CVA6型手足口病影响因素分析

Influencing factors of hand-foot-mouth disease caused by CVA6

目的研究柯萨奇病毒A6(CVA6)型手足口病发病的影响因素,为预防与控制CVA6型手足口病提供科学的参考。方法采用病例对照研究的方法,从2014年1月至2014年12月,每月随机抽取深圳市松岗人民医院和光明新区人民医院手足口病临床诊断病例,采集其粪便或肛拭子,用荧光RT-PCR法检测肠道病毒特异性核酸片段并进行分型分析。采样的同时进行问卷调查,调查其基本情况、生活环境及卫生行为习惯等信息。共采集样品474份,完成手足口病患者调查问卷474份,选择其中CVA6阳性的186例患者作为病例组,松岗医院与公明医院186名非感染性疾病患者作为对照组,并对对照组进行问卷调查。利用Logistic回归分析CVA6型手足口病的影响因素。结果多因素非条件logistic回归分析显示:散居儿童(OR=2.499)、吸手指咬玩具习惯(OR=2.257)、共用玩具(OR=1.834)、与手足口病患者接触过(OR=19.438)等4个因素为CVA6型手足口病发病的危险因素,而接受过手足口病宣教(OR=0.560)、饭前便后经常洗手(OR=0.451)、定期清洗消毒玩具(OR=0.188)等3个因素为CVA6型手足口病发病的保护因素。结论 CVA6型手足口病的防控,应重视传染源的妥善管理与接触隔离,加强对散居儿童家庭的健康教育,促进其养成良好的生活卫生习惯。

Objective To study the influencing factors of hand-foot-mouth disease caused by Coxsackievirus A6（CVA6）,and provide scientific reference to prevention and control of this disease. Methods HFMD patients were chosen randomly in the People’s Hospital of Songgang and Guangming new district in Shenzhen from Jan. to Dec. 2014, and their feces or anal swab samples were collected. Patients’ information such as basic situation, living environment and health habits were investigated. 474 samples and questionnaires of HFMD were collected. 186 CVA6 positive patients were selected as the case group while 186 non-infectious disease patients were selected as control group, and questionnaire survey was conducted among the control group. Logistic regression analysis was performed to find the influencing factors of HFMD caused by CVA6. Results Multi-factor unconditional logistic regression analysis showed that scattered children（OR =2.499）, habits like sucking finger or biting toys（OR =2.257）, shared toys（OR =1.834）, having ever contacted with HFMD patients（OR =19.438） were the risk factors to HFMD caused by CVA6, while facters such as HFMD health education（OR =0.560）,frequently washing hands before dinner and after defecate（OR =0.451）, regularly cleaning and disinfection toys（OR=0.188） were the protecting factors of this disease. Conclusion In order to prevent and control HFMD caused by CVA6, more attention should be paid to the proper management and isolation of infectious source, and enhance health education on scattered children’s family, and promote their health habits.