麻疹家庭内传播干预措施效果评价

Evaluation on intervention measures for measles household transmission

目的评价天津市麻疹家庭内传播的干预措施效果。方法以家庭获得性病例家庭为病例组,社区病例家庭为对照组,开展病例对照研究。结果 2014—2015年天津市麻疹监测系统共报告麻疹确诊病例3 022例,家庭获得性病例35例,占病例总数的1.15%。共纳入病例组32个家庭,对照组64个家庭,干预措施包括病例隔离分居、3 d内应急接种、开窗通风、现场消毒、健康教育、个人防护。单因素χ~2检验显示,干预措施只有隔离分居有统计学意义（χ^2=4.54,P=0.03）,多因素逐步回归logistic分析显示,隔离分居是麻疹家庭内传播的影响因素（χ^2=6.00,P=0.01）,OR=0.27（95%CI 0.10～0.77）。在隔离分居中,居家隔离发生家庭内传播的只有11.62%,住院隔离发生家庭内传播的比例达到47.05%,两组间差异有统计学意义（χ^2=12.02,P〈0.01）,OR=0.15（95%CI 0.05～0.47）。结论隔离分居能有效减低麻疹家庭内传播风险,目前居家隔离效果好于住院隔离。

[Objective] To evaluate the effect of intervention measures for measles household transmission in Tianjin.[Methods]The household-acquired cases were recruited in the case group while the community cases were selected as the control group,to perform a case-control study.[Results] 3022 measles cases were confirmed by the measles surveillance system of Tianjin from 2014-2015,and there were 35 household-acquired cases,accounting for 1.15% of all cases. The case group included 32 households and the control group included 64 households. The intervention measures were separation,emergency vaccination within 3 days,ventilation,disinfection,health education and personal protection. Single factor chi-square test showed the only separation was the significant intervention（χ2=4.54, P=0.03）. Multi-factors stepwise logistic regression revealed that separation was the influencing factor of measles household transmission（χ2=6.00,P=0.01）,OR=0.27（95%CI：0.10-0. 77）.The incidence rate of measles household transmission in household separation was 11.62%,while that in hospital separation reached 47.05%,and the difference was statistically significant（χ^2 =12.02,P〈 0.01）,OR =0.15（95% CI：0.05-0.47）.[Conclusion]Separation can effectively reduce the risk of measles household transmission,and the household separation has better effect than hospital separation.