宁波市2010—2011年学校传染病暴发危险因素及防控分析

Risk factors and evaluation on control and prevention of infectious disease outbreaks in schools in Ningbo,2010-2011

目的了解宁波市学校传染病暴发现状,研究暴发的主要危险因素,评价疫情控制措施,为制定有效的防控对策提供科学依据。方法选择2010—2011年宁波市发生传染病暴发的18所学校和未发生传染病暴发的36所学校,进行1∶2匹配病例对照研究,所得资料进行单因素和多因素条件Logistic回归分析;防控措施评价采用综合评分法。结果2010—2011年宁波市学校传染病暴发报告病例362例,平均罹患率为4.45%。暴发时间集中在夏秋季,水痘暴发占全部事件的77.8%(14/18),小学占66.67%(12/18)。多因素分析结果显示,"提供洗手用品"(OR=0.13),"开设健康教育课程"(OR=0.12)是传染病暴发的保护性因素。暴发控制措施评价为良好5起,一般10起,较差3起。结论小学生的水痘疫情是学校传染病防控重点。提供洗手用品和开设健康教育课程可以减少学校传染病的暴发。

Objective To explore the epidemiology and risk factors of infectious disease outbreaks in schools in Ningbo and to provide scientific bases for infectious disease control and prevention. Methods A total of 18 schools with infectious disease outbreaks and 36 schools without outbreaks in Ningbo during 2010-201 lwere selected by 1 ： 2 matched case-control method. Uni- variate and muhivariate conditioned logistic regression analysis were used for data analysis. Comprehensive assessment was selected to evaluate the measures of control and prevention. Results During 2010-2011, a total of 362 cases had been reported in infec- tious disease outbreaks in schools in Ningbo. The average attack rate was 4.45%. The outbreak occurred mainly on summer and autumn. Varicella outbreak accounted for 77.8% （14/18） of all events. Primary schools accounted for 66.67 % （12/18 ） of all schools. Multivariate conditioned logistic regression revealed that hand-washing product offering and health education curriculum were protective factors for infectious disease outbreak, odd ratio was 0.13 and 0.12, respectively. Five outbreaks management were evaluated as good, ten were evaluated and 3 were evaluated as slightly worse. Conclusion The prevention of varicella outbreak in primary schools should be the focus of future work. Hand-washing products offering and health education curriculum were protective for infectious disease outbreaks.