儿童手足口病影响因素病例对照研究

Risk factors of hand-foot-mouth disease among children:a case-control study

目的探讨儿童手足口病（hand-foot-mouth disease,HFMD）发生的影响因素。方法收集江苏省手足口病哨点监测医院手足口病临床病例396例,肠道病毒71型（enterovirus 71,EV71）感染的手足口病病例195例,分别进行1：1配对病例对照研究,应用SPSS 13.0软件进行单因素和多因素条件logistic回归分析。结果多因素条件Logis-tic回归分析表明,城乡（OR=1.999,95%CI=1.433~2.789）、家庭收入（OR=0.806,95%CI=0.692~0.938）、饭前便后洗手情况（OR=0.719,95%CI=0.590~0.877）、最近1周外出就餐情况（OR=1.914,95%CI=1.019~3.596）、最近1周接触患者史（OR=3.771,95%CI=2.137~6.654）为手足口病临床病例的影响因素;城乡（OR=2.417,95%CI=1.522~3.839）、饭前便后洗手情况（OR=0.693,95%CI=0.517~0.929）、近1周接触患者史（OR=3.942,95%CI=1.808~8.594）为EV71感染的手足口病影响因素。结论居住地为农村,最近1周患者接触史是手足口病发病的主要影响因素;饭前便后洗手是降低感染机会的保护因素。

Objective To study risk factors of hand-foot-mouth disease（HFMD） among children.Methods A hospital-based matched case-control study was carried out in Jiangsu province,which involved 396 cases of probable HFMD and 195 cases of enterovirus type 71（EV71）infection.Conditional logistic regression model was used for univariate and multivariate analysis with SPSS13.0 to estimate odds ratio（OR） and 95% confidence interval（CI） of the risk factors.Results Results from multiple conditional logistic regression analysis showed that the relevant factors of probable HFMD included living in countryside（OR=1.999,95%CI：1.433-2.789）,family income（OR=0.806,95%CI：0.692-0.938）,washing hand before dinner or after defecating（OR=0.719,95%CI：0.590-0.877）,having dinner in restaurant in recent one week（OR=1.914,95%CI=1.019-3.596）,and contacting with HFMD case in the recent one week（OR=3.771,95%CI：2.137-6.654）.The relevant factors of EV71 infection included living in countryside（OR=2.417,95%CI：1.522-3.839）,washing hand before dinner or after defecating（OR=0.693,95%CI：0.517-0.929）,and contacting with HFMD case in recent one week（OR=3.942,95%CI：1.808-8.594）.Conclusion The main risk factors of HFMD are linving in coutryside and contacting with HFMD cases in recent one week and the most important protective factors is washing hand before dinner or after defecating.