广西壮族自治区居民冬季腹泻危险因素研究

A study of risk factors of infectious diarrhea in winter,Guangxi

目的探讨广西居民冬季腹泻的危险因素,为进一步干预活动提供依据。方法采用社区整群随机抽样,开展入户调查。调查中捕获腹泻病例,在邻居中按1:2选择对照,应用多因素条件Logistic回归进行病例对照研究。结果本次调查共访问家庭5 914户,21 754人。调查中发现腹泻病例194例,配对对照388人。病例组与对照组间,性别、城乡比例相同,两组间人群年龄、职业构成差异无统计学意义。病例对照研究中,"喝生水"、"食物未煮熟煮透"、"发病前接触腹泻病人"、"家中有家禽家畜或宠物"、"腹泻相关知识"等暴露因素的比值比差异具有统计学意义。多因素分析中有"喝生水"、"患慢性病"、"腹泻病人接触史"等7个变量进入模型。结论本次调查病例组与对照组间有较好的均衡性。调查发现"喝生水"为冬季腹泻的强关联危险因素,"患慢性病"、"腹泻病人接触史"、"家中有家禽家畜宠物"为中等关联强度的危险因素,"腹泻病危险行为知晓程度"和"腹泻病传播途径知晓程度"为中等强度的保护因素。冬季腹泻干预活动应当注重安全饮水、腹泻病传播途径和危险行为等方面的卫生宣传教育。

Objective To explore the risk factors of diarrhea diseases in winter, and to provide evidence for intervention activities. Methods A 1 ： 2 matched case-control study was applied in this survey. The diarrhea patients found in household survey were selected as case group and neighbors around the cases were randomly chosen as controls. A multiple conditional logistic regression model was built to analyze the risk factors. Results One hundred and ninety-four cases with 388 controls were investigated in the survey. There was perfect matched between cases and controls. Drinking unboiled water, not fully cooked food, contacting with diarrhea patients, contact with animals and diarrhea related knowledge had statistical significance in case-control study. Seven variables, including raw water, patients with chronic diseases and contact history with diarrhea patients were selected in the logistic regression model. Conclusion Drinking unboiled water is confirmed as the strongest associated risk factor. Patients with chronic diseases and contact history were as moderate associated risk factors. Relevant knowledge level about dangerous behaviors and transmission routes were as moderate associated protective factors. Clean water drinking and health information on transmission routes as well as dangerous behaviors should be better educated.