四川省钩端螺旋体病高发因素调查

Investigationon High- risk Factors of Leptospirosis in Sichuan Province

目的分析四川省近年钩端螺旋体病高发因素,为采取针对性干预措施提供依据。方法选取近年报告钩端螺旋体病最多的四川省仪陇县作为调查县。对仪陇县2009-2012年4年中报告的临床诊断病例或实验室诊断病例进行回顾性病例对照调查研究,收集病例暴露危险行为和环境危险因素。结果病例143例,对照129例。病例调查率为60%,病例发病时间越久,调查率越低。收割水稻时田中有水、发病前1个月接触到动物粪便、发病前15 d手或脚有伤口为病例发病危险因素,接种钩体疫苗为保护因素。结论仪陇县钩端螺旋体病高发与病例居住环境、田间劳作环境及病例在钩端螺旋体流行季节的个人行为有关,注射2针钩端螺旋体疫苗可有效预防钩体病。

Objective To analyze the high- risk factors of leptospirosis in Sichuan province in recent years so as to provide evidence for leptospirosis prevention and control. Methods As the leptospirosis high- reported county in Sichuan province,Yilong county was chosen for investigation. A retrospective case-control study was conducted in clinical diagnosed and laboratory diagnosed cases from 2009 to 2012 to identify high- risk behaviors and environmental risk factors. Results There were 143 patients and 129 controls collected,the investigation rate was 60%. Longer detection time was associated with lower investigation rate. The risk factors included： water in the field when the rice was harvesting,people contacting to other animal feces one month before the onset,and hands or feet with wounds 15 days before the onset;while leptospirosis vaccine was the protective factors. Conclusion The high- risk factors of leptospirosis in Yilong county are field working environment,living environment and the individual behaviors in summer. Double inoculation of leptospirosis vaccine is effective to prevent this disease.