广州市番禺区0~3岁散居儿童手足口病发病影响因素病例对照研究

Case-control Study on the Influencing Factors of HFMD in Scattered Children Aged 0 to 3 Years in Panyu District,Guangzhou

目的:探讨广州市番禺区0~3岁散居儿童手足口病发病的危险因素,提出有针对性的防控措施。方法:选取自2021年1月1日起上传到传染病报告信息管理系统中现住地址为番禺区内、年龄为0~3岁的手足口病患儿400例作为病例组。选取同时期在番禺区妇幼保健院保健科就诊的400名儿童作为对照组,选取原则是与病例组同性别、月龄±2月、同社区无手足口病/疱疹性咽峡炎/发热伴出疹症状的儿童。通过问卷调查,整理数据,运用单因素和多因素logistic回归法筛选出影响散居儿童手足口病发病的危险因素和保护因素。结果:研究显示,近10天内乘坐过公共交通工具、到过游乐公共场所玩耍、去过医院、有病例接触史、与5岁以下儿童居住、与孩子常共用餐具、孩子常吸吮手指或咬玩具为手足口病发病的危险因素(OR值分别为2.132、3.493、5.33、10.91、2.244、1.943、4.513,P值均<0.05),孩子和看护人常洗手、并用肥皂洗手、室内常通风或消毒、接种手足口病EV71疫苗是手足口病发病的保护因素(OR值分别为0.544、0.443、0.213、0.324、0.581、0.313,P值均<0.05)。结论:影响番禺区散居儿童手足口病发病的危险因素较多,政府部门应各尽其责,采取有针对性的防控措施,以降低散居儿童手足口病发病率。

OBJECTIVETo explore the risk factors of hand, foot and mouth disease in 0~3 years old scattered children in Panyu district, and to put forward targeted prevention and control measures. METHODS Using the method of 1:1 matched case-control study, the selected cases were children with hand, foot and mouth disease aged 0~3 years old who were uploaded to the infectious disease report information management system from January 1, 2021. In the control group, 400 children from the health care department were selected. The principle was that children of the same sex, age ± 2 months, and without hand foot mouth disease/herpetic angina/fever with rash symptoms in the same community. The risk factors and protective factors of hand, foot and mouth disease in scattered children were screened by single factor and multi factor Logistic regression. RESULTS Research showed that the risk factors of hand, foot and mouth disease were taking public transport, playing in public places, going to hospitals, case contact history in the past 10 days, living with children under the age of 5, often shared tableware with children, and children often sucked fingers or biting toys( OR=2.132, 3.493, 5.33, 10.91, 2.244, 1.943, 4.513, P<0.05).Children and caregivers often washed their hands with soap, ventilate or disinfect indoors, and vaccination against hand, foot and mouth disease EV71 vaccine was the protective factor of hand, foot and mouth disease( OR=0.544, 0.443, 0.213, 0.324, 0.581, 0.313, P<0.05). CONCLUSION There are many risk factors affecting the incidence of hand, foot and mouth disease in scattered children in Panyu District.Government departments should take full responsibility and take targeted preventive measures to reduce the incidence rate of hand foot mouth disease in scattered children.