湘潭市农村地区5岁以下儿童手足口病危险因素调查

Investigation on Risk Factors for Hand-foot-mouth Disease Among Children Under 5 Years Old in Rural Areas of Xiangtan Prefecture

目的探索湘潭市农村地区5岁以下儿童手足口病（HFMD）发病的危险因素，为防控手足口病提供科学依据。方法选择湘潭市农村地区60例HFMD患儿作为病例组，同期同一乡镇60例健康儿童作为对照组，采用统一的调查表进行调查，SPSS13．0软件进行单因素和多因素非条件Logistic回归分析。结果确诊的24例HFMD病例中，Ev71和CoxA16感染的构成比分别为66．7％（16／24）和4．2％（1／24）。单因素分析结果有统计学意义的变量包括居室内外有家禽粪便、儿童近3个月发生上呼吸道感染、腹泻或胃肠炎、儿童作息规律、儿童接种过轮状病毒疫苗共4项刚素。多因素分析结果显示儿童作息规律（OR=0．05，95％CI：0．01～0．26），接种过轮状病毒疫苗（OR=0．16，95％CI：0．06-0．40）是儿童ttFMD发病的保护因素；近3个月儿童发生上呼吸道感染、腹泻或胃肠炎（OR=11.65，95％ CI：375～36．15）则是儿童HFMD发病的危险因素。结论提高儿童机体免疫力、养成良好的生活卫生习惯有助于控制农村地区儿童HFMD发生。

Objective To explore the risk factors for hand foot mouth disease （HFMD） among children under 5 years old in rural areas of Xiangtan prefecture, so as to provide scientific basis for the prevention and control of HFMD. Methods Totally, 60 HFMD patients under 5 years old in the rural area of Xiangtan prefecture were recruited into the case group, and 60 healthy children with the same township in the same period were recruited into the control group. Their guardians were investi- gated with the unified survey questionnaire. The data were analyzed by univariate analysis and muhivariate non- conditional lx）- gistic regression analysis with SPSS13.0. Results Among the pathogens of 24 confirmed HFMD cases, EV71 and CoxAl6 constituted 66.7 % （16/24） and 4.2 % （1/24）, respectively. Univariate analysis showed that statistically significant variables in- cluded in＆~or and outdoor poultry manure, upper respiratory tract infection, diarrhea or gastroenteritis in recent 3 months, activi- ty and rest routines, and immunization with Rotavirus vaccine in childhood. Multivariate analysis indicated that activity and rest routines （0R=0.05, 95%CI： 0.01-0.26）, immunization with Rotavirus vaccine （OR-0.16, 95%CI： 0.06 0.40） in children were protection factors against HFMD, while upper respiratory tract infection, diarrhea or gastroenteritis in recent 3 months （ OR 11.65, 95 % CI ： 3.75 - 36.15） were risk factors. Conclusions Improving children＇ s immunity and culti vating their good hygienic habits are helpful to the control of HFMD in children in rural areas.