邯郸市农村地区儿童手足口病发病影响因素病例对照研究

Influencing factors of incidence of hand-foot-mouth disease among children in rural area of Handan City,a case-control study

目的分析农村地区儿童手足口病发病流行的影响因素,为制定针对性的防控措施提供科学依据。方法用病例对照研究方法,在邯郸市选取两个手足口病高发县进行调查,采用分层抽样的方法确定病例300例,按1:2配对原则选取600例未患过手足口病的儿童为对照组,利用自制问卷收集资料。采用Epi Data3.1建立数据库,用SPSS17.0统计软件进行单因素和多因素条件logistic回归分析。结果随意倾倒生活垃圾(OR=2.145)、儿童有病例接触史(OR=12.546)、儿童断奶月龄小(OR=4.189)、家庭饮用水地下井水(OR=1.955)、家庭年均净收入低(OR1=2.789,OR2=1.779)和经常带儿童赶集(OR=4.758)为手足口病的主要危险因素,主要的保护因素有大小便能自理(OR=0.577)、儿童玩耍后洗手(OR=0.491)、看护人外出回家后洗手(OR=0.482)。结论改善农村地区环境及饮水条件,养成良好的个人卫生习惯;提倡母乳喂养,适当延长母乳喂养时间;避免儿童接触手足口病患者能够降低患手足口病的风险。

Objective To analyze the factors influencing the epidemic of hand-foot-mouth disease （HFMD） in rural children in Handan City so as to provide scientific evidence for formulating targeted prevention and control measures. Methods We selected 2 counties with high incidence of HFMD in Handan City to conduct a case-control study. A stratified sampling method was used to identify 300 HFMD cases. Based on 12 matching principle, 600 children without HFMD were selected as the control group. The data were collected by a self-designed questionnaire. The database was built with EpiData3.1, and univariate and multivariate conditional logistic regression analyses were performed with SPSS17.0 statistical software. Results The main risk factors for HFMD were at-will dumping domestic garbage （OR=2.145）, having case contact history（OR=12.546）, shorter-term breastfeed（OR=4.189）, underground well-water as household drinking water（OR=1.955）, low annual average family income （OR1=2.789,OR2=1.779）and frequently going to a fair with children（OR=4.758）. The main protective factors were self-care of defecation and urination （OR=0.577）, washing hands after playing （OR=0.491）, and caregivers’ washing hands after returning home （OR=0.482）. Conclusions To reduce the risk of children suffering from HFMD, we should improve the environment and drinking water condition in rural areas, cultivate good personal hygiene habits, advocate breastfeed, extend breastfeed time appropriately and avoid contacting with HFMD patients.