2018~2019年北京市大兴区手足口病病原学特征及影响因素分析

Analysis of etiological characteristics and influencing factors of hand-foot-mouth disease in Daxing District,Beijing from 2018 to 2019

目的分析2018~2019年北京市大兴区手足口病病原学特征及影响因素。方法数据来源于2018年1月~2019年12月大兴区手足口病监测及疫情采集的799例咽拭子标本的肠道病毒核酸检测结果,采用Stata/SE 15进行阳性病例病原学构成的描述性统计分析和利用Logistic回归的影响因素分析。结果在手足口病阳性样本中,2018年优势毒株为柯萨奇A组6型(Coxsackie virus group A type 6,CA6)(59.97%),2019年为柯萨奇A组16型(Coxsackie virus group A type 16,CA16)(48.82%)和CA6(40.53%),差异有统计学意义(P<0.05)。从不同社会经济学特征下手足口病病原的构成来看,描述性统计分析结果显示,CA6在不同年龄组、性别、职业和城乡分布均占最高比例,但病原学构成在不同社会经济学特征不存在统计学意义(P>0.05)。Logistic分析结果显示,CA16在2019年发生的可能性要更高(OR=3.654,P<0.01),CA6和其他肠道病毒发生在2018年的可能性要更高(OR<1,P<0.01);CA16更易发生在具备女性、2岁组、托幼、郊区等社会经济学特征的人群中(OR>1),CA6更易发生在具备男性、3岁组、学生、城区等社会经济学特征的人群中(OR>1),但差异无统计学意义。结论应进一步研发针对CA16和CA6等的多价手足口病疫苗,并结合病原在不同社会经济学特征的分布情况,有效应对手足口病病原学的动态变化;未来应进一步加强有关手足口病病原学构成及影响因素的研究。

Objective To analyze the etiological characteristics and influencing factors of hand-foot-mouth disease(HFMD)in Daxing District,Beijing from 2018 to 2019.Methods Data were obtained from enterovirus nucleic acid test results of 799 pharyngeal swabs collected from hand,foot and mouth disease surveillance and epidemic situation in Daxing District from January 2018 to December 2019.Descriptive statistical analysis of pathogenic composition of positive cases was performed using Stata/SE 15 and influencing factors were analyzed using Logistic regression.Results In the positive samples of HFMD,the dominant strains were Coxsackie virus group A type 6(CA6)(59.79%)in 2018,and Coxsackie virus group A type 16(CA16)(48.82%)and CA6(40.53%)in 2019,and the differences were statistically significant(P<0.05).From the perspective of the composition of HFMD pathogens under different socioeconomic characteristics,descriptive statistical analysis results showed that CA6 accounted for the highest proportion in different age groups,gender,occupation and urban and rural distribution,but there was no statistical significance in the composition of pathogens under different socioeconomic characteristics(P<0.05).Logistic analysis results showed that CA16 was more likely to occur in 2019(OR=3.654,P<0.01),CA6 and other enteroviruses were more likely to occur in 2018(OR<1,P<0.01).CA16 was more likely to occur among people with socioeconomic characteristics such as women,2-years old group,childcare,and suburbia(OR>1).CA6 was more likely to occur in people with socioeconomic characteristics such as men,3-year-old group,students,urban areas(OR>1),but the difference was not statistically significant.Conclusion It is necessary to further develop multivalent HFMD vaccines for CA16 and CA6,and effectively respond to the dynamic changes of HFMD etiology by combining the distribution of pathogens in different socioeconomic characteristics.In the future,studies on the etiological composition and influencing factors of HFMD should be further strengthened.