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| 医院就诊情况与麻疹高发关联的病例对照研究 | |
| 引用本文： | 傅利军,郭天英,吴建宏,黄朝辉,史愉聪,方益荣. 医院就诊情况与麻疹高发关联的病例对照研究[J]. 疾病监测, 2014, 29(5): 383-386. DOI: 10.3784/j.issn.1003-9961.2014.05.012 |
| 作者姓名： | 傅利军 郭天英 吴建宏 黄朝辉 史愉聪 方益荣 |
| 作者单位： | [1]绍兴市疾病预防控制中心,浙江绍兴312000 [2]中国疾病预防控制中心中国现场流行病学培训项目（CFETP-12）,北京100050 |
| 摘 要： | 目的了解浙江省绍兴市2013年麻疹发病率突然升高的原因,分析医院就诊情况与麻疹高发之间的病因关联。方法采用病例对照设计,调查实验室诊断麻疹病例166例,并按照1∶3的比例,在每名麻疹病例现住村(社区)选择3名年龄组匹配的共498名作对照。调查持续时间为2013年1-6月,所有调查对象均需完成麻疹传播因素病例对照调查表、入户调查记录表和知情同意书。统计分析方法包括χ2检验(Pearson、Mantel-Haenszel)、两独立样本t检验和Cox比例风险回归分析。结果麻疹潜伏期内有医院就诊史是麻疹发病的危险因素,其关联强度(ORHM)在7月龄以下组为9.08(95%CI:2.58~31.95)、7月龄至14岁组为13.01(95%CI:2.85~59.40)、15岁以上组为16.53(95%CI:8.16~33.47)。多因素Cox比例风险回归分析结果显示,因发热、咳嗽等流感样症状到医院就诊罹患麻疹的可能性是其他原因到医院就诊的36.21倍(95%CI:4.56~289.16);相对于停留在挂号、诊室等空旷的场所,停留在输液室(ORadjust=3.72,95%CI:1.06~13.04)、病房(ORadjust=8.50,95%CI:1.70~42.38)等拥挤场所罹患麻疹的风险更大。结论医院暴露与麻疹发病存在很强的关联,医院预检分诊制度不完善,病房、输液室等场所主动通风工作落实不到位,都可增加麻疹发病的风险。 |
| 关 键 词： | 麻疹 病例对照研究 医院感染 病因分析 |
| 收稿时间： | 2014-01-07 |
Case-control study on correlation between medical care seeking and high incidence of measles |
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| FU Li-jun,GUO Tian-ying,WU Jian-hong,HUANG Zhao-hui,SHI Yu-cong,FANG Yi-rong. Case-control study on correlation between medical care seeking and high incidence of measles[J]. Disease Surveillance, 2014, 29(5): 383-386. DOI: 10.3784/j.issn.1003-9961.2014.05.012 | |
| Authors: | FU Li-jun GUO Tian-ying WU Jian-hong HUANG Zhao-hui SHI Yu-cong FANG Yi-rong |
| Affiliation: | 1. Shaoxing Center for Disease Control and Prevention, Shaoxing 312000 , Zhejiang , China; 2. China Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beifing 100050, China) |
| Abstract: | Objective To understand the reason for the increase of measles incidence in Shaoxing, Zhejiang province in 2013. Methods The correlation between medical care seeking and high incidence of measles was analyzed through a case-control study of 166 laboratory diagnosed measles cases and 498 age-matched controls living in same areas. The study was conducted from January to June 2013. All the subjects completed the questionnaires on risk factors for measles, household survey record forms and written informed consents. Data were analyzed by using Pearson X2 test, Mantel-Haenszel χ2 test, T-test of independent sample and Cox proportional hazards regression model. Results Medical care seeking during measles incubation period was correlated with the reported increase of measles incidence, the OR was 9.08 （95 % CI： 2. 58 - 31.95 ） among children aged 〈 7 months, 13.01 （ 95 % CI： 2. 85 - 59.40 ） among children aged 7 months to 14 years, and 16.53 （95% CI：8. 16 - 33. 47） among children aged 〉 15 years. Cox proportional hazards regression analysis indicated that medical care seeking due to respiratory symptoms including cough and fever, was the risk factor to be attacked by measles （ ORMH = 36. 21, 95% CI：4.56 - 289. 16）. Staying in treatment room （ OR = 3.72, 95 % CI： 1.06 - 13.04 ） and ward （ OR = 8.50,95 % CI： 1.70 - 42.38 ） had higher risk than staying in registration room and consulting room. Conclusion Strong correlation between hospital exposure and high incidence of measles do exist. Inappropriate triage of patients in hospitals and insufficient ventilation in treatment rooms and wards were the major risk factors. |
| Keywords: | Measles Case-control study Nosocomial infection Analysis |
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