肇庆市人群腹泻病流行特征分析

Community-based analysis of epidemic characteristics of diarrhea in Zhaoqing city

目的了解肇庆市腹泻病的流行特征、临床表现,为制定腹泻病预防控制相关政策提供科学依据。方法采用分层多阶段随机整群抽样方法,选取端州区的4个社区和封开县的6个村作为调查点。于2006年12月、2007年3月、6月、9月对调查点的居民进行入户问卷调查,并对腹泻病例的基本情况、发病情况、就诊和住院情况等内容进行调查。结果 4次共调查27 834人次,年均两周发病率为0.49%,年发病率为12.74%,年均发病次数约为0.13次。男女之间发病率差异无统计学意义（χ2=1.743,P=0.187）;年龄以0~岁组两周发病率最高为8.15%,低年龄组呈现随着年龄的增加而发病率逐渐降低的趋势;职业以散居儿童的两周发病率最高为1.98%;12月份的发病率最高为1.25%;农村腹泻病发病率较城市高,差异有统计学意义（χ2=15.471,P〈0.001）。大多数病例（83.72%）的病程都在3天以内;每天最多腹泻次数以3~5次最多,占87.79%,10次以上者占2.33%;粪便性状以水样便所占比例最多,为47.09%。58.14%的腹泻病例发病后到医疗机构就诊;城市的就诊率较农村高,差异有统计学意义（χ2=19.426,P〈0.001）;腹泻病病例未就诊的原因主要是＂症状轻,无需就诊＂,其次是＂自我处理＂就可以。结论肇庆市腹泻病发病率农村明显高于城市,散居儿童、托幼儿童和农民工是腹泻病防治的重点人群。

Objective To investigate the epidemic characteristics and clinical manifestation of diarrhea in Zhaoqing,and provide scientific basis for developing diarrhea prevention and control policies. Methods With multi-stage stratified random cluster sampling method, four communities in Duanzhou and six villages in Fengkai were included in this study.Information regarding disease onset, infection situation, medical treatment seeking, be hospitalized and other related information were collected by door-to-door survey among residents in above area in December 2006, March 2007, June,and September. Results This study included 27 834 person-times（PTs） in four investigations. The annual average twoweek incidence rate of diarrheal was 0.49%, annual incidence was 12.74%, which meant that approximately each person suffered from diarrhea disease 0.13 times every year. There was no statistical difference in incidence between male and female（χ2=1.743,P=0.187）. Two-week incidence rate of 0~aged group（8.15%） was the highest; the incidence rate of low age groups presenting gradually descending trend with the increase in age. Two-week incidence rate of scattered children（1.98%） was the highest among different occupations. Two-week incidence rate of December（1.25%） was the highest. The diarrheal disease incidence rate in rural was higher than in city; the difference was statistically significant（χ2=15.471,P〈0.001）. Most patients（83.72%） endured no longer than 3 days course of diarrhea. Most patients suffered from diarrhea for 3-5 times one day, accounting for 87.79% of all cases, while 2.33% cases were much severer, with more than 10 times diarrhea one day. About 47.09% patients had watery stool,which was the main excrement characteristic. About 58.14% diarrhea patients visit doctors. There was significant difference between rates of residents seeking medical treatment in rural and in city（χ2=19.426, P 〈0.001）. Diarrhea patients didn’t go for treatment mainly because of no severe symptoms. Conclusion Incidence rate of diarrhea in rural residents was significantly higher than in city. The main crowd of the diarrhea disease was scattered children, children in childcare and migrant workers.