广东省儿童手足口病发病影响因素病例对照研究

陈思秇; 吴为; 彭接文; 刘涛; 郑婵娇; 张丹桃

doi:10.11847/zgggws1132658

广东省儿童手足口病发病影响因素病例对照研究

Influencing factors of hand, foot, and mouth disease among children in Guangdong province: a case-control study

摘要

摘要:
目的了解广东省儿童手足口病发病的影响因素，为开展手足口病的综合防控和机制研究提供科学依据。
方法采用病例对照研究方法对2017年5 — 7月在广东省江门市新会区和河源市龙川县2家医院抽取的339例新发手足口病确诊患儿和与确诊患儿在同家医院就诊或同社区居住的339名无腹泻、胃肠炎及既往手足口病、疱疹性咽峡炎等与手足口病相关疾病的儿童进行问卷调查。
结果病例组患儿家中 < 14岁儿童数 ≥ 3个、近1个月使用中成药、经常吸吮手指、偶尔在地上打滚和玩耍、经常在地上打滚和玩耍、每次体育活动时间40～59 min和近1个月接触手足口病患者的比例分别为12.09 %、13.57 %、18.29 %、55.46 %、24.78 %、14.75 % 和20.35 %，均高于对照组儿童的5.90 %、9.73 %、10.06 %、44.97 %、21.30 %、8.88 % 和0.59 %（均P < 0.01）；父亲大专及以上文化程度、母亲大专及以上文化程度、经常饭前便后洗手、外出后洗手、近1个月偶尔食用含益生元食物、近1个月经常食用含益生元食物、偶尔喝凉茶和经常喝凉茶的比例分别为23.01 %、20.65 %、70.50 %、60.18 %、18.88 %、2.65 %、52.51 % 和9.14 %，均低于对照组儿童的34.91 %、31.86 %、84.91 %、76.33 %、23.96 %、12.43 %、60.36 % 和12.13 %（均P < 0.05）。多因素非条件logistic回归分析结果显示，近1个月使用中成药、经常吸吮手指、每次体育活动时间20～59 min和近1个月接触手足口病患者是广东省儿童手足口病发病的危险因素，近1个月经常食用含益生元食物和偶尔喝凉茶是广东省儿童手足口病发病的保护因素。
结论广东省儿童手足口病发病受接触史、卫生习惯、益生元食用和疾病用药等多种因素的影响。

Abstract:
Objective To explore influencing factors of hand, foot, and mouth disease (HFMD) among children in Guangdong province and to provide evidences for developing comprehensive measures on HFMD prevention and control and mechanism.
Methods With a self-designed questionnaire and face-to-face interview with the participants′ legal guardians, we conducted a case-control study during May – July 2017. The cases were 339 children (177 boys and 162 girls aged 3.54 ± 1.17 years) initially diagnosed with HFMD at two hospitals in a prefecture and a county of Guangdong province; the controls were 339 hospital/community-matched children without diarrhea, gastroenteritis, history of suffering from HFMD, herpangina or other related diseases.
Results Compared to the controls, the cases were reported with significantly higher proportions of with 3 or more children under the age of 14 years in the family (12.09% vs. 5.90%), taking Chinese patent medicine in the past month (13.57% vs.9.73%), sucking fingers frequently (18.29% vs. 10.06%), playing on the ground occasionally (55.46% vs. 44.97) or frequently (24.78% vs. 21.30%), spending 40 – 59 minutes in every physical activity (14.75% vs. 8.88%), and having a contact with someone suffering from HFMD in the past month (20.35% vs. 0.59%) but lower proportions of with paternal education of college and above (23.01% vs. 34.91%), with maternal education of college and above (20.65% vs. 31.86%), washing hands frequently before eating and after using toilet (70.50% vs. 84.91%), washing hands frequently after going out (60.18% vs. 76.33%), consuming food supplemented with prebiotics in the past month occasionally (18.88% vs. 23.96%) or frequently (2.65% vs. 12.43%), and drinking herbal tea occasionally (52.51% vs. 60.36%) or frequently (9.14% vs. 12.13%) (P < 0.05 for all). Unconditional multivariate logistic regression analysis revealed that significant risk factors of HFMD incidence included taking Chinese patent medicine in the past month, sucking fingers frequently, spending 20 – 59 minutes in every physical activity, and contacting with HFMD cases in the past month; while, consuming prebiotics frequently in the past month and drinking herbal tea occasionally were protective factors against HFMD incidence.
Conclusion HFMD incidence is affected by many factors such as exposure to HFMD cases, hygiene habits, prebiotics consumption, and taking medicine among children in Guangdong province.

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