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目的了解幼托机构手足口病暴发疫情后儿童隐性感染情况及相关因素,为疫情暴发后及时采取有效防控措施提供参考。方法收集2011年1月至2015年7月,厦门市报告的5起托幼机构手足口病暴发疫情的流行病学和实验室检测资料,采用荧光定量RT-PCR方法检测总肠道病毒及EV71和Cox A16分型,采用二分类因素Logistic回归分析方法分析儿童隐性感染情况及其相关因素。结果 250名研究对象接受调查和采样,其中疫情组的隐性感染率为32.4%(45/136),高于对照组的14.0%(16/114)(χ~2=11.408,P=0.001)。疫情组所在小小班、小班和中班的隐性感染率分别为44.2%,29.1%和17.2%,首例病例至停课的时间间隔<3 d、3~5 d和>5 d的隐性感染率分别为16.7%,24.1%和41.6%,差异均有统计学意义(χ~2趋势值分别为6.558,6.952,P值均<0.05)。Logistic回归分析显示,年级越低,首例病例至停课的时间间隔越长,儿童隐性感染率越高。结论幼托机构特别是低年级儿童发生手足口病暴发疫情后,及时采取停课措施是必要的,且越早停课越好。
Objective To understand the latent infection and related factors of children after the outbreak of hand-foot-mouth disease in kindergarten, and to provide reference for timely and effective prevention and control measures after the outbreak of the epidemic. Methods Epidemiology and laboratory testing data of 5 HFMD outbreaks reported from Xiamen from January 2011 to July 2015 were collected. The total enterovirus and EV71 And Cox A16, Logistic regression analysis was used to analyze the latent infection in children and its related factors. Results 250 subjects were investigated and sampled. The rate of latent infection in the epidemic group was 32.4% (45/136), which was higher than that in the control group (14.0%, 16/114) (χ ~ 2 = 11.408, P = 0.001) . The latent infection rates of small class, small class and mid-class in the outbreak group were 44.2%, 29.1% and 17.2% respectively. The first case to recessive infection with interval <3 days, 3-5 days and> 5 days Rates were 16.7%, 24.1% and 41.6%, respectively, and the differences were statistically significant (χ ~ 2 trends were 6.558,6.952, P <0.05). Logistic regression analysis showed that the lower the grade, the longer the first case-to-class time interval, the higher the latent infection rate in children. Conclusion It is necessary to take timely suspension measures after the onset of hand-foot-mouth disease outbreaks in kindergartens, especially in the lower grades, and the sooner the suspension is stopped, the better.