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目的分析东莞地区学龄前儿童手足口病流行病学和病原学特征。方法收集2013年1月-2015年12月来本院就诊的学龄前手足口病儿童2 559例,记录患儿基本信息,并采集确诊后2 d内的咽拭子或肛门拭子标本,用荧光免疫PCR法检测肠道病原菌。结果近3年本地区学龄前儿童手足口病呈逐年上升趋势,各年度发病率比较差异均有统计学意义(P<0.05)。学龄前手足口病患儿发病年龄多集中在5岁以下,占总发病数的97.73%;其中1~3岁为高发年龄段;各年龄段发病率比较差异均有统计学意义(P<0.05)。近3年市区学龄前儿童中手足口病发病数高于乡镇,差异有统计学意义(P<0.05)。本研究共采集患儿标本352份,其中276份标本肠道病毒阳性,占78.41%;其他肠道病毒检出数明显高于EV71、CA16,差异有统计学意义(P<0.05)。2013年EV71检出率最高,2014年和2015年其他肠道病毒检出率最高。不同性别患儿肠道病毒检出情况之间差异无统计学意义(P>0.05)。结论东莞地区近3年学龄前儿童手足口病发病数逐年增加,5岁以下儿童是肠道病毒感染的主要人群,其中1~3岁为高发年龄段;肠道病毒由以EV71、CA16为主转变为以其他肠道病毒为主。
Objective To analyze the epidemiological and etiological characteristics of hand-foot-mouth disease in preschool children in Dongguan area. Methods A total of 2 559 preschool children with HFMD were enrolled in our hospital from January 2013 to December 2015. The basic information of children was collected and the throat swab or anus swab specimens were collected within 2 days after diagnosis. Fluorescent Immunoassay for Detection of Enteric Pathogens. Results The hand-foot-mouth disease of preschool children in this area showed an upward trend year by year in recent 3 years. The incidence rates of each year were statistically significant (P <0.05). The onset age of preschool children with HFMD was mostly below 5 years old, accounting for 97.73% of the total number of cases. Among them, 1 to 3 years old were the high incidence age group, and the incidence of each age group was statistically significant (P <0.05 ). The incidence of hand-foot-mouth disease among preschool children in urban areas in recent three years was higher than that in towns and townships (P <0.05). In this study, 352 samples of children were collected, of which 276 samples were positive for enterovirus, accounting for 78.41%. The detection rates of other enterovirus were significantly higher than those of EV71 and CA16 (P <0.05). The highest rate of EV71 was detected in 2013 and the highest rate of other enterovirus was detected in 2014 and 2015. There was no significant difference in the detection of enterovirus between children with different genders (P> 0.05). Conclusion The incidence of hand-foot-mouth disease in preschool children in Dongguan area has increased year by year in recent 3 years. Children under 5 years old are the major population of enterovirus infection, of which 1 to 3 years old are high-incidence age. Enterovirus is mainly composed of EV71 and CA16 Transform to other enterovirus-based.