南宁市托幼机构手足口病暴发疫情罹患率及流行时长的影响因素分析

Analysis on the influencing factors of the attack rate and epidemic duration of hand-footmouth disease outbreak in kindergartens in Nanning

目的:分析广西南宁市托幼机构手足口病暴发疫情罹患率及流行时长的影响因素,为手足口病暴发疫情处置提供科学依据。方法:收集整理2008年5月至2019年12月广西南宁市报告的托幼机构手足口病暴发疫情处置资料,采用有序多分类Logistic回归分析其罹患率及流行时长的影响因素。结果:2008年5月至2019年12月广西南宁市累计报告托幼机构手足口病暴发疫情82起,均为一般突发公共卫生事件,罹患率中位数6.76%,流行时长中位数13 d;罹患率有序多分类Logistic回归分析结果显示,公办托幼机构罹患率较民办托幼机低(OR=0.13,95%CI:0.05~0.33),城市及县镇幼儿园罹患率较乡村幼儿园低(OR=0.22,95%CI:0.06~0.77;OR=0.20,95%CI:0.06~0.71),托幼机构有校医较无校医罹患率低(OR=0.24,95%CI:0.07~0.83);疫情流行时长有序多分类Logistic回归分析结果显示,托幼机构被动发现较主动报告的疫情流行时长长(OR=3.64,95%CI:1.07~12.35),采取停课措施的托幼机构流行时长较未采取的短(OR=0.37,95%CI:0.15~0.93),发现疫情1 d内停课可有效降低疫情流行时长(OR=0.22,95%CI:0.06~0.87)。结论:落实托幼机构校医配备,强化民办托幼机构手足口病防控工作,实现早发现早处置早停课,可进一步有效控制疫情蔓延。

Objective:To analyze the influencing factors of the attack rate and epidemic duration of hand-footmouth disease outbreak in kindergartens in Nanning,so as to provide scientific evidences for the treatment of hand-foot-mouth disease outbreak.Methods:The data of hand-foot-mouth disease outbreak in kindergartens reported in Nanning from May 2008 to December 2019 were collected,and the influencing factors of attack rate and epidemic duration were analyzed by ordered multi-classification Logistic regression.Results:A total of 82 outbreaks of hand-foot-mouth disease in kindergartens were reported in Nanning from May 2008 to December 2019,all of which were general public health emergencies.The median incidence rate was 6.76%,and the median epidemic duration was 13 days.The results of ordered multi-classification Logistic regression analysis of attack rate showed that the attack rate of public kindergartens was lower than that of private kindergartens(OR=0.13,95%CI:0.03-0.62),the attack rate of kindergartens in cities and towns was lower than that of rural kindergartens(OR=0.22,95%CI:0.06-0.77;OR=0.20,95%CI:0.06-0.71),and that the attack rate of kindergartens with school doctors was lower than that without school doctors(OR=0.24,95%CI:0.07-0.83).The results of ordered multiclassification Logistic regression analysis of epidemic duration showed that,the epidemic duration of kindergartens that passively detect outbreaks longer than actively reported ones(OR=3.67,95%CI:1.07-12.35),and the epidemic duration of kindergartens that have taken suspension was shorter than those have not(OR=0.37,95%CI:0.15-0.93).It was found that suspension of classes within 1 day of the epidemic could effectively reduce the duration of epidemic(OR=0.18,95%CI:0.05-0.64).Conclusion:Equipping the provision of school doctors in kindergartens,strengthening the prevention and control of hand-foot-mouth disease in private kindergartens,and realizing early detection,early treatment and early suspension of classes can further effectively control the spread of the epidemic.