2009-2012年仪陇县钩端螺旋体病发病影响因素分析

Influencing Factors for Leptospirosis in Yilong County From 2009 to 2012

目的探讨仪陇县钩端螺旋体病发病影响因素,为控制钩端螺旋体病提供科学依据。方法选择2009-2012年仪陇县报告的临床诊断和实验室诊断钩端螺旋体病129例,按1∶1比例配对同性别、年龄相差3岁以内、当年没发病的邻居作为对照。收集病例和对照的基本信息、生活习惯、生产方式,采用单因素分析和条件Logistic回归分析。结果单因素结果显示收割水稻时田中有水(OR=6.01,95%CI:1.61~22.33),发病前15天手脚有伤口(OR=11.25,95%CI:4.90~25.80),住所在雨天易被淹(OR=2.67,95%CI:1.28~5.57)、自家田地紧邻厕所或猪圈(OR=2.19,95%CI:1.19~4.02)、发病前一个月接触动物排泄物(OR=2.90,95%CI:1.76~4.77)为发病危险因素,接种两针疫苗(OR=0.06,95%CI:0.02~0.14)为保护因素。多因素分析结果显示收割水稻时田中有水(OR=13.75,95%CI:3.56~54.55)、住所在雨天易被淹(OR=2.35,95%CI:1.13~4.89)、自家田地紧邻厕所或猪圈(OR=2.53,95%CI:1.35~4.76)为危险因素,当年接种两针疫苗为保护因素(OR=0.04,95%CI:0.01~0.11)。结论夏季收割水稻时放干农田、疏通居住地排水沟、让厕所或猪圈远离农田以及每年及时接种两针次钩体疫苗为预防钩体病发病的重要措施。

Objective To investigate influencing factors for leptospirosis in Yilong County and provide a scientific basis for the control of leptospirosis. Methods A pair - matched case - control study was conducted in 129 clinically and laboratory - diagnosed leptospirosis patients in Yilong County from 2009 to 2012 and pair - matched at a ratio of 1 ： 1 with neighbors of the same sex, with an age difference within 3 years and without onset of leptospirosis in the same year as controls. General information, life habits and labor modes of the cases and controls were collected; single - factor analysis and conditional Logistic regression analysis were conducted. Results Single - factor analysis showed that presence of water in paddy fields at the time of harvesting （ OR = 6.01, 95% CI： 1.61 - 22. 33） , wounds of hands or feet within 15 days before onset （ OR = 11.25, 95%CI： 4.90- 25.80）, residences prone to be flooded in rainy weather （ OR = 2.67, 95 % CI.. 1.28 - 5.57） , paddy fields adjacent to toilets or pigsties （ OR = 2. 19, 95% CI. 1.19 - 4.02）, contact with animal waste within one month before onset （ OR = 2.90, 95% CI： 1.76 - 4.77） were risk factors; and vaccination by two doses was a protective factor （OR = 0. 06, 95% CI： 0.02 - 0. 14 ）. Multifactor analysis results showed presence of water in paddy fields at the time of harvesting （ OR = 13.75, 95% CI： 3.56 - 54.55 ） , residences prone to be flooded in rainy weather （OR =2. 35, 95% CI： 1.13 -4. 89） and paddy fields adjacent to toilets or pigsties （ OR = 2. 53, 95% CI： 1.35 - 4. 76）, while vaccination by two doses was a protective factor （OR =0. 04, 95% CI： 0. 01 -0. 11 ）. Conclusion Discharging water completely from paddy fields in harvesting in summer, dredging ditches in residences, building toilets or pigsties far away from paddy fields and accepting two doses of leptospira vaccine each year are important measures for preventing leptospirosis.