杭州市余杭区小儿轮状病毒腹泻临床检测和流行病学特征分析

Clinical detection and epidemiological characteristics of infantile diarrhea induced by rotavirus in Yuhang District,Hangzhou City

目的分析杭州市余杭区轮状病毒腹泻发病流行特征、趋势及与气象因素关系,提出防治建议。方法对法定传染病报告系统中余杭区2008-2010年轮状病毒腹泻监测报告病例进行流行病学分析;并将日发病数与气象因素进行多元线性回归分析。结果 2008-2010年余杭区轮状病毒腹泻发病率分别为150.76/10万、125.65/10万、245.60/10万;病例主要集中在闲林镇、乔司镇、临平街道、余杭镇及仓前镇五个流动人口较为聚集的乡镇;发病高峰主要在每年的11-12月;病例集中于2岁及以下散居儿童(发病率6 609.95/10万);男性发病率明显高于女性(χ2=225.25,P=0.001);医院监测数据显示每年的11-12月份检测阳性率明显高于其他月份(χ2=94.87,P=0.001)。轮状病毒腹泻发病率与日平均气温(℃)、湿度(%)和能见度(km)呈负相关。结论余杭区轮状病毒腹泻流行特征与国内外情况基本一致,发病高峰出现在每年的10-12月份,流动人口聚集区域高发,2岁及以下散居儿童所占比例最大,临床检测阳性率与流行趋势一致。发病率主要受气温、湿度和能见度的影响,呈负相关。建议加大对重点人群尤其是2岁及以下儿童在气温和湿度较低的秋冬季节对轮状病毒腹泻的防护和宣教工作,采取积极有效的防治措施,控制轮状病毒腹泻的暴发。

Objective To analyze the epidemiological features and trend of rotavirus- induced diarrhea in Yuhang District, Hangzhou City, and to explore the relationship between rotavirus diarrhea and climate factors so as to put forward targeted advice for its prevention and treatment. Methods Retrospective epidemiologieal method was used to analyze the characteristics of the reported rotavirus diarrhea cases through the Notifiable Disease Surveillance System in Yuhang District, Hangzhou City from 2008 to 2010. Multiple regression analyses were conducted to examine the association between the daily incidence of rotavirus diarrhea and climatic factors. Results The incidence of rotavims diarrhea in Yuhang District during 2008 - 2010 was 150.76/ 100,000, 125.65/100,000 and 245.60/100,000, respectively, which mainly occurred in Xianlin Town, Qiaosi Town, Linping Street, Yuhang Town and Cangqian town. The peak of the yearly rotavims epidemic occurred mainly between November and De- cember. The majority of the cases were scattered children 2 years of age and under （with the incidence of 6,609.95/100,000）. The incidence of rotavirus diarrhea was significantly higher in mates than in females （ X^2 = 225.25, P = 0. 001）. The surveillance data reported by hospitals showed that the positive rate of rotavirus was higher in November and December than those in other months each year （ X^2 = 94.87, P = 0. 001 ）. The incidence of rotavims diarrhea was negatively associated with daily average temperature （℃）, humidity （ % ） and visibility （km）. Conclusions The epidemiological characteristics of rotavirus diarrhea in Yuhang District during 2008 - 2010 are similar to those of other regions both at home and abroad. There is a morbidity peak during November and December in each year. The high incidence is mainly presented in the regions with dense floating popula- tion, and scattered children 2 years of age and under accounted for the largest proportion. The positive rate of rotavirus detection in clinical practice is consistent with the epidemic tendency. The incidence of rotavirus diarrhea is negatively related to atmospher- ic temperature, humidity and visibility. More efforts should be intensified to protect and educate the high- risk group especially the scattered children 2 years of age and under in autumn and winter and effective countermeasures should be taken so as to de- cline the outbreak of rotavirus diarrhea.