成都市托幼机构手足口病高发危险因素研究

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目的探讨成都市托幼机构手足口病高发的影响因素,为成都市托幼机构手足口病防控提供针对性的措施。方法采用分层随机方法抽取2014年成都市高发、低发托幼机构各58家,采用调查、访谈、现场观察等方式收集托幼机构硬件、人员配置、儿童洗手卫生习惯等资料。同时对纳入的托幼机构随机抽取3名健康儿童进行咽拭子采样,并进行实时荧光PCR检测,收集在园健康儿童病毒携带情况。采用Epidata3.1软件录入数据,使用SPSS 18.0进行单因素、多因素非条件logistic回归分析。结果单因素结果显示,健康儿童病毒携带、单独设置睡床、洗手规范、洗手设施数量是托幼机构手足口病高发的影响因素。多因素分析结果显示;健康儿童病毒携带(OR=8.77,95%CI:2.59~29.76)是托幼机构手足口病高发的危险因素,单独设置睡床(OR=0.10,95%CI:0.01~0.88);规范洗手(OR=0.24,95%CI:0.08~0.72)为托幼机构手足口病高发的保护因素。结论健康儿童病毒携带、单独设置睡床、规范洗手是托幼机构手足口病高发的影响因素。因而,加强手足口病患者管理,隔离传染源,加强健康儿童的个人自我防护,督促托幼机构为幼儿单独设置睡床,培训幼儿采用规范方式洗手等措施,对成都市托幼机构手足口病防控具有现实意义。 Objective To explore the influential factors of hand-foot-mouth disease (HFMD) in kindergarten institutions in Chengdu and to provide targeted measures for the prevention and control of hand-foot-mouth disease in kindergartens in Chengdu. Methods Totally 58 high-fathers and low-fat babies serving children in Chengdu were recruited in a stratified randomized way in 2014. Data of hardware, staffing and hygiene of children’s handwashing were collected by means of surveys, interviews and on-site observation. At the same time, 3 healthy children were randomly selected from the nurseries to be included in the throat swab sampling, and real-time fluorescence PCR detection was performed to collect the viral load of healthy children in the park. Data were entered using Epidata 3.1 software and univariate and multivariate non-conditional logistic regression analysis was performed using SPSS 18.0. Results The results of univariate analysis showed that the number of healthy children carrying the virus, setting the bed separately, hand washing norms and the number of hand washing facilities were the most influential factors in hand-foot-mouth disease. Multivariate analysis showed that the risk of hand-foot-and-mouth disease (HFMD) was higher in healthy children (OR = 8.77,95% CI: 2.59-29.76) 0.88). The standardized hand washing (OR = 0.24, 95% CI: 0.08-0.72) was the protective factor of hand-foot-mouth disease in nurseries. Conclusion Healthy children carry the virus, set the bed alone, and regulate the hand washing is the most important factor affecting hand-foot-mouth disease in kindergartens. Therefore, strengthening the management of HFMD, isolating the source of infection, strengthening the self-protection of healthy children, urging kindergartens to set up bed for infants alone and training children to use standard methods to wash their hands and other measures, Prevention is of practical significance.
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