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目的探讨8月龄~14岁儿童中麻疹传播影响因素,评价现行免疫措施实施效果,探索可能对其采取的保护措施。方法选取常州市范围内在2009-2013年发病的8月龄~14岁儿童,采用病例对照研究的方法,就病例和对照的发病与就诊情况、可能的暴露史、居住地和旅行史、既往麻疹患病史、卫生服务情况、社会人口学和经济学信息等内容进行入户个案访谈调查。结果单因素及多因素分析结果显示:家长对预防接种的态度积极(OR=0.041,OR95%CI=0.004~0.404)、有麻疹疫苗接种史(OR=0.013,OR95%CI=0.003~0.051)是8月龄~14岁儿童麻疹发病的保护因素,外来流动人口(OR=6.016,OR95%CI=2.341~15.462)、发病前7~21 d医院暴露史(OR=7.015,OR95%CI=2.846~17.290)、接种次数较少(OR=5.865,OR95%CI=1.679~20.485)是8月龄~14岁儿童麻疹发病的危险因素,疫苗接种次数越少危险性越大。结论高质量的麻疹疫苗常规免疫和强化免疫可以减少8月龄以上儿童发病,并应重视加强流动儿童和院内感染的管理。
Objective To explore the influencing factors of measles transmission in children aged from 8 months to 14 years, assess the effect of the current immunization measures, and explore the possible protective measures. Methods Children from the age of 8 months to 14 years of age from 2009 to 2013 in Changzhou were enrolled in this study. The case-control study was used to analyze the incidence and treatment of cases and controls, possible exposure history, place of residence and travel history, previous measles History of illness, health services, social demography and economics information and other content of the interview case investigation. Results The results of univariate and multivariate analysis showed that parents had positive attitude toward vaccination (OR = 0.041, OR95% CI = 0.004-0.404), history of measles vaccination (OR = 0.013, OR95% CI = 0.003-0.051) The protective factors of measles in children aged from 8 months to 14 years were as follows: migrant population (OR = 6.016, OR 95% CI = 2.341-15.462), hospital exposure before 7-21 days (OR = 7.015, OR 95% CI 2.846 ~ (OR = 5.865, OR95% CI = 1.679 ~ 20.485) were the risk factors for the onset of measles in children aged from 8 months to 14 years. The less the number of vaccination was, the higher the risk was. Conclusion High-quality measles vaccine routine immunization and intensive immunization can reduce the incidence of children over eight months of age, and should pay attention to strengthening the management of migrant children and nosocomial infections.