上海浦东新区14岁以下儿童麻疹发病影响因素的分析
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摘要
目的分析上海市浦东新区14岁以下儿童麻疹发病的影响因素,为麻疹防控提供参考。方法采用1∶1配对的病例对照研究,选择2016～2017年浦东新区14岁以下儿童麻疹确诊病例,以年龄、性别、户籍、居住地相匹配的无麻疹患病史的儿童作为对照,比较两组的人口学、暴露史、麻疹免疫史等信息。结果共调查对象122例,单因素logistic分析显示,有公共场所出入史、医院暴露史和离沪史是麻疹发病的危险因素,儿童麻疹免疫史、母亲麻疹免疫史是保护因素;多因素logistic分析显示,有公共场所出入史和医院暴露史是麻疹发病的危险因素,儿童麻疹免疫史是保护因素。结论麻疹防控应确保儿童麻疹疫苗接种的及时性和规范性,控制院内感染,加强公共场所和医疗机构的麻疹防控宣教,提高人群麻疹防护意识。
Objective To analyze the influencing factors of incidence of measles among children at ages of less than 14 years in Pudong New Area,Shanghai,China so as to provide a reference for prevention and control of measles. Methods A 1 ∶ 1 matched case-control study was used to collect the information on children with diagnosed measles,at ages of less than 14 years,from 2016 to 2017. The control group were recruited in parallel and matched to cases by age,gender,household register and residential area. The questionnaire included social demographic characteristics as well as histories of exposure and measles vaccination. Results A total of 122 subjects were investigated in this study. Univariate logistic regression analysis showed that the histories of exposures to public place and hospital and leaving Shanghai were risk factors of incidence of measles, while the immunization histories in children and mothers were protective factors.However,multivariate logistic regression analysis showed that the histories of exposures to public place and hospital were risk factors,while the immunization history in children was a protective factor. Conclusion According to the results of the study, we propose to ensure the timeliness and standardization of measles vaccination, to control nosocomial infections,to strengthen the propaganda and education of measles prevention in public places and medical institutions,and to improve the people′s awareness of measles protection in children.
Objective To analyze the influencing factors of incidence of measles among children at ages of less than 14 years in Pudong New Area,Shanghai,China so as to provide a reference for prevention and control of measles. Methods A 1 ∶ 1 matched case-control study was used to collect the information on children with diagnosed measles,at ages of less than 14 years,from 2016 to 2017. The control group were recruited in parallel and matched to cases by age,gender,household register and residential area. The questionnaire included social demographic characteristics as well as histories of exposure and measles vaccination. Results A total of 122 subjects were investigated in this study. Univariate logistic regression analysis showed that the histories of exposures to public place and hospital and leaving Shanghai were risk factors of incidence of measles, while the immunization histories in children and mothers were protective factors.However,multivariate logistic regression analysis showed that the histories of exposures to public place and hospital were risk factors,while the immunization history in children was a protective factor. Conclusion According to the results of the study, we propose to ensure the timeliness and standardization of measles vaccination, to control nosocomial infections,to strengthen the propaganda and education of measles prevention in public places and medical institutions,and to improve the people′s awareness of measles protection in children.
引文
[1] ZHANG Y,WAGNER A L,WANG X,et al. Risk factors for measles among infants in Tianjin,China[J]. Public Health,2017,151(10):114-117.
[2] HAO L,MA C,WANNEMUEHLER K A,et al. Risk factors for measles in children aged 8 months-14 years in China after nationwide measles campaign:A multi-site case-control study,2012-2013[J]. Vaccine,2016,34(51):6545-6552.
[3] SHI Y,ZHANG J F,HU J Y,et al. Analysis on measles epidemiological characteristics in Shanghai from 1999-2004[J].Chin J Vac Immun,2006,12(1):32-34.(in Chinese)施燕,张金芳,胡家瑜,等.上海市1999~2004年麻疹流行病学特征分析[J].中国计划免疫,2006,12(1):32-34.
[4] SUN X D,ZHAO L L,HU J Y,et al. A survey on immunization coverage rates and affecting factors of four EPI vaccines and hepatitis B vaccine among children in 1999 in Shanghai[J]. Chin J Vac Immun,2001,7(5):262-266.(in Chinese)孙晓冬,赵丽丽,胡家瑜,等.上海市儿童计划免疫与乙型肝炎疫苗免疫接种率及其影响因素调查分析[J].中国计划免疫,2001,7(5):262-266.
[5] TANG Z Z,XIE Y H,JIRAPHONGSA C,et al. Risk factors for measles in children younger than age 8 months:A case-control study during an outbreak in Guangxi,China,2013[J].Am J Infect Control,2016,44(4):e51-e58.
[6] MENG F Y,LU Z J,SHEN Y G,et al. Influencing factors for measles infection in Anhui province:a case-control study,2015-2016[J]. Chin J Dis Prev,2017,21(6):581-585.(in Chinese)孟凡亚,陆志坚,沈永刚,等.安徽省2015-2016年麻疹发病影响因素病例对照研究[J].中华疾病控制杂志,2017,21(6):581-585.
[7]詹绍康,王克利,邓春勤,等.现场调查技术[M]. 2版.上海:复旦大学出版社,2010:141-143.
[8]刘亚谊,闫静,王燕,等.麻疹的实验室诊断和鉴别诊断[J].现代检验医学杂志,2006,21(4):63-64.
[9] GAO J,SHEN B,XIONG J,et al. The measles epidemic trend over the past 30 years in a central district in Shanghai,China[J]. PLoS One,2017,12(6):e179470. doi:10.1371/journal.pone.0179470.
[10] WAGNER A L,BOULTON M L,SUN X,et al. Perceptions of measles,pneumonia,and meningitis vaccines among caregivers in Shanghai,China,and the health belief model:a cross-sectional study[J]. BMC Pediatr,2017,17(1):143.
[11] ZHANG N J,ZHANG X S,FU H,et al. Study on the risk fac tors of measles among the 8-month-olds and children≥15years of age in Gansu province[J]. Chin J Epidemiol,2014,35(10):1095-1098.(in Chinese)张宁静,张晓曙,付鸿,等.甘肃省<8月龄及≥15岁人群麻疹发病危险因素分析[J].中华流行病学杂志,2014,35(10):1095-1098.
[12] LIN W,XIONG Y,TANG H,et al. Factors associated with delayed measles vaccination among children in Shenzhen,China:a case-control study[J]. Hum Vaccin Immunother,2014,10(12):3601-3606.
[13] LIU Y B,HU Y,DENG X Y,et al. Risk factor analysis for measles infection in 8 months to 14 years children and older than 15 years adults in Jiangsu province:a 1∶3 matched casecontrol study[J]. Chin J Dis Control Prev,2016,20(8):796-800.(in Chinese)刘元宝,胡莹,邓秀英,等.江苏省儿童和成人麻疹传播影响因素的1∶3配比病例对照研究[J].中华疾病控制杂志,2016,20(8):796-800.
[14] CAI L,FANG Q,WANG Y G,et al. Analysis on the epidemiological features of measles and the factors influencing its incidence in Futian district,Shenzhen city in 2013[J]. Pract Prev Med,2015,22(5):565-567.(in Chinese)蔡琳,方琼,王永刚,等.深圳市福田区2013年麻疹流行病学特征及发病影响因素分析[J].实用预防医学,2015,22(5):565-567.
[15] WANG M,MA C,LUO H M. A review on the effectiveness and its influencing factors of measles vaccine[J]. Chin J Epidemiol,2014,35(2):215-217.(in Chinese)王曼,马超,罗会明.麻疹疫苗保护效果及其影响因素[J].中华流行病学杂志,2014,35(2):215-217.
[16] BIAN C,ZHANG J T,LING L J,et al. Analysis on the factors affecting measles transmission among children aged between 8 months and 14 years in Changzhou city[J]. Pract Prev Med,2015,22(8):921-924.(in Chinese)卞琛,张建陶,凌良健,等.常州市8月龄~14岁儿童麻疹传播影响因素分析[J].实用预防医学,2015,22(8):921-924.
[17]樊静洁,陈珠蝶,陈素丽.深圳市南山区麻疹流行特征及影响因素分析[J].浙江预防医学,2016,28(4):388-390.
[18] CHEN B H,GUAN X H,ZHAN F X,et al. Investigation on the risk factors for reported rising of measles incidence during November,2011 to February,2012,in some areas of Hubei province[J]. Chin J Epidemiol,2013,34(7):714-716.(in Chinese)陈邦华,官旭华,詹发先,等.湖北省部分地区2011-2012年度麻疹流行期间高发原因调查[J].中华流行病学杂志,2013,34(7):714-716.
[2] HAO L,MA C,WANNEMUEHLER K A,et al. Risk factors for measles in children aged 8 months-14 years in China after nationwide measles campaign:A multi-site case-control study,2012-2013[J]. Vaccine,2016,34(51):6545-6552.
[3] SHI Y,ZHANG J F,HU J Y,et al. Analysis on measles epidemiological characteristics in Shanghai from 1999-2004[J].Chin J Vac Immun,2006,12(1):32-34.(in Chinese)施燕,张金芳,胡家瑜,等.上海市1999~2004年麻疹流行病学特征分析[J].中国计划免疫,2006,12(1):32-34.
[4] SUN X D,ZHAO L L,HU J Y,et al. A survey on immunization coverage rates and affecting factors of four EPI vaccines and hepatitis B vaccine among children in 1999 in Shanghai[J]. Chin J Vac Immun,2001,7(5):262-266.(in Chinese)孙晓冬,赵丽丽,胡家瑜,等.上海市儿童计划免疫与乙型肝炎疫苗免疫接种率及其影响因素调查分析[J].中国计划免疫,2001,7(5):262-266.
[5] TANG Z Z,XIE Y H,JIRAPHONGSA C,et al. Risk factors for measles in children younger than age 8 months:A case-control study during an outbreak in Guangxi,China,2013[J].Am J Infect Control,2016,44(4):e51-e58.
[6] MENG F Y,LU Z J,SHEN Y G,et al. Influencing factors for measles infection in Anhui province:a case-control study,2015-2016[J]. Chin J Dis Prev,2017,21(6):581-585.(in Chinese)孟凡亚,陆志坚,沈永刚,等.安徽省2015-2016年麻疹发病影响因素病例对照研究[J].中华疾病控制杂志,2017,21(6):581-585.
[7]詹绍康,王克利,邓春勤,等.现场调查技术[M]. 2版.上海:复旦大学出版社,2010:141-143.
[8]刘亚谊,闫静,王燕,等.麻疹的实验室诊断和鉴别诊断[J].现代检验医学杂志,2006,21(4):63-64.
[9] GAO J,SHEN B,XIONG J,et al. The measles epidemic trend over the past 30 years in a central district in Shanghai,China[J]. PLoS One,2017,12(6):e179470. doi:10.1371/journal.pone.0179470.
[10] WAGNER A L,BOULTON M L,SUN X,et al. Perceptions of measles,pneumonia,and meningitis vaccines among caregivers in Shanghai,China,and the health belief model:a cross-sectional study[J]. BMC Pediatr,2017,17(1):143.
[11] ZHANG N J,ZHANG X S,FU H,et al. Study on the risk fac tors of measles among the 8-month-olds and children≥15years of age in Gansu province[J]. Chin J Epidemiol,2014,35(10):1095-1098.(in Chinese)张宁静,张晓曙,付鸿,等.甘肃省<8月龄及≥15岁人群麻疹发病危险因素分析[J].中华流行病学杂志,2014,35(10):1095-1098.
[12] LIN W,XIONG Y,TANG H,et al. Factors associated with delayed measles vaccination among children in Shenzhen,China:a case-control study[J]. Hum Vaccin Immunother,2014,10(12):3601-3606.
[13] LIU Y B,HU Y,DENG X Y,et al. Risk factor analysis for measles infection in 8 months to 14 years children and older than 15 years adults in Jiangsu province:a 1∶3 matched casecontrol study[J]. Chin J Dis Control Prev,2016,20(8):796-800.(in Chinese)刘元宝,胡莹,邓秀英,等.江苏省儿童和成人麻疹传播影响因素的1∶3配比病例对照研究[J].中华疾病控制杂志,2016,20(8):796-800.
[14] CAI L,FANG Q,WANG Y G,et al. Analysis on the epidemiological features of measles and the factors influencing its incidence in Futian district,Shenzhen city in 2013[J]. Pract Prev Med,2015,22(5):565-567.(in Chinese)蔡琳,方琼,王永刚,等.深圳市福田区2013年麻疹流行病学特征及发病影响因素分析[J].实用预防医学,2015,22(5):565-567.
[15] WANG M,MA C,LUO H M. A review on the effectiveness and its influencing factors of measles vaccine[J]. Chin J Epidemiol,2014,35(2):215-217.(in Chinese)王曼,马超,罗会明.麻疹疫苗保护效果及其影响因素[J].中华流行病学杂志,2014,35(2):215-217.
[16] BIAN C,ZHANG J T,LING L J,et al. Analysis on the factors affecting measles transmission among children aged between 8 months and 14 years in Changzhou city[J]. Pract Prev Med,2015,22(8):921-924.(in Chinese)卞琛,张建陶,凌良健,等.常州市8月龄~14岁儿童麻疹传播影响因素分析[J].实用预防医学,2015,22(8):921-924.
[17]樊静洁,陈珠蝶,陈素丽.深圳市南山区麻疹流行特征及影响因素分析[J].浙江预防医学,2016,28(4):388-390.
[18] CHEN B H,GUAN X H,ZHAN F X,et al. Investigation on the risk factors for reported rising of measles incidence during November,2011 to February,2012,in some areas of Hubei province[J]. Chin J Epidemiol,2013,34(7):714-716.(in Chinese)陈邦华,官旭华,詹发先,等.湖北省部分地区2011-2012年度麻疹流行期间高发原因调查[J].中华流行病学杂志,2013,34(7):714-716.