黄冈市2009~2013年手足口病重症病例流行病学分析

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目的分析黄冈市手足口病重症病例的流行病学特征,为进一步制定防控措施提供科学依据。方法应用描述流行病学方法对黄冈市2009~2013年手足口病重症病例的流行病学特征进行分析,率的比较采用卡方检验。结果2009~2013年黄冈市共报告手足口病重症病例64例,重症发生率为0.2%,重症病例病死率为9.38%。轻症手足口病患儿中男性比女性更容易进展为手足口病重症患儿(χ2=4.42,P=0.035),98.4%(63/64)的重症病例发生在﹤3岁组婴幼儿中;不同年龄组间重症发生率差异也有统计学意义(χ2=117.01,P=0.000),且随着年龄上升,重症发生率有下降的趋势(趋势χ2=57.48,P=0.000)。散居儿童重症发生率高于幼托和学生(χ2=6.73,P=0.01)。全市有7个县有重症病例报告,浠水县报告最多(68.75%);79.7%的重症病例集中在6月和7月。重症病例以EV71型为主(59.4%),6例死亡病例中EV71阳性5例。结论黄冈市手足口病疫情逐年升高,应对高发地区、高发人群及高发季节采取针对性的宣传教育工作,以降低手足口病重症发生率。 Objective To analyze the epidemiological characteristics of HFMD cases in Huanggang City and provide scientific basis for further prevention and control measures. Methods Epidemiological methods were used to analyze the epidemiological characteristics of HFMD cases from 2009 to 2013 in Huanggang City. The rates were compared by chi-square test. Results A total of 64 cases of hand-foot-mouth disease were reported in Huanggang City from 2009 to 2013, the incidence of severe disease was 0.2% and the case-fatality rate of severe cases was 9.38%. Among children with mild hand-foot-mouth disease, men were more likely to develop severe hand-foot-mouth disease (χ2 = 4.42, P = 0.035) and 98.4% (63/64) were more likely to develop severe disease in children <3 years of age There was also a significant difference in the incidence of severe diseases among different age groups (χ2 = 117.01, P = 0.000). The incidence of severe diseases decreased with age (trend χ2 = 57.48, P = 0.000). The incidence of diarrhea in critically ill children was higher than that in child care and children (χ2 = 6.73, P = 0.01). Seven counties in the city have reported severe cases, Xishui County has the most reports (68.75%), and 79.7% of severe cases have been concentrated in June and July. The major cases were EV71 (59.4%), and EV71 was positive in 5 of 6 deaths. Conclusion The epidemic situation of hand, foot and mouth disease in Huanggang city is increasing year by year. It is necessary to take targeted propaganda and education work in high incidence areas, high incidence population and high incidence season in order to reduce the incidence of HFMD.
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