上海市宝山区戊型肝炎发病危险因素的病例对照分析

A case-control study of risk factors for hepatitis E in Baoshan District of Shanghai

目的了解上海市宝山区戊型病毒性肝炎(戊肝)发病的危险因素,为戊肝防控策略提供参考依据。方法采用病例对照方法分析戊肝发病危险因素。病例选择常住上海市宝山区的2019年1月1日—2021年1月31日新发戊肝病例,共77例。按照1∶2配比,选择与病例居住在同一社区的健康人群为对照。收集研究对象人口学特征以及感染的可能危险因素等,并对数据进行分析。结果病例对照调查共调查77例戊肝病例和154名对照,平均年龄(56.86±14.92)岁,男女性别比为1.66∶1。病例组和对照组在受教育程度(χ^(2)趋势=9.197)、户籍(χ^(2)=3.983)、近半年内外出就餐或外卖情况(χ^(2)趋势=9.324)、近半年内食用生炝贝壳类食物史(χ^(2)=10.253)、近半年内食用生炝海鲜食物史(χ^(2)=16.797)、饭前便后洗手习惯(χ^(2)趋势=7.500)、既往肝炎病史(χ^(2)=11.461)方面差异均有统计学意义(均P<0.05)。相较于大学及以上学历,小学及以下学历(OR=19.06,95%CI:4.04~89.96)和初中及高中学历(OR=7.10,95%CI:2.27~22.26)为戊肝发病的危险因素,既往有肝炎病史(OR=7.39,95%CI:1.63~33.43)、近半年内经常(每月≥4次)外出就餐或外卖(OR=4.93,95%CI:1.38~17.71)以及近半年内有生炝海鲜类食用史(OR=5.61,95%CI:2.03~15.55)也是戊肝的危险因素(均P<0.01)。结论既往有肝炎病史、受教育程度低、近半年内经常外出就餐或外卖以及近半年内有生炝海鲜类食品食用史为戊肝发病的危险因素,提示戊肝发病与卫生习惯及饮食习惯有关,应进一步加强食品卫生监督以及强化洗手等防病习惯的宣教,提高居民预防疾病的意识。

Objective To explore the risk factors of hepatitis E in Baoshan District of Shanghai,provide reference for hepatitis E prevention and control strategies.Methods The risk factors of hepatitis E were analyzed by case-control study.77 new cases of hepatitis E,who lived in Baoshan District of Shanghai from January 1,2019 to January 31,2021 were selected as the cases.According to the ratio of 1∶2,the healthy people living in the same community were matched as the controls.The demographic characteristics and possible risk factors of infection were collected.And the data were analyzed.Results A total of 77 hepatitis E cases and 154 controls were investigated in this case-control study.The mean age was(56.86±14.92)years old,and the male to female ratio was 1.66∶1.There were statistically significant differences in the education level(χ^(2)trend=9.197),household registration(χ^(2)=3.983),the frequency of eating out including takeaway in the last half year(χ^(2)trend=9.324),consumption of raw or undercooked shellfish in the last half year(χ^(2)=10.253),consumption of raw or undercooked sea food in the last half year(χ^(2)=16.797),habit of washing hands before meals and after toileting(χ^(2)trend=7.500)and history of hepatitis(χ^(2)=11.461)between the case group and the control group(all P<0.05).Compared to education level of college or above,the education level of elementary school or below(OR=19.06,95%CI:4.04-89.96)and education level of junior high school and senior high school(OR=7.10,95%CI:2.27-22.26)were the risk factors for the hepatitis E infection.And the history of hepatitis(OR=7.39,95%CI:1.63-33.43),often(≥4 times per month)eating out including takeaway in the last half year(OR=4.93,95%CI:1.38-17.71),and consumption of raw or undercooked seafood in the last half year(OR=5.61,95%CI:2.03-15.55)were the risk factors for the hepatitis E infection(all P<0.01).Conclusion The history of hepatitis,lower education level,often eating out including takeaway in the last half year,and consumption of raw or undercooked seafood in the last half year are risk factors for hepatitis E infection,indicating that the hepatitis E infection is related to hygiene habits and eating habits,and the relevant departments should strengthen the supervision of food hygiene and publicity and education of washing hands to improve the residents’awareness of disease prevention.