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目的探索居民散发诺如病毒感染的潜在危险因素。方法采用1∶2配比病例对照研究方法,选取2015年3月1日至2016年4月30日在上海市宝山区各级医疗机构肠道门诊就诊、实验室确诊为诺如病毒感染的80例患者为病例组,选择2周内无腹泻、呕吐症状的人群作为对照组。利用自行设计的调查表进行问卷调查,应用条件logistic回归进行单因素与多因素分析。结果 80例诺如病毒感染病例,实验室分型GⅡ型66例,占82.50%,GⅠ型14例,占17.50%。单因素分析显示从事低体力劳动的人群感染诺如病毒的风险是从事高强体力劳动的人群的2.446倍(OR=2.446,95%CI:1.228~4.872);发病前3 d接触呕吐、腹泻患者(OR=8.267,95%CI:2.359~28.975)、发病前3 d有外出就餐史(OR=2.822,95%CI:1.467~5.429)和发病前3 d食用海鲜(OR=3.000,95%CI:1.841~4.888)是诺如病毒感染的危险因素。多因素分析显示:发病前3 d接触呕吐、腹泻患者(OR=6.959,95%CI:1.896~25.537)和发病前3 d食用海鲜(OR=2.283,95%CI:1.336~3.899)为诺如病毒感染的危险因素,饭前洗手(OR=0.609,95%CI:0.408~0.909)为保护性因素。结论上海市宝山区诺如病毒感染以GⅡ型为主。接触患者和食用海鲜是诺如病毒感染的可能危险因素。应加强健康宣传,做好海水产品卫生监测工作。
Objective To explore the potential risk factors of residents transmitting norovirus infection. Methods A 1: 2 matched case-control study was conducted. The patients were enrolled in the intestinal clinic at various levels of medical institutions in Baoshan District, Shanghai from March 1, 2015 to April 30, 2016. The laboratory diagnosed as Norovirus infection Cases of patients for the case group, choose 2 weeks no diarrhea, vomiting, the crowd as a control group. Using self-designed questionnaires for questionnaires, using conditional logistic regression to univariate and multivariate analysis. Results 80 cases of norovirus infection, 66 cases of laboratory typing G Ⅱ type, accounting for 82.50%, G Ⅰ 14 cases, accounting for 17.50%. Univariate analysis showed that the risk of Norovirus infection was 2.446 folds higher in those with low manual labor (OR = 2.446, 95% CI: 1.228 to 4.872) than in those with high manual labor. In the patients with vomiting and diarrhea OR = 8.267,95% CI: 2.359-28.975). There was a history of eating out before 3 days (OR = 2.822, 95% CI: 1.467-5.429) 1.841 ~ 4.888) is a risk factor for Norovirus infection. Multivariate analysis showed that patients with vomiting and diarrhea (OR = 6.959, 95% CI: 1.896-25.537) and food before 3 days before onset (OR = 2.283, 95% CI: 1.336-3.899) The risk factors of virus infection, washing hands before meals (OR = 0.609, 95% CI: 0.408 ~ 0.909) were protective factors. CONCLUSION: Norovirus infection in Baoshan District of Shanghai is predominantly G Ⅱ type. Contact with patients and consumption of seafood is a possible risk factor for norovirus infection. Health promotion should be strengthened, and health monitoring of marine products should be well done.