福建省人感染H7N9禽流感病例对照研究

Risk factors for human infection with avian influenza A(H7N9) virus in Fujian province, China:a case-control study

目的探索福建省人感染H7N9禽流感发病危险因素,以期为制定和调整防控策略提供科学指导。方法采用病例对照研究方法,连续地收集2014年11月-2017年10月确诊共75个病例,运用多因素logistic回归分析危险因素。结果病例和对照组在性别、年龄组、城乡和体质指数(BMI)构成方面无统计学差异。单因素分析提示36个因素与发病相关,经多因素逐步logistic回归分析显示:患肺部疾病(OR=4.95)、糖尿病(OR=4.46)、暴露活禽市场(OR=3.66)、暴露使用机械脱毛摊点(OR=5.78)、触摸家禽笼舍(OR=5.77)、暴露野鸟排泄物(OR=2.77)是人感染H7N9禽流感危险因素;经常洗手(OR=0.07),可使发病风险降低,得到的回归方程对训练样本预测一致率为89.40%,拟合优度良好(C=0.90)。结论患肺部疾病、患糖尿病、暴露活禽市场、暴露使用机械脱毛摊点、家禽笼舍、野鸟排泄物是福建省人感染H7N9禽流感的危险因素;经常洗手是保护因素。

Objective To explore risk factors of human infections with avian influenza H7 N9 in Fujian province and to provide evidences for developing and adjusting related control strategies. Methods We collected the data on 75 pathogenically confirmed human avian influenza H7 N9 infection cases with census registration of Fujian province from November 2014 to October 2017. Residence(housing estate or village) and age(± 3 years) group-matched controls(n = 300)were also selected simultaneously. Multivariate logistic regression was performed to analyze potential risk and protective factors for human H7 N9 avian influenza infection. Results There were no significant differences in gender and body mass index(BMI) index between the cases and the controls. Univariate analysis resulted in 36 factors associated with human avian influenza infection. Stepwise multivariate logistic regression revealed following factors for human avian influenza H7 N9 infection: pulmonary disease(odds ratio [OR]= 4.95), diabetes(OR = 4.46), exposure to live poultry market(OR = 3.66),exposure to poultry epilation sites(OR = 5.78), contact with poultry cage(OR = 5.77), and exposure to wildfowl feces;the regression analysis also demonstrated that regular hand-washing(OR = 0.07) may reduce the risk of the infection. The concordance rate for the prediction of regression equation on training samples was 89.40%, indication a fair goodness of fit of the model(C = 0.90). Conclusion Among residents in Fujian province, pulmonary disease, diabetes, exposure to live poultry market, exposure to poultry epilation sites, contact with poultry cage, and exposure to wildfowl feces are the risk factors for human infections with avian influenza H7 N9 and regular hand-washing may be a protective factor.