2010—2018年南宁市兴宁区学校传染病突发公共卫生事件特征及其影响因素分析

Characteristics and influencing factors of public health outbreaks of infectious diseases in schools in Xingning District,Nanning City from 2010 to 2018

目的对2010—2018年南宁市兴宁区学校传染病突发公共卫生事件进行分析,探讨影响疫情暴发的相关因素,为制定防控策略提供参考。方法收集2010—2018年南宁市兴宁区学校传染病暴发疫情资料,采用描述性流行病学方法分析疫情特征,应用多元回归分析方法分析影响疫情控制效果的相关因素。结果南宁市兴宁区2010—2018年共报告学校传染病突发公共卫生事件26起,报告病例1262例,罹患率为8.05%。事件以流感、水痘等呼吸道传染病为主(73.08%),以学校主动报告发现为主(46.16%),3—5月和9—12月是学校传染病突发公共卫生事件发病高峰,小学和幼儿园是主要发病场所(80.77%);首例病例发病到接到报告时间中位数为9.00d,疫情持续时间中位数为22.50d;乡镇学校学生罹患率高于市区学生罹患率(χ^2=103.327,P=0.000),幼儿园儿童(9.66%)罹患率高于小学(8.79%)和中学(6.05%),差异有统计学意义(χ^2=40.631,P=0.000);疾病潜伏期(rp=0.899,P=0.015)、疫情报告及时性(t=5.008,P=0.000)、总病例数(t=5.736,P=0.000)、接到报告时发现的病例数(t=-4.253,P=0.000)对疫情控制效果有影响。结论流行性感冒、水痘和手足口病是兴宁区学校突发公共卫生事件的好发病种,提高疫情报告及时性,及早采取措施是控制学校传染病突发公共卫生事件的关键。

Objective To investigate the characteristics of public health emergent events of infectious diseases and discuss the relevant factors affecting the outbreaks in schools in Xingning District,Nanning City from 2010 to 2018,so as to provide the reference for the formulation of prevention and control strategies.Methods The data of school epidemics in Xingning District of Nanning City from 2010 to 2018 were collected and analyzed by the descriptive epidemiological method to study the characteristics of the emergencies.The factors affecting the control effects were analyzed by the multivariate regression analysis method.Results From 2010 to 2018,26 public health emergent events of infectious diseases in schools in Nanning Xingning District were reported,involving 1262 cases.The attack rate was 8.05%.Most events were caused by respiratory infections such as influenza and chickenpox(73.08%),which were mainly reported by schools(46.16%).The peaks of infectious diseases outbreaks in schools were from March to May and from September to December.The outbreaks were most common in primary schools and kindergartens(80.77%).The median of the period from the first case to the report was 9.00 days,and the median of the outbreak span was 22.50 days.The attack rate of students in township schools was higher than that of students in urban areas(χ^2=103.327,P=0.000).The attack rate in child care institutions(9.66%)was higher than that of in primary schools(8.79%)and in secondary schools(6.05%),and the difference was statistically significant(χ^2=40.631,P=0.000).The incubation period(rp=0.899,P=0.015),timeliness of outbreak reporting(t=5.008,P=0.000),total number of cases(t=5.736,P=0.000),and the number of cases discovered at the time of reporting(t=-4.253,P=0.000)had impacts on the effectiveness of epidemic control.Conclusion Influenza,chickenpox,and hand-foot-mouth disease are very common in public health emergencies in schools in Xingning District.Reporting epidemics in time and taking steps promptly are the keys to confine the situation of public health emergencies of infectious diseases in schools.