96) ,intimate contact with the patients of HFMD(OR=4 .59 ,95% CI:1 .44~14 .6) ,more than two children in the family(OR=4 .84 ,95% CI:1 .26~18 .54) . Conclusion:Contact transmission was one way of HFMD infection ,so reducing children to contact with the patient would be effective to control HFMD spread .In addition ,developing good health habits ,advocating natural delivery and breastfeeding should protect infant and children from HFMD .%目的：探索深圳市西部地区托幼机构儿童手足口病（Hand-Foot-Mouth Disease ，HFMD）发病的危险因素。方法：采用问卷调查的方式，对深圳市西部某幼儿园所有儿童回顾性调查其在过去3年间的 H FM D患病史，采用单因素和多因素Logistic回归分析，分析影响 HFMD 的主要危险因素。结果：363名调查对象中，HFMD患者为79名，此队列人群发病密度为72．5/1000人年。单因素分析发现6个暴露因素和 H FM D发生有关；多因素分析显示 H FM D有2个保护因素和2个危险因素，分别为：非深圳户口（O R＝0．55，95％ C I：0．32～0．95），自然分娩（O R＝0．56，95％CI：0．33～0．96），5岁以下儿童数为2人以上（OR＝4．84，95％ CI：1．26～18．54），和手足口病人密切接触（OR＝4．59，95％ CI：1．44～14．6）。结论：接触传播是HFMD传播方式之一，因此减少儿童与患者接触对于控制HFMD传播起到重要作用。此外，养成良好的卫生习惯，提倡自然分娩和增加纯母乳喂养对预防婴幼儿患H FM D 起到保护性作用。