唐山市228例布鲁菌病病例流行病学调查及危险因素分析

目的 了解唐山市布鲁菌病（布病）的流行动态、临床特征及危险因素，为制定布病防控措施提供参考依据。方法 对2014 - 2016年重点职业人群筛查出的228例确诊病例进行流行病学个案调查，并通过病例对照研究、χ2检验及Logistic回归分析找出布病感染的危险因素。结果 2014 - 2016年共筛查重点职业人员2 534人，确诊布病阳性病例228例，感染率为9.0%。布病患者春夏季高发；40～69岁男性多见；饲养人员阳性率最高（12.5%）；回民感染布病的危险是汉族人的1.9倍；新发病例以发热、关节酸痛、乏力为主。多因素Logistic回归分析证实与羊接触、不使用防护衣或手套、不使用消毒液、饲养环境未定期消毒、接触流产物或为羊接生、接触牲畜时有外伤、人畜共饮井、吃过病死牲畜、食用不太熟的畜肉、饮用生奶是高危人群感染布病的危险因素，与动物密切接触时使用防护措施为其保护性因素。结论 开展重点人群监测、健康教育和行为干预，做好个人防护，同时加强牲畜检疫和市场监管是布病防控的有效措施。

Epidemiological survey and analysis of risk factors of 228 brucellosis cases in Tangshan city

Objective The aim of this study was to assess the epidemic dynamic and clinical features of brucellosis among the key occupation groups to analyze the risk factors, and thus to provide a reference for prevention and treatment of brucellosis. Methods Epidemiological survey was conducted on 228 cases from 2014 to 2016. Case-control studies, χ2 test and logistic regression analysis were performed to find out the risk factors of brucellosis. Results Totally, 2543 people were investigated and 228 were confirmed positive(9.0%). Most people were infected in the spring and summer, and concentrated in 40-69-year-old males. People working in breeding had the highest positive rate(12.5%). The risk of Hui people infected with brucellosis was 1.9 times more than Han nationality. New cases were mainly with fever, joint pain, and weakness. Multivariate logistic regression analysis showed that contacting with sheep, using no protective clothing, gloves, or thimerosal, no disinfected regularly for feeding environment, handling abortion or deliver sheep, injured skin exposed to animals, people and animals drinking the same well, intake of dead animals or incomplete cooked meat, as well as drinking raw milk were risk factors for brucellosis infection in the key occupation groups. Using protective measures was brucellosis protective factors. Conclusion It is necessary to carry out surveillance, health education and behavior intervention, personal protection in occupation groups, and strengthen livestock quarantine and market supervision to prevent and control brucellosis.