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目的了解广东省狂犬病高发地区学龄期儿童狂犬病暴露现状和相关危险因素。方法采取典型抽样的方法,选择广东省狂犬病高发的某市1所地市级小学、1所县级小学、2所乡镇中心小学和2所村级小学,系统抽取部分小学生,以统一问卷调查2007年1月至2008年5月期间狂犬病暴露情况。采用logistic回归分析方法分析其影响因素。结果共调查1 246名小学生,发现狂犬病暴露99人次,总暴露率为7.95%。暴露部位以四肢为主,占97.1%(96/99);Ⅱ级暴露占66.7%(66/99),Ⅲ级暴露占33.3%(33/99);致伤动物以犬为主,占68.7%(68/99);暴露后狂犬疫苗接种率为63.6%(63/99)。农村小学生狂犬病暴露风险高于城市(RR=13.64,95%CI:3.26～57.14);随着年龄增加,暴露风险下降(RR=0.58,95%CI:0.37～0.89);激惹流浪犬猫是危险行为(RR=2.83,95%CI:1.10～7.30)。结论农村是儿童狂犬病防制的重点地区,加强对豢养宠物和流浪动物的管理、提高动物的狂犬疫苗接种率是减少儿童暴露的重要措施。
Objective To understand the status and related risk factors of rabies exposure in school-age children in Guangdong province with high incidence of rabies. Methods A typical sampling method was adopted to select a primary school, a county primary school, two township primary schools and two village primary schools in a city with high prevalence of rabies in Guangdong Province. Some primary school students were systematically selected to conduct a questionnaire survey 2007 Rabies exposure from January to May 2008. Logistic regression analysis was used to analyze the influencing factors. Results A total of 1,246 primary school students were investigated. The rabies exposure rate was 99 and the total exposure rate was 7.95%. Exposed areas were mainly limbs, accounting for 97.1% (96/99); Grade Ⅱ exposure accounted for 66.7% (66/99), Grade Ⅲ exposure accounted for 33.3% (33/99); dogs were mainly injured, accounting for 68.7 % (68/99); rabies vaccination rate after exposure was 63.6% (63/99). The risk of rabies exposure in rural primary school students was higher than that in urban areas (RR = 13.64, 95% CI: 3.26-57.14); exposure risk decreased with age (RR = 0.58, 95% CI: 0.37-0.89) Dangerous behavior (RR = 2.83, 95% CI: 1.10 ~ 7.30). Conclusion The rural areas are the key areas for the prevention of rabies in children. Strengthening the management of pets and stray animals and raising rabies vaccination rate in animals are important measures to reduce the exposure of children.