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目的研究衢州市手足口病(hand-foot-mouth disease,HFMD)流行病学特征和危险因素,为制定综合防控措施提供依据。方法导出2009-2013年衢州市医疗机构通过中国疾病预防控制信息系统(CISFDCP)报告的HFMD报告病例数据,统计分析本市手足口病的流行强度和流行特征;抽取1所市级医院和1所县级医院作为哨点,对2013年因HFMD入院的患儿家长进行问卷调查,同期因其他疾病入院的其他患儿作为对照组开展病例对照研究,分析手足口病发病危险因素。结果共分析12 465份HFMD病例数据,发病率106.514/10万,重症率1.5%,发病率和重症率在性别、年龄组间差异有统计学意义(P<0.001);各月份均有病例报告但有明显的季节差异,5-7月为主峰期报告病例最多,占全年报告病例的50.4%~76.8%;多因素logistic回归分析结果喂养方式(OR=1.390,95%CI=1.210~1.526),户籍(OR=0.531,95%CI=0.277~0.874),生活类型(OR=0.668,95%CI=0.484~0.873),水痘流感史(OR=4.512,95%CI=1.499~8.581),卫生习惯(OR=0.495,95%CI=0.203~1.360)进入回归模型,是独立的影响因素。结论高发季节5-7月加强3岁以下婴幼儿HFMD防控,如宣传母乳喂养、改善农村地区婴幼儿卫生条件、加强散居儿童管理、培养良好的卫生习惯等。
Objective To study the epidemiological characteristics and risk factors of hand-foot-mouth disease (HFMD) in Quzhou city and provide the basis for comprehensive prevention and control measures. Methods Data of HFMD cases reported by medical institutions in Quzhou City from 2009 to 2013 through the China Disease Prevention and Control Information System (CISFDCP) were collected and statistically analyzed for prevalence and prevalence of HFMD in this Municipality; 1 municipal hospital and 1 County hospitals were sentinel sites to conduct questionnaire surveys on parents of children admitted to hospital for HFMD in 2013. Other children admitted to hospital for other diseases during the same period were included as control subjects in a case-control study to analyze the risk factors for HFMD. Results A total of 12 465 cases of HFMD were analyzed. The incidence rate was 106.514 / 100 000 and the rate of severe disease was 1.5%. There was a significant difference in incidence and severity between sex and age groups (P <0.001) But there were obvious seasonal differences. The number of reported cases was the highest in May-July, accounting for 50.4% -76.8% of the reported cases in the whole year. Multivariate logistic regression analysis showed that the feeding patterns (OR = 1.390, 95% CI = 1.210-1.526 ), Family history (OR = 0.531,95% CI = 0.277-0.874), life style (OR = 0.668,95% CI = 0.484-0.873), history of varicella (OR = 4.512, 95% CI = 1.499-8.581) Hygienic habits (OR = 0.495, 95% CI = 0.203 ~ 1.360) into the regression model, is an independent factor. Conclusions From May to July in the high incidence season, the prevention and control of HFMD in infants and children under 3 years of age are strengthened, such as promoting breastfeeding, improving infant health conditions in rural areas, strengthening the management of scattered children and cultivating good hygiene habits.