南京市社区居民急性胃肠炎疾病流行特征及负担评估

Epidemic characteristics and population-based burden estimate of acute gastrointestinal illness in Nanjing

目的了解南京市社区居民急性胃肠炎的流行特征,并对疾病负担进行初步评估。方法采用分层随机抽样的方法抽取调查对象,进行面对面问卷调查。结果共调查3600人。南京市社区人群急性胃肠炎月患病率为3.9%,年发病率为0.55次/人年。0~4岁年龄组月患病率最高,为2/20(10.0%)。不同文化程度人群月患病率差异有统计学意义(χ~2=37.192,P<0.01),小学文化组人群最高,为36/449(8.0%);不同职业人群间月患病率差异有统计学意义(χ~2=32.041,P<0.01),失业人群组最高,为24/279(8.6%);城市和农村人群月患病率差异有统计学意义(χ~2=3.951,P<0.05),农村[41/762(5.4%)]高于城市[107/2838(3.8%)]。发病高峰出现在10月和3月。46.6%的患者怀疑发病由受污染的食物引起,其中肉与肉制品占比最高,为63.8%。患者就诊率44.6%,就诊者中71.2%选择街道或社区卫生服务中心就诊,医院就诊和自行服药者中分别有71.4%和59.3%的患者服用过抗生素。就诊者门诊治疗费用人均为133.7元/人次,未就诊患者治疗费用人均为16.1元/人次。结论南京市社区居民急性胃肠炎的疾病负担较重。急性胃肠炎的病例多以散发为主,发病高峰出现在春、秋季节,近半数病例可能与进食不洁食物有关。

Objective To determine the distribution and disease burden of acute gastrointestinal illness （AGI） in community population of Nanjing. Methods A stratified random sampling method was used to extract the object, and a face-to-face survey was carried out. Results A total of 3600 people were investigated. The adjusted monthly prevalence was 3.9% with 0. 55 AGI episodes/person per year. Children aged 0 - 4 years had the highest prevalence 2/20 （ 10. 0% ） of AGI. There were significant differences in AGI prevalence among cultural level （highest prevalence in primary group, 36/ 449, 8. 0%, χ^2 = 37. 192, P 〈 0. 01 ）, occupation status （ highest prevalence in unemployed group, 24/279, 8.6%, χ^2 =32. 041 , P 〈0. 01 ） and residence （higher prevalence in rural residents, 41/762, 5.4% ,χ^2 =3. 951, P 〈0. 05）. October had the highest prevalence, followed March. 46. 6% of those with AGI suspected their illness had been caused by consuming contaminated food, and meat and meat products accounted for a maximum of 63.8%. 44. 6% of cases visited hos- pitals, and 71.2% of them chose street or community health service centers. There were 71.4% and 59. 3% of cases reported taking antibiotics who visited hospital or took medicine itself. The treatment expense of visiting hospital and taking medicine himself/herself were 133.7 RMB/person and 16. 1 RMB/person, respectively. Conclusion The community residents had heavy disease burden of AGI in Nanjing. The predominant AGI cases were sporadic. The peak incidence occurred in spring and autumn, and nearly half of the cases may be associated with eating contaminated food.