山东省邹城市859例Ⅱ、Ⅲ级狂犬病暴露者特征及狂犬病疫苗接种情况分析

Analysis on characteristics and rabies vaccination status of 859 cases of grade Ⅱ and Ⅲ rabies exposers in Zoucheng city,Shandong province in 2022

目的了解2022年山东省邹城市Ⅱ、Ⅲ级狂犬病暴露者人群特征及狂犬病疫苗、狂犬病免疫球蛋白的接种情况,为预防和控制狂犬病提供科学依据。方法回顾性分析2022年1-12月在山东省邹城市某犬伤门诊就诊的859例狂犬病Ⅱ、Ⅲ级暴露者的资料,主要收集狂犬病Ⅱ、Ⅲ级暴露者的性别、年龄、职业、致伤动物、暴露场所、暴露时间、暴露分级、疫苗接种等资料。采用χ^(2)检验分析狂犬病暴露人群特征,采用二元logistic回归分析狂犬病暴露人群疫苗全程接种率的影响因素。结果2022年在山东省邹城市某犬伤门诊就诊狂犬病Ⅱ、Ⅲ级暴露人群859例;就诊高峰为5-9月份,共490例;年龄以0~14岁为最多(274/859,占31.90%);职业以学生为最多(266/859,占30.97%);暴露分级以Ⅲ级暴露为最多(628/859,占73.11%);暴露部位以手部为最多(602/859,占70.08%);致伤动物以犬为最多(480/859,占55.88%);暴露场所以户内为最多(792/859,占92.20%);Ⅲ级暴露者中,狂犬病免疫球蛋白接种率为35.03%(220/628)。不同年龄、职业、暴露分级人群狂犬病疫苗全程接种率比较,差异有统计学意义(χ^(2)值分别为92.55、119.64、3.38,P<0.05)。二元logistic回归分析结果显示,0~14岁(OR=9.06,P<0.01)、15~29岁(OR=2.41,P<0.05)、30~44岁(OR=2.39,P<0.05)、45~59岁(OR=2.33,P<0.05)、学生(OR=3.71,P<0.01)、公务人员(OR=2.00,P<0.05)、Ⅲ级暴露(OR=1.48,P<0.05)是狂犬病疫苗全程接种率的保护因素。结论就诊的狂犬病Ⅱ、Ⅲ级暴露者中以Ⅲ级暴露为主,就诊高峰为5-9月,暴露部位以手部为最多,致伤动物以犬为最多,暴露场所以户内为最多。年龄、职业、暴露程度是Ⅱ、Ⅲ级暴露者狂犬病疫苗全程接种率的影响因素。

Objective To understand the population characteristics of the grade Ⅱ and grade Ⅲ rabies exposers in Zoucheng city,Shandong province in 2022,as well as the vaccination status of rabies vaccines and rabies immunoglobulins,so as to provide a scientific basis for the prevention and control of rabies.Methods A retrospective analysis was conducted on 859 cases of grade Ⅱ or grade Ⅲ rabies exposers who visited a rabies clinic in Zoucheng city,Shandong province from January to December 2022.The main information collected were gender,age,occupation,injured animals,exposure location,exposure time,exposure grade,and vaccination.A chi square test was used to analyze the characteristics of the rabies exposers,and a binary logistic regression analysis was used to analyze the influencing factors of the full vaccination rate of the rabies exposers.Results In 2022,A total of 859 grade Ⅱ and grade Ⅲ rabies exposure cases were treated at a rabies clinic in Zoucheng city,Shandong province.The peak of medical visits was from May to September,with a total of 490 cases.The most common age group was 0-14 years old(274/859,31.90%).The majority of professions were students(266/859,30.97%);grade Ⅲ exposure was the most common exposure classification(628/859,73.11%).The most exposed parts were the hands(602/859,70.08%).Dogs were the most common animals causing injuries(480/859,55.88%).The most exposed places were indoors(792/859,92.20%).Among grade Ⅲ exposers,the rabies immunoglobulin vaccination rate was 35.03%(220/628).There was a statistically significant difference in the overall vaccination rate of rabies vaccines among people of different ages,occupations,and exposure grades(χ^(2)=92.55,119.64,3.38,P<0.05).The results of binary logistic regression analysis showed that 0-14 years old(OR=9.06,P<0.01),15-29 years old(OR=2.41,P<0.05),30-44 years old(OR=2.39,P<0.05),45-59 years old(OR=2.33,P<0.05),students(OR=3.71,P<0.01),public officials(OR=2.00,P<0.05),and grade Ⅲ exposure(OR=1.48,P<0.05)was protective factors for the overall rabies vaccine coverage rate.Conclusion Among the level Ⅱ and Ⅲ rabies patients seeking medical attention,level Ⅲ exposure is the main type,with a peak of May-September.The most exposed areas are in the hands,the most injurious animals are dogs,and the most exposed areas are indoors.Age,occupation,and exposure level are the influencing factors of the overall vaccination rate of rabies vaccines for level Ⅱ and Ⅲ exposed individuals.