2013—2016年兰州市腹泻病例监测分析

Surveillance and analysis of diarrhea cases in Lanzhou city from 2013 to 2016

目的了解甘肃省兰州市腹泻的流行病学特征和可能的影响因素,为预防和控制提供依据。方法收集2013—2016年兰州市腹泻疾病哨点医院肠道门诊腹泻病人的基本信息和临床症状等,并采集病人的新鲜粪便标本,检测沙门菌和志贺菌。结果 2013—2016年兰州市共监测腹泻病人3 197例,其中2013年最多(1 097例,34.3%),男性1 790例(56.0%),0~7岁最多(1 872例,58.6%),腹泻病人食物史多以进食加热食物为主(63.5%),就餐地点以在外进食为主(64.0%),各年之间的年龄(χ~2=1 052.007)、食品是否加热(χ~2=278.378)和就餐地点(χ~2=718.505)构成差异有统计学意义(P<0.05);以恶心、呕吐、腹痛、腹泻和发热的临床症状为主,3 197例腹泻病例中有2 853例(89.2%)采集粪便检测了病原菌,检出阳性137例、阳性率4.8%,以沙门菌和志贺菌感染为主,6—9月粪便样本病原菌阳性率较高,且各月构成差异有统计学意义(χ~2=33.409,P<0.05)。结论兰州市腹泻的发生存在年龄差异和季节性,减少在外就餐次数、0~7岁儿童及每年6—9月是预防腹泻的关键。

Objective To explore the epidemiologic characteristics and associated factors of diarrhea in Lanzhou city in order to provide suggestions for its prevention and control. Methods The basic information and clinic symptoms of diarrhea patients were collected at sentinel hospital of diarrhea disease in Lanzhou from 2013 to 2016. As well, the fresh stool specimens were tested for Salmonella and Shigella. Results There were 3 197 diarrhea patients from 2013 to 2016, with the most in 2013（1 097 cases, 34.3%）. There were 1 790 cases（56.0%） in the female. The cases were mainly concentrated in children of 0 to 7 year-old（1 872 cases, 58.6%）. Within the patients, most of them ate heating food（63.5%） outside（64.0%）.There were statistical differences（P〈0.05） in the proportion among patients at various ages（χ^2=1 052.007）, whether food heating or not（χ^2=278.378）, and different dining spots distribution（χ^2=718.505）. The main clinical symptoms were nausea,vomiting, abdominal pain, diarrhea and fever. Of the 3 197 diarrhea patients, 2 853 cases（89.2%） were collected stool specimen to detect pathogens, with 137 cases detected positive pathogens（4.8%）, which were mainly Salmonella and Shigella.The positive rate was high from June to September, with statistical difference in monthly distribution（χ^2=33.409, P〈0.05）.Conclusions The incidence of diarrhea is age-related variation and seasonal variation. Accordingly, the key to prevent diarrhea is protecting children at age of 0 to 7 year-old and from June to September every year.