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目的建立浙江省儿童肠道传染病传播风险评估模型,筛选高危因素,了解浙江省儿童肠道传染病传播风险现状。方法通过头脑风暴法建立浙江省儿童肠道传染病传播风险列表,咨询55位专家获得专家评分,采用层次分析法建立评估模型;其后于2012年4月和5月,选取位于浙江省北部和西南部的杭州市萧山区和龙游县,根据随机的方式,在其中各选一个农村和一个城镇社区,采用入户调查的方式,对家庭中有13岁及以下儿童的监护人,开展儿童肠道传染病传播风险现场调查;对现场调查数据进行描述性分析后,对照风险评估模型列表,计算各项风险因素实际发生频率与各自权重的乘积,汇总后计算总风险得分。使用SPSS 13.0统计软件分析,计数资料采用t检验,P<0.05为差异有统计学意义。结果层次分析法建立的评估模型中准则层包括儿童卫生习惯、家庭环境、社区环境,指标层有接触病例等15项,模型具有较好的一致性和满意度,准则层CI=0.019 3,CR=0.033 2,指标层各项CI和CR也均小于0.10。在社区共调查458人,监护人年龄以25~42岁为主,共380人(占82.97%),职业主要为家务及待业、服务业和工人,共202人,占44.10%,有53.49%的儿童年龄在5岁以下,男女性别比为1.36∶1,散居儿童占38.64%。综合评分显示浙江省社区儿童肠道传染病传播风险综合评分为16.40分(满分100分),其中接触患者(5.84)、家庭经济状况差(1.78)和经常饮生水(1.74)是重要的风险因素。城镇和农村差异无统计学意义(P>0.05)。结论总体看来,浙江省社区儿童肠道传染病存在一定的传播风险,尽管风险并不严重,但要采取措施以减少社区内患病儿童与正常儿童的接触;利用层次分析法建立风险评估模型,结合现场调查问卷进行传染病传播风险评估的方法具有实用价值。
Objective To establish a risk assessment model for the transmission of intestinal infectious diseases in children in Zhejiang Province and screen the risk factors to understand the current status of the spread of intestinal infectious diseases in children in Zhejiang Province. Methods The brainstorm method was used to establish a list of the risk of intestinal infectious diseases among children in Zhejiang province. 55 experts were consulted to obtain the experts’ scores and the analytic hierarchy process was used to establish the evaluation model. Subsequently, in April and May 2012, Xiaoshan District and Longyou County in the southwest of Hangzhou, according to a random way, in which a selected rural and urban communities, using household surveys, the family of children under the age of 13 and under the guardian to carry out children’s intestines Conduct a site survey on the risk of transmission of infectious diseases. After descriptive analysis of field survey data, compare the list of risk assessment models to calculate the product of the actual occurrence frequency of each risk factor and their respective weights, and then calculate the total risk score. Using SPSS 13.0 statistical software analysis, count data using t test, P <0.05 for the difference was statistically significant. Results In the evaluation model established by the AHP, 15 criteria including child health habits, family environment, community environment and contact cases at the index level were obtained. The model had good consistency and satisfaction, and the criterion level was CI = 0.0193. CR = 0.033 2, indicators of the CI and CR are also less than 0.10. A total of 458 persons were surveyed in the community. The guardians, aged 25-42, comprised 380 (82.97%) of the respondents, with a total of 202 workers (44.10%) and 53.49% Children under the age of 5, sex ratio for men and women was 1.36: 1, scattered children accounted for 38.64%. The comprehensive score showed that the community-based risk of intestinal infectious disease in children in Zhejiang Province was 16.40 points out of 100, of which, contact with patients (5.84), poor family economy (1.78) and regular drinking water (1.74) factor. The difference between urban and rural areas was not statistically significant (P> 0.05). Conclusion Generally speaking, there is a certain risk of intestinal infectious disease in children in Zhejiang community. Although the risk is not serious, measures should be taken to reduce the contact between sick children and normal children in the community. The AHP method is used to establish risk assessment model It is of practical value to carry out the risk assessment of infectious disease in combination with on-site questionnaires.