南宁市武鸣县1268名手足口病多次感染病例流行病学分析

Epidemiological analysis on 1268 cases of repeated hand foot and mouth disease in Wuming County of Nanning City

目的分析南宁市武鸣县儿童多次罹患手足口病的流行病学特征,为科学预防控制手足口病提供科学依据。方法利用2009—2012年广西南宁市武鸣县疾病监测信息报告管理系统手足口病的个案数据,筛选多次感染病例,计算发生率,分析发病特点。结果武鸣县2009—2012年报告手足口病12 361例,其中1 268名患者多次感染,多次感染的发生率为10.25%。在多次感染的病例中有9例为重症病例,其中初次感染重症病例占7例。多次感染发病平均间隔10.18个月,发病时间分布规律与总发病水平相关(r=0.87,P<0.01)。发病平均年龄2.28岁,3岁以下儿童占78.68%;男女发病比为1.75∶1。散居儿童占64.38%,但随着重复感染次数的增加,幼托儿童发病构成比也逐次增加(χ2=204.51,P<0.01)。全县各乡镇均有多次感染病例分布,相对高发的是城厢镇、双桥镇、宁武镇、陆斡镇、两江镇、仙湖镇。结论武鸣县儿童多次罹患手足口病存在明显季节、地区、性别年龄差异。应加强托幼机构管理,加强健康教育宣传,促使民众养成良好的卫生习惯、创造清洁卫生的生活环境。

[ Objective ] To analyze epidemiological characteristics of repeated hand foot and mouth disease （HFMD） among children in Wuming County of Nanning City, provide scientific basis for prevention and control of HFMD. [ Methods] The repeated HFMD cases were collected from the Disease monitoring information management system in Wuming County from 2009-2012, to calculate the incidence and analyze the epidemiological characteristics. [ Results] Among 12 361 HFMD cases reported during 2009-2012, 1268 cases occurred the repeated infections with the incidence rate of 10.25%. There were 9 severe cases among repeated infection cases, and 7 severe cases among primary infection cases. An average interval of repeated infections was 10-18 months, and the temporal distribution of repeated infections had relationship with whole incidence rate （ r = 0.87, P 〈 0.01 ）. The average age of onset was 2.28 years old, and 78.68% of cases were children under 3 years old. The ratio of male-to-female was 1.75 ： 1. It mainly occurred in scattered children, which accounted for 64.38%. With the increasing of number of repeated infections, the pro- portion of preschool children increased （ X2 = 204.51, P 〈 0.01 ）. The cases of repeated infections were reported in all townships of Wuming County, and the incidence rates in Chengxiang Town, Shuangqiao Town, Ningwu Town, Luwo Town, Liangjiang Town and Xianhu Town were relatively high. [ Conclusion] There are obvious differences in season, region, sex and age among Children with repeated HFMD in Wuming County. It is necessary to strengthen the management of nurseries, improve the health education, en- courage people to develop good health habits, and create a clean living environment.