海南垦区5岁以下儿童手足口病影响因素病例对照研究

Influencing factors of hand-foot-mouth disease among children under five years old in Hainan reclamation area: a case-control study

目的：探讨海南垦区5岁以下儿童手足口病的影响因素，为有效控制手足口病疫情提供科学依据。方法：垦区按照区域的分布，划分为东、南、西、北、中5个方位，按分层随机抽样的方法，每个方位抽取2～3家农场，根据其2011—2012年上报的5岁以下儿童手足VI病临床病例，随机抽取约70％作为病例组，同期选择相应地区5岁以下非手足口病儿童作为对照的抽样框，随机抽取约20％作为对照组，采用回顾性调查的方法进行问卷调查。结果：①共调查2596名儿童，其中病例组809例，对照组1787例；男性1398例，女性1198例，病例组与对照组性别间差别有统计学意义（χ2=11．181，P〈0．001），病例组幼托儿童及散居儿童间差异有统计学意义（χ2=34．417，P〈0．001）。②单因素非条件Logistic回归分析结果显示对临床病例有意义的影响因素有早产儿、留守儿童、每一次吃东西前洗手习惯、饭前洗手习惯等13个因素。③多因素非条件Logistic回归分析性别、地区、儿童职业（幼托儿童和散居儿童）、留守儿童、大小便自理、每一次吃东西前洗手习惯、饭前洗手习惯、家庭人均居住面积等12个因素进入回归方程。结论：手足口病的影响因素是多方面的，又具有地方特异性，要进行针对性、综合性、可行性预防。

Objective： To explore the influence factors of hand -foot -mouth disease （HFMD） among children under five years old in Hainan reclamation area, provide a scientific basis for controlling HFMD effectively. Methods： According to the regional distribution of reclamation area, Hainan reclamation area was divided into five directions ： east, south, west, north, and middle ： 2 - 3 farms were extracted from each direction according to stratified random sampling method; according to the reported clinical cases with HFMD under five years old from 2011 to 2012, about 70% of them were extracted randomly as case group; the children without HFMD under five years old in the same direction during the same period were selected, and about 20% of them were extracted randomly as control group, a retrospective ques- tionnaire survey was conducted. Results： A total of 2 596 children were surveyed, including 809 cases in case group and 1 787 cases in control group; 1 398 boys and 1 198 girls were included, there was statistically significant difference in gender between the two groups （X2 = 11.181, P 〈 0. 001 ） ; in case group, there was statistically significant difference in gender between reschool children and scattered children （χ2= 34. 417, P 〈 0. 001 ） ; univariate non- conditional logistic regression analysis showed that the influencing factors included 13 factors, such as premature birth, left - behind children, hand washing before eating every time, washing hands before meals. Multivariate non - conditional logistic regression analysis showed that 12 factors entered the regression equation, such as gender, region, occupation, the left -behind children, the size of care, hand washing before eating every time, washing hands before meals, family per capita living space. Conclu- sion： Many factors can affect HFMD, which have local specificity, targeted, comprehensive, and feasible preventive measures should beconducted.