论文部分内容阅读
目的探讨非麻疹疫苗免疫目标人群麻疹发病相关危险因素,为预防控制该人群麻疹发病提供依据。方法对2008-2009年广州市白云区的麻疹病例进行1∶1配对,配对因素为性别、年龄和居住地,对相关危险因素进行条件Logistic回归分析及多因素非条件Logistic回归分析。结果调查病例中71.43%的病例为流动人口;28.57%的病例或其监护人为初中以下文化程度;32.80%的病例或其监护人月均收入低于1000元;15岁以上病例既往有麻疹疫苗接种史的仅占4.65%;24.87%的病例病前3周曾与麻疹病人有过接触;32.80%患者病前3周曾去医院就诊,就诊医院级别中省市级、区县级、卫生院分别占62.29%、20.97%和17.74%,就诊科别中以儿科、内科为主,分别占70.97%和25.81%;38.10%的病例病前3周内曾乘坐公共交通工具。单因素分析显示,经济水平低(OR=0.59,OR95%CI=0.37～0.94)、未种麻疹疫苗(OR=0.32,OR95%CI=0.19～0.52)、有麻疹病例接触史(OR=0.22,OR95%CI=0.13～0.36)、流动人口(OR=0.22,OR95%CI=0.13～0.36)、就诊史(OR=0.30,OR95%CI=0.18～0.51)、就诊医院类型(OR=0.33,OR95%CI=0.18～0.51)和就诊科别(OR=0.34,OR95%CI=0.22～0.52)等因素与麻疹发病有明显的相关性。多因素Logistic分析显示,经济水平低(OR=0.49,OR95%CI=0.28～0.87)、未接种麻疹疫苗(OR=0.67,OR95%CI=0.52～0.86)、有麻疹病例接触史(OR=0.14,OR95%CI=0.08～0.25)、流动人口(OR=0.25,OR95%CI=0.15～0.43)、就诊史(OR=8.51,OR95%CI=2.65～27.30)、就诊科别(OR=0.15,OR95%CI=0.05～0.46)等因素与麻疹的发病密切相关。结论经济水平低、未接种麻疹疫苗、病前3周内有麻疹病例接触史、流动人口、病前3周内有就诊史和就诊科别等因素可能是影响非麻疹疫苗免疫目标人群麻疹发病的主要危险因素。
Objective To investigate the risk factors related to the incidence of measles in the target population of non-measles vaccine and provide the basis for preventing and controlling the incidence of measles in this population. Methods The measles cases in Baiyun District of Guangzhou from 2008 to 2009 were matched by 1: 1. The paired factors were sex, age and place of residence. Logistic regression analysis and multivariate non-conditional logistic regression analysis were performed on the relevant risk factors. Results Among the investigated cases, 71.43% of the cases were floating population; 28.57% of the cases or their guardians were below junior high school; 32.80% of the cases or their guardians had an average monthly income of less than 1000 yuan; past 15 years and older had measles vaccination history Accounted for only 4.65%; 24.87% of the cases had contact with measles patients 3 months before the illness; 32.80% of the patients had visited the hospital 3 weeks before the illness, and the level of hospitals, municipalities, districts and counties and hospitals 62.29%, 20.97% and 17.74% respectively. The main pediatric and medical departments were 70.97% and 25.81% respectively. 38.10% of cases had used public transport within 3 weeks before the illness. Univariate analysis showed that the incidence of measles cases was lower (OR = 0.59, OR 95% CI = 0.37-0.94) and no measles vaccine (OR = 0.32, OR 95% CI = 0.19-0.52) (OR = 0.30, OR 95% CI = 0.13 ~ 0.36), floating population (OR = 0.22, OR 95% CI = 0.13-0.36) % CI = 0.18 ~ 0.51) and the treatment group (OR = 0.34, OR95% CI = 0.22 ~ 0.52) and other factors were significantly associated with the incidence of measles. Multivariate Logistic analysis showed that there was a lower incidence of measles (OR = 0.49, OR95% CI = 0.28-0.87) and no measles vaccine (OR = 0.67, OR95% CI = 0.52-0.86) , OR95% CI = 0.08-0.25), the floating population (OR = 0.25, OR 95% CI = 0.15-0.43), the history of treatment (OR = 8.51, OR 95% CI = 2.65-27.30) OR95% CI = 0.05 ~ 0.46) and other factors and the incidence of measles are closely related. Conclusions The low level of economy, the unvaccinated measles vaccine, the history of measles cases within three weeks before the disease, the floating population, the history of visits within three weeks before the illness, and the medical treatment may affect the incidence of measles in the non-measles vaccine target population The main risk factors.