西安市5岁及以下儿童轮状病毒感染影响因素研究

Factors influencing rotavirus infection in children 5 and under in Xi’an

目的研究西安市儿童轮状病毒感染相关因素。方法采用随机抽样方法抽取2017年7月至2019年6月在西安市某医院确诊为轮状病毒(RV)感染的5岁及以下儿童为病例组,按年龄1∶1选取同期在同医院进行健康体检的无腹泻症状儿童作为对照组,对2组儿童家长进行问卷调查,内容包括儿童基本信息、家庭基本信息、主要看护人喂养习惯、轮状病毒疫苗接种史、不良习惯(如不洗手、吮手指等)、外出史、腹泻患者接触史、卫生情况(如饮食、玩具)等。采用单、多因素分析方法对儿童感染轮状病毒相关因素进行分析。结果本研究共对西安市5岁及以下(0~59月龄)确诊为轮状病毒感染儿童(病例组)和对照组儿童家长各300人进行调查。病例组男童168例,女童132例,平均(15.76±7.52)月龄,病程2~7 d,平均病程(2.84±2.35)d。对照组男童160人,女童140人,平均(16.53±8.16)月龄。2组儿童的性别构成、平均年龄差异均无统计学意义(均P>0.05)。条件logistic回归分析结果显示,主要看护人文化程度为小学及以下(OR=3.330)、有腹泻患者接触史(OR=5.114)、有不良习惯(OR=3.347)、有不洁饮食(OR=3.931)是5岁及以下儿童感染RV的危险因素。主要看护人职业为企事业单位职工(OR=0.154)、服务业人员(OR=0.168)、自由职业者(OR=0.316),有轮状病毒疫苗接种史(OR=0.131),有良好洗手习惯(OR=0.204),看护人喂养前洗手(OR=0.401),餐具/奶具消毒(OR=0.439)可能降低西安市5岁及以下儿童感染RV的风险。结论主要看护人文化程度低、有腹泻患者接触史、不良习惯及有不洁饮食是婴幼儿感染RV的主要危险因素。应针对文化程度低的婴幼儿看护人开展各种通俗易懂、客观直接的宣教形式,提高看护人的卫生意识,避免儿童接触其他腹泻患儿,培养儿童良好的生活习惯,降低儿童感染RV的风险。

Objective To determine factors influencing rotavirus infection in children in Xi’an.Method Children 5 and under who were diagnosed with rotavirus infection in a hospital in Xi’an from July 2017 to June 2019 were randomly selected as a case group. The children without diarrhea who had physical examinations at the same hospital and the same period were selected as a control group. Two groups were matched by age at a 1∶1 ratio. A questionnaire survey was conducted among parents of two groups of children,including general information of the children and families,feeding habits of primary caregivers,history of rotavirus vaccination,bad habits(such as not washing hands,sucking fingers,etc.),history of going out,history of contact with diarrhea patients,hygienic conditions(such as diet,toys). Univariate and multivariate logistic regressions were applied to determine factors influencing rotavirus infection in children.Results This study included 300 parents of children 5 and under(0-59 months)with rotavirus infection in case group and 300 parents of children in control group. There were 168 boys and 132 girls in the case group,with an average age of(15.76 ±7.52)months and average disease duration of(2.84 ± 2.35)days,ranging 2-7 days. The control group had 160 boys and140 girls,with an average age of(16.53 ± 8.16)months. There were no significant differences in gender composition and mean age between the two groups(P>0.05 for both). Conditional logistic regression analysis showed that the primary caregivers’ education levels were primary school and below(OR=3.330),history of contact with diarrhea patients(OR=5.114),bad habits(OR=3.347),and unclean diet(OR=3.931)were risk factors for rotavirus infection in the children.The primary caregiver occupations being employees of enterprises and institutions(OR=0.154),service workers(OR=0.168),freelancers(OR=0.316),history of rotavirus vaccination(OR=0.131),good habits of washing hand(OR=0.204),caregivers washing their hands before feeding(OR=0.401),and tableware/milk utensils disinfection(OR=0.439)may reduce the risk of rotavirus infection in children 5 and under.Conclusion Low educational level of primary caregivers,history of contact with diarrhea patients,bad habits,and unclean diet are main risk factors for rotavirus infection in infants and young children. It is necessary to carry out easy-to-understand,objective and direct propaganda and education for caregivers with low education level to improve their health awareness,avoid contacting with diarrhea patients,and cultivate good living habits,so as to reduce the incidence of rotavirus infection in the children.