中山市5岁以下儿童手足口病发病相关因素分析

The risk factors analysis of Hand-foot-mouth disease for under 5 years old children in Zhongshan

目的探讨中山市〈5岁儿童手足口病发病的相关因素，为制定手足口病防控措施提供参考依据。方法采用病例对照研究设计，以中山市妇幼保健院2014年5～8月间儿科住院治疗的手足口病患儿为病例组，以同期在儿保科进行健康体检的儿童为对照组，采用自行设计的手足口病个案调查表进行调查，调查内容包括居住情况、健康状况、生活习惯、接种轮状病毒疫苗情况等。采用卡方检验和Logistic回归分析手足口病危险因素。结果手足口病儿童与健康儿童在户籍、散居／托幼、看护人、生活习惯（儿童饭前便后洗手、吮吸手指与玩具、作息规律）、健康和疫苗接种（是否接种过轮状病毒疫苗、近3个月发生上呼吸道感染或腹泻胃肠炎、近1周去过医院就诊）方面差异具有统计学意义（P〈0．05）。流动户籍（0R=1．612）、散居（OR=11．851）、看护人为祖辈或其他相比父母（OR=1．353、2．344）、儿童饭前便后不洗手或偶尔洗手（0R=2．363）、吮吸手指与玩具（OR=2．017）、作息不规律（0OR=3．156）、未接种过轮状病毒疫苗（0R=11．129）、近3个月发生上呼吸道感染、腹泻或胃肠炎（OR=4．808）、近1周去过医院就诊（OR=2．337）的儿童发病风险较高。结论中山市〈5岁儿童手足口病发病与居住情况、健康状况、生活习惯等密切相关，应针对性采取预防措施，降低手足口病发病率。

Objective To explore the risk factors of Hand-foot-mouth disease （HFMD） for under 5 years old children in Zhongshan, to provide the scientific basis for the prevention and care for HFMD. Methods A case-control design was used. The pediatric hospitalized children with HFMD in the maternal and child health care hospital between May and August in 2014 were selected as the case group. The children for health physical examination in the same period were selected as the control group. Self-designed questionnaires were used to investigate the risk factors. The chi-square test and Logistic regression analysis were applied for analysis. Results The differences were significant for the household registration, scattered/nursery, caretakers, living habit （washing hands before and after meals, sucking fingers and toys, living routine）, health and vaccination （whether a rotavirus vaccine, for nearly three months of the upper respiratory tract infection or gastroenteritis, diarrhea nearly 1 week to hospital） between Hand-foot-mouth disease children and healthy children （P 〈 0.05）. The children who had current household registration （OR=1.612）, scattered （OR=1.851）, the nursing human ancestors OR other than their parents （OR=1.353, 2.344）, washing hands before and after meals （OR=2.363）, sucking fingers and toys （OR=2.017）, irregular work and rest （OR=3.156）, never accepted rotavirus vaccine （ORal 1.129）, for nearly three months of the upper respiratory tract infection, diarrhea or gastroentefitis （OR=4.808）, nearly 1 week to hospital （OR=2.337） had higher risk. Conclusion The onset of HFMD for the children under the age of five in Zhongshan, were closely related to health status and living habits, which reveal preventive measures should be targeted to take, to reduce the incidence of HFMD.