广州市海珠区托幼机构手足口病疫情危险因素分析

Study on risk factors of hand-foot-mouth disease in kindergartens based on the class

目的探讨托幼机构手足口病疫情的危险因素,为完善托幼机构手足口病防控措施提供参考依据。方法选取广州市海珠区2013年4—7月发生手足口病疫情的30个托幼机构,在每个托幼机构选取发生聚集性病例疫情、散发病例疫情和无病例3种情况的班级各1个共90个班级,用病例对照研究方法研究相关因素与手足口病疫情的关系。结果单因素分析显示,聚集性病例疫情、散发病例疫情和无病例3种情况的班级间教室温度、教室通风面积、教室窗地比、玩具表面细菌菌落数、老师手足口病知识得分、规范洗手率和午检率差异均有统计学意义(F值分别为3.72,3.87,4.02,8.55,4.08,4.20,7.42,P值均<0.05);线性回归结果显示,教室通风面积(B=-0.319)和午检率(B=-0.233)为手足口病疫情发生的保护因素,而玩具表面细菌菌落数较多(B=-0.319,P<0.05)为手足口病疫情发生的危险因素(P值均<0.05)。结论加强教室通风、提高教师防控能力和做好玩具消毒对预防手足口病疫情发生有积极作用。

Objective To explore the risk factors of hand-foot-mouth disease（ HFMD） epidemic situation of kindergartens,and to provide reference for improving the HFMD prevention and control strategies in kindergartens. Methods Case-control study was conducted during April to July,2013 in Haizhu District of Guangzhou to screen the risk factors. Thirty kindergartens were chosen,each of which including 1 class with clustering HFMD cases,1 class with sporalic cases and 1 class with no case. Results Univariate analysis indicated that seven factors had statistical significance,including class temperature,vent area,AC / AD,bacterial colonies of toys＇ surface,scores of HFMD knowledge of teacher,rate of regular handwashing and rate of midday examination.Multivariate linear regression analysis showed that class vent area and rate of midday examination were protection factors,but bacterial colonies of toys＇ surface was a risk factor. Conclusion Strengthening class ventilation,improving prevention and control ability of teacher and doing well toys＇ disinfection could prevent the outbreak of HFMD.