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目的:探索江苏省北部部分地区手足口病(hand-foot-mouth disease,HFMD)发病的危险因素。方法:采用问卷调查的方式,在江苏省盐城市和淮安市6个县(区)回顾性调查儿童在过去3年间的HFMD患病史,采用单因素分析和多因素Logistic回归分析,分析影响HFMD的主要危险因素。结果:1 239名调查对象中,HFMD患者为170例,此队列人群发病密度为50.36/1 000人年,门诊病例和住院病例分别为153、17例。单因素分析发现5个暴露因素和HFMD发生有关;多因素分析显示HFMD有3个危险因素和2个保护因素,分别为:性别为男性(OR=1.60,95%CI:1.12～2.27),居住在城镇(OR=1.71,95%CI:1.15～2.53),患儿经常发生上呼吸道感染、腹泻等(OR=1.96,95%CI:1.20～3.21),纯母乳喂养时间为3～6个月(OR=0.39,95%CI:0.17～0.84),饭前便后洗手(OR=0.54,95%CI:0.36～0.81)。结论:城镇人口密度大,接触传播是HFMD传播方式之一,因此减少儿童与患者接触对于控制HFMD传播起到重要作用。此外,养成良好的卫生习惯,增加纯母乳喂养对预防婴幼儿患HFMD起到保护性作用。
Objective: To explore the risk factors of hand-foot-mouth disease (HFMD) in some areas of northern Jiangsu Province. Methods: The prevalence of HFMD in children over the past 3 years was retrospectively surveyed in 6 counties of Yancheng City and Huaian City of Jiangsu Province by means of questionnaire. Univariate analysis and multivariate logistic regression analysis were used to analyze the prevalence of HFMD The main risk factors. Results: Of the 1 239 respondents, 170 were HFMD patients, and the incidence of this cohort was 50.36 / 1000 person-years. The outpatient and in-hospital cases were 153 and 17 cases, respectively. Univariate analysis showed that five exposure factors were related to the occurrence of HFMD. Multivariate analysis showed that HFMD had three risk factors and two protective factors, which were male (OR = 1.60, 95% CI: 1.12-2.27) In urban areas (OR = 1.71, 95% CI: 1.15-2.53), upper respiratory tract infections and diarrhea frequently occurred in children (OR = 1.96,95% CI: 1.20-3.21). Breastfeeding duration was 3-6 months (OR = 0.39, 95% CI: 0.17-0.84). Wash hands before and after meals (OR = 0.54, 95% CI: 0.36-0.81). CONCLUSIONS: Urban population density is high and contact transmission is one of the modes of transmission of HFMD, therefore reducing child-to-patient contact plays an important role in controlling the spread of HFMD. In addition, good hygiene practices and increased exclusive breastfeeding play a protective role in preventing HFMD in infants and young children.