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目的评价天津市麻疹家庭内传播的干预措施效果。方法以家庭获得性病例家庭为病例组,社区病例家庭为对照组,开展病例对照研究。结果 2014—2015年天津市麻疹监测系统共报告麻疹确诊病例3 022例,家庭获得性病例35例,占病例总数的1.15%。共纳入病例组32个家庭,对照组64个家庭,干预措施包括病例隔离分居、3 d内应急接种、开窗通风、现场消毒、健康教育、个人防护。单因素χ~2检验显示,干预措施只有隔离分居有统计学意义(χ~2=4.54,P=0.03),多因素逐步回归logistic分析显示,隔离分居是麻疹家庭内传播的影响因素(χ~2=6.00,P=0.01),OR=0.27(95%CI 0.10~0.77)。在隔离分居中,居家隔离发生家庭内传播的只有11.62%,住院隔离发生家庭内传播的比例达到47.05%,两组间差异有统计学意义(χ~2=12.02,P<0.01),OR=0.15(95%CI 0.05~0.47)。结论隔离分居能有效减低麻疹家庭内传播风险,目前居家隔离效果好于住院隔离。
Objective To evaluate the effect of interventions transmitted in measles families in Tianjin. Methods A case-control study was conducted in families with family-acquired cases and community-based cases as control groups. Results A total of 3 022 confirmed cases of measles and 35 cases of family-acquired cases were reported in Tianjin measles monitoring system during 2014-2015, accounting for 1.15% of the total cases. A total of 32 families were enrolled in the case group and 64 families in the control group. Interventions included isolation and isolation of cases, emergency inoculation within 3 days, ventilation through windows, disinfection on site, health education and personal protection. The single factor χ ~ 2 test showed that there was only statistical significance (χ ~ 2 = 4.54, P = 0.03) for intervening interventions. Logistic regression analysis showed that isolation and separation were the influencing factors of transmission in measles families (χ ~ 2 = 6.00, P = 0.01), OR = 0.27 (95% CI 0.10-0.77). In segregation, there was only 11.62% incidence of in-home transmission in home isolation and 47.05% in in-home transmission in hospital isolation. The difference between the two groups was statistically significant (χ ~ 2 = 12.02, P <0.01) 0.15 (95% CI 0.05 to 0.47). Conclusion Segregation and separation can effectively reduce the risk of transmission within measles families. At present, the effect of home isolation is better than that of hospitalization.