新疆维吾尔自治区伽师县荒漠型黑热病暴发流行危险因素分析

目的 探讨新疆维吾尔自治区伽师县荒漠型黑热病暴发流行的危险因素.方法 采用病例对照研究,自制凋查问卷,以2008年1月-2008年11月网络直报的47例黑热病患者为病例组,在同村按1:3匹配选择141名年龄相仿的健康儿童作为对照组,对性别、环境和行为等13个潜在危险因素进行单因素和多因素条件logistic回归分析.结果 单因素分析显示:户外露宿习惯、被叮咬、邻居有黑热病患者、黄昏时带孩子户外活动、驱避剂的使用等凶素与本次迦师县荒漠型黑热病暴发流行关系密切,危险比(HR)值和95%可信区间(95%CI)依次为73.846(10.070,541.510)、78.875(10.719,576.910)、15.149(5.876,39.054)、63.912(8.996,454.048)和0.020(0.005,0.008);多冈素回归分析显示:户外露宿习惯是危险冈素,HR值和95%CI为80.963(5.119,1 280.596),而驱避剂的使用是暴发流行的保护因素,HR值和95%CI为0.021(0.003,0.162).结论 在目前传染源尚不叫确的情况下,养成良好的生活习惯,尽量不在外露宿,安伞使用药浸蚊帐或纱窗,规范使用驱避剂和定期在院内喷洒杀虫剂是预防控制黑热病感染的有效措施.

Analysis on risk factors of desert-type Kala-azar outbreak in Jiashi County, Xinjiang Uygur Autonomous Region

Objective To investigate the risk factors of desert.type Kala-agar outbmak in Jiashi County of Xinjiang Uygur Autonomous Region. Methods A ease-control study with self-made questionnaire was conducted.The ease group included 47 Cases of Kala-azar patients from network.straight.reported from Junnary 2008 to November 2008 while the control group was 1:3 matched.including 141 healthy children at the same village and similar age.Thirteen potential risk factors including gender,environment and behavior factors were analysed by singh and multivariate conditional logistic regression. Results The single-variable conditional logistic regression analysis showed that the factors such as outdoor sleep habit,outdoor bite,Kala.azar patients near dwelling place,outdoor activities in evening with the children.pesticide use were all closely related to the desert-type Kala-azar outbreak,the hazaxd ratio(HR)values and 95%confidence interval(95%CI)were 73.846(10.070,541.510),78.875(10.719,576.910),15.149(5.876,39.054),63.912(8.996,454.048),0.020(0.005,0.008)respectively.Multivariate conditional logistie regression analysis showed that outdoor sleep habit was the risk factor,HR(95%CI)was 80.963(5.119,1280.596),the use of pesticides Was the protective factor to avoid the desert-type Kala.azar outbreak.HR(95%CI)Was 0.02l(0.003.0.162).Conclusion The adoption of a healthy life.style,not to sleep outside.the safe use of mosquito nets or screens soaked by pesticides,the use of repellent regularly and regular spraying of insecticides in the courtyard are all effective measures for prevention and control of Kala.agar.