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 case-control study
-
摘要: 目的 探讨江苏省8月龄~14岁儿童(儿童)、≥15岁成人(成人)麻疹传播影响因素,为控制和消除麻疹提供科学依据。方法 选择儿童、成人麻疹实验室确诊病例,采用1:3病例对照研究方法开展调查。结果 共有24组儿童,74组成人纳入分析,单因素分析结果显示,儿童发病危险因素为出疹前7~21 d医院就诊史(就诊史)、去过人口密集室内场所、最常去医院级别高,保护因素为孩子母亲患过麻疹、含麻疹成分疫苗史(疫苗史);成人麻疹发病危险因素有就诊史、出疹前7~21 d外出旅行史(旅行史),保护因素有疫苗史、本地长期居住。多因素分析结果显示,对于儿童,危险因素为就诊史(OR=165.13,95% CI:2.32~3 980.88),保护因素为疫苗史(OR=0.06,95% CI:0.01~0.86)。对于成人,就诊史(OR=12.71,95% CI:4.25~38.02)、旅行史(OR=6.74,95% CI:1.51~30.18)为危险因素,接种史(OR=0.18,95% CI:0.06~0.49)为保护因素。结论 要达到控制消除麻疹目标,应改进院内感染控制措施,提高儿童疫苗覆盖率,对成人也应探索可行的疫苗接种策略。Abstract: Objective To explore risk factors of measles infection in children aged 8 months-14 years and adults older than 15 years in Jiangsu province to provide scientific basis for measles prevention and control measures. Methods A 1:3 matched case-control study was conducted. Newly reported laboratory confirmed cases from 8 months-14years and more than 15 years were analyzed, respectively. Results Totally 24 groups of months-14years children and 74 groups of older than 15 years adults were included in the analysis. For 8 months-14 years old children, visited hospital on 7-21 days before the rash, went to the densely populated sites, and went to the large hospital were risk factors, while mother had measles and measles vaccination history were protective factors of measles infection. For adults, visited hospital on 7-21 days before the rash, travel history on 7-21 days before the rash were risk factors, while measles vaccination history, local inhabitants were protective factors. Conditional logistic analysis showed that for 8 months-14 years old children, visited hospital on 7-21 days before the rash (OR=165.13, 95% CI: 2.32-3 980.88) was risk factor and measles vaccination history (OR=0.06, 95% CI: 0.01- 0.86) were protective factor. For more than 15 years old adults, visited hospital on 7-21 days before the rash (OR=12.71, 95% CI: 4.25-38.02) and travel history on 7-21 days before the rash (OR=6.74, 95% CI: 1.51-30.18), and measles vaccination history (OR=0.18, 95% CI: 0.06-0.49) was protective factor. Conclusions To achieve the purpose of the measles control and elimination, nosocomial infection should be strengthened and high measles vaccine coverage should be maintained for the 8 months-14 years old children, and feasible vaccination strategies should be explored for adults.
-
Key words:
- Measles /
- Case-control studies /
- Vaccines /
- Immunity
-
李静,李国明,雷亚克,等. 2012-2013年湖北省麻疹病毒流行株核蛋白N基因和血凝素蛋白H基因特征分析 [J]. 中华疾病控制杂志, 2015,19(8):760-764. Sniadack DH, Mendoza-Aldana J, Jee Y, et al. Progress and challenges for measles elimination by 2012 in the Western Pacific Region [J]. J Infect Dis, 2011,204(1):S439-446. 杨杨,邢远,侯铁军,等. 西安市2008-2013年麻疹流行病学特征分析 [J]. 中华疾病控制杂志, 2015,19(3):307-309. 马超,罗会明,安志杰,等.中国2006-2007年麻疹流行病学特征及消除麻疹措施分析 [J]. 中国疫苗和免疫, 2008,14(3):208-213. Liu Y, Lu P, Hu Y, et al. Cross-sectional surveys of measles antibodies in the Jiangsu Province of China from 2008 to 2010: the effect of high coverage with two doses of measles vaccine among children [J]. PLoS ONE, 2013,8(6): e66771. Simons E, Ferrari M, Fricks J, et al. Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data [J]. Lancet, 2012,379(9832): 2173-2178. 陈万庚,张毓鑫,何飞. 麻疹发病危险因素的Meta分析 [J]. 职业与健康, 2011,27(3):312-313. Ernst E. Anthroposophy: a risk factor for noncompliance with measles immunization [J]. Pediatr Infect Dis J, 2011,30(3):187-189. van Binnendijk RS, Hahné S, Timen A, et al. Air travel as a risk factor for introduction of measles in a highly vaccinated population [J]. Vaccine, 2008,26(46):5775-5777. Yaméogo KR, Perry RT, Yaméogo A, et al. Migration as a risk factor for measles after a mass vaccination campaign, Burkina Faso, 2002 [J]. Int J Epidemiol, 2005,34(3):556-564. Gidding HF, Wood J, MacIntyre CR, et al. Sustained measles elimination in Australia and priorities for long term maintenance [J]. Vaccine, 2007,25(18):3574-3580. 李慧,张晓曙,漆可发,等. 麻疹发病与麻疹疫苗接种的病例对照研究 [J]. 中国计划免疫, 2006,12(1):29-31. 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. 谭吉宾,曹卫华,逄增昌,等. 青岛市成人麻疹发病相关因素的病例对照研究 [J]. 中华流行病学杂志, 2006,27(3):226-229. 卞琛,凌良健,徐文国,等. 常州市低于8月龄婴儿麻疹传播影响因素分析 [J]. 现代预防医学, 2014,41(23):4278-4281. 贾成梅,陶红,陆培善,等. 江苏省麻疹流行病学特征演变及消除措施分析 [J]. 南京医科大学学报:自然科学版, 2011,31(9):1374-1378.
点击查看大图
计量
- 文章访问数: 256
- HTML全文浏览量: 59
- PDF下载量: 40
- 被引次数: 0