摘要：
目的 研究广州市北部地区散居儿童手足口病的危险因素,为防控提供科学依据.方法 采用病例对照的方法,于2017年5-7月对广州市北部地区散居儿童手足口病危险因素进行回顾性问卷调查,共调查462名散居儿童手足口病确诊病例和485名同期散居的健康儿童,采用非条件Logistic回归进行多因素分析.结果 多因素分析结果显示,家庭中有其他托幼机构儿童(0R=2.621,95％CI:1.829～3.755),发病前2周内接触过手足口病病例(OR =29.285,95％ CI:11.421～75.092)、接触过疱疹性咽峡炎病例(OR=8.223,95％CI:3.275～20.647)、玩过公共场所游乐设施(OR=2.488,95％CI:1.821～3.399)、进行过输液(OR=4.216,95％CI:1.510～11.770)、去过医院急诊科(OR=4.203 95％CI:2.003～8.816)是手足口病发病的危险因素;病例居住类型为城区(OR=0.369,95％CI:0.027～0.502),户口类型为常住人口(OR=0.022,95％CI:0.003～0.167),发病前2周内接触过流感病例(OR=8.657,95％CI:0.364～0.817)则是手足口病发病的保护因素.结论 接触手足口病和疱疹性咽峡炎病例、使用公共场所娱乐设施、至医院急诊科和输液等行为是散居儿童手足口病发病的危险因素,做好手足口病和疱疹性咽峡炎病例发病后居家隔离、公共场所共用设施和医疗机构公用场所清洁消毒、以及乡镇和流动人口的手足口病防控知识宣教工作是预防散居儿童手足口病的关键.%Objective To analyze the risk factors of hand,foot and mouth disease (HFMD) in scattered children in the northern area of Guangzhou,and provide scientific evidences for HFMD control and prevention.Methods The questionnaire survey of risk factors was conducted in scattered children from May to July 2017 in the northern part of Guangzhou city by case-control study.The study included 462 confirmed HFMD cases and 485 healthy children.Non-conditional logistic regression was used for multiple factors analysis.Results Multiple factors analysis showed that family having other children in kindergarten (OR=2.621,95％CI:1.829-3.755),children had contacted with HFMD cases within 2 weeks before the disease onset (OR=29.285,95％CI:11.421-75.092),had contacted with herpangina cases (OR=8.223,95％CI:3.275-20.647),had played in public facilities (OR=2.488,95％CI:1.821-3.399),had received transfusion (OR=4.216,95％CI:1.510-11.770),and had visited emergency department in the hospital(OR=4.203 95％CI:2.003-8.816) were risk factors of HFMD.Children living in city area (OR=0.369,95％CI:0.027-0.502),permanent resident population (OR=0.022,95％CI:0.003-0.167),and children had contacted with flu cases within 2 weeks before the disease onset (OR=8.657,95％CI:0.364-0.817) were protective factors of HFMD.Conclusions Children who contact with HFMD or herpangina cases,play in public facilities,visit emergency department in the hospital or receive infusion are risk factors of HFMD.Home quarantine after onset of HFMD and herpangina;cleaning and disinfection in public places and medical institutions;health education of HFMD prevention in county and migrant population are key prevention measures of HFMD in scattered children.
