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目的探讨2013-2015年厦门市恙虫病流行特征和感染的危险因素,为预防和控制恙虫病提供依据。方法对厦门市2013-2015年恙虫病疫情资料进行分析,并选择2013-2015年厦门市中山医院、厦门市第一医院和厦门市中医院报告的175例患者为病例组,按1∶1匹配选择175名健康人为对照组,开展病例对照研究。结果 2013-2015年厦门市共报告本地病例392例,年平均发病率为3.49/10万,47.96%为男性,以40~、50~年龄组为主,占49.23%,农民是高危人群;发病时间每个月均有病例报告,主要集中在6-10月,占82.14%;恙虫病感染危险单因素分析显示:经常田间作业、发病前感知不明昆虫叮咬、经常坐卧草地、居住村边、经常野外活动、家中常有鼠类活动、住宅附近有草地、个人卫生习惯差等8个因素有统计学意义(P<0.05)。多因素分析结果显示:经常野外活动、经常田间作业和发病前感知不明昆虫叮咬是恙虫病流行的危险因素。结论厦门市恙虫病以中老年农民发病为主,6-10月份发病高峰,经常野外活动、经常田间作业和发病前感知不明昆虫叮咬是恙虫病感染主要危险因素。
Objective To investigate the epidemiological characteristics and risk factors of tsutsugamushi disease in Xiamen City from 2013 to 2015 and provide evidence for the prevention and control of tsutsugamushi disease. Methods The epidemiological data of tsutsugamushi disease in 2013-2015 in Xiamen City were analyzed and 175 cases of patients reported by Xiamen Hospital, Xiamen No.1 Hospital and Xiamen Hospital of Traditional Chinese Medicine from 2013 to 2015 were selected as case group and matched by 1: 1 Select 175 healthy people as control group, to carry out case-control study. Results A total of 392 local cases were reported in Xiamen City from 2013 to 2015, with an average annual incidence rate of 3.49 / 100 000 and 47.96% as male subjects, accounting for 49.23% of the total population in 40 ~ 50 years of age. Farmers were at high risk. There were case reports in time every month, mainly in June-October, accounting for 82.14%. Single-factor analysis of risk of infection of scrub typhus showed that: often field work, before the onset of an unknown insect bites, often sitting in the grass, living in the village edge, There were 8 factors including regular field activities, frequent rodent activities at home, grassland near houses and poor personal hygiene habits (P <0.05). Multivariate analysis showed that frequent field activities, frequent field operations and pre-morbidity insect bites were the risk factors for the epidemic of scrub typhus. Conclusions Xiamen tsutsugamushi disease is mainly caused by middle-aged and elderly peasants, and peaked from June to October. It is a major risk factor for tsutsugamushi infection due to frequent field activities, frequent field operations and pre-onset unawareness of insect bites.