潍坊市4岁以下儿童轮状病毒感染流行病学及影响因素分析

Study on epidemiology and influencing factors of rotavirus infection in children under 4 years of age in Weifang city

目的分析潍坊市4岁以下儿童感染轮状病毒的相关因素。方法采用分层抽样方法抽取2020年9月~2021年8月在潍坊医学院附属医院和潍坊市妇幼保健院确诊为轮状病毒感染的4岁以下儿童为实验组,按年龄2∶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,对比2组血红蛋白水平、血清25-(OH)D、锌和铁水平,并分析其与轮状病毒感染的相关性。对2组儿童家长进行问卷调查,内容包括儿童基本信息、轮状病毒疫苗接种史、腹泻患者接触史、不良习惯(如挑食、吮手指等)、外出史、卫生情况(如洗手、饮食、餐具、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。结果潍坊市4岁以下儿童发生轮状病毒性腹泻主要集中在1~4月份,对应季节为冬季和早春,并且轮状病毒性腹泻好发于12~35月龄的幼儿中(P<0.05),感染轮状病毒患儿的性别差异无统计学意义(P>0.05)。实验组血红蛋白水平、血清25-(OH)D、锌和铁水平均明显低于对照组(t=-4.39,-9.60,-13.34,-3.28,均P<0.05),实验组诊断为贫血的患儿明显多于对照组(χ^(2)=6.294,P<0.05)。多因素Logistic回归分析结果显示,有吮指习惯(OR=4.82)、挑食习惯(OR=4.08)、发病前3d内生冷饮食史(OR=30.27)、发病前3d内腹泻患者接触史(OR=49.39)是感染轮状病毒的危险因素。有良好洗手习惯(OR=0.03)、饮食用具消毒习惯(OR=0.31)以及接种RV疫苗(OR=0.09)是感染轮状病毒的保护因素。结论潍坊市4岁以下儿童发生RV感染主要集中在1~4月,且好发于12~35月龄、存在维生素D缺乏、锌缺乏及贫血的儿童中。纠正孩子挑食、吮指、进食生冷食物等不良习惯,家长及儿童提高卫生意识,勤洗手,定期消毒餐具,按时接种RV疫苗可以有效降低感染轮状病毒的风险。

Objective To study the related factors of rotavirus infection in children under 4 years of age in Weifang city.Methods Children younger than 4 years old who were diagnosed with rotavirus infection in the Affiliated Hospital of Weifang Medical University and Weifang Maternal and Child Health Care Hospital from September 2020 to August 2021 were selected as the experimental group by stratified sampling method.Children without diarrhea symptoms who underwent physical examination in the same hospital during the same period were selected as the control group in a ratio of 2∶1 and grouped according to age.Hemoglobin levelsserum 25-(OH)Dzinc and iron levels were compared between the 2 groups and their correlation with rotavirus infection were analyzed.Questionnaires were administered to parents of children in 2 groupsincluding children’s basic informationrotavirus vaccination historycontact history of diarrhea patientsbad habits(such as picky eating,sucking fingers etc),history of going out,hygienic conditions(such as hand washing,food,table,waretoys),etc.The factors related to rotavirus infection in children were analyzed by univariate and multivariate analysis methods.Results The occurrence of rotavirus diarrhea in children under 4 years of age in Weifang was mainly concentrated in January to Aprilcorresponding to the winter and early spring seasons.And rotavirus diarrhea was more frequent in children aged 12~35 months(P<0.05)and there was no statistical significance in gender of children infected with rotavirus(P>0.05).The hemoglobin levelserum 25-(OH)D zinc and iron were significantly lower in the experimental group than those in the control group(t=-4.39,-9.60,-13.34,-3.28,all P<0.05),and significantly more children in the experimental group were diagnosed with anemia than in the control group(χ^(2)=6.294,P<0.05).Multivariate Logistic regression analysis showed that finger sucking habit(OR=4.82),fussy eating habit(OR=4.08),history of raw and cold diet within 3 days before onset(OR=30.27),and history of contact with diarrhea patients within 3 days before onset(OR=49.39)were risk factors for rotavirus infection.Good habits of washing hand(OR=0.03),disinfection of eating utensils(OR=0.31)and RV vaccination(OR=0.09)were protective factors for rotavirus infection.Conclusion RV infection in children under 4 years of age in Weifang is mainly concentrated in the months of January to Apriland tends to occur in children aged 12~35 monthsand in children with vitamin D deficiencyzinc deficiency or anemia.Correcting children’s bad habits such as picky eatingfinger sucking and eating raw and cold foodraising awareness of hygiene among parents and childrenwashing hands frequentlydisinfecting tableware regularly and getting RV vaccination on time can effectively reduce the risk of rotavirus infection.