北京市昌平区恙虫病血清流行病学调查及危险因素分析
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摘要
目的调查昌平区恙虫病的感染现状及危险因素,为制定全区恙虫病的防控策略提供依据。方法 2017年10-12月,在昌平区8个镇随机抽取常住人口开展恙虫病血清流行病学调查并进行危险因素分析。分别采用独立χ~2检验、分层χ~2检验及趋势性χ~2检验进行组间感染率分析。结果本次调查共检测480份血清样本,其中55份恙虫病IgG抗体阳性,阳性率为11.45%;不同年龄(χ~2=57.712,P<0.001)、教育程度(χ~2=35.257,P<0.001)、职业(χ~2=17.222,P<0.001)和地区(χ~2=69.469,P<0.001)人群阳性率的差异有统计学意义。田间劳作(OR=3.03,95%CI:1.31～6.98)和草地行走(坐卧)(OR=3.18,95%CI:1.07～9.46)分别是农民和在职人员感染的危险因素。涂抹防虫剂(OR=0.45,95%CI:0.21～0.98)和外出后洗澡换衣(OR=0.48,95%CI:0.25～0.93)是保护因素。结论北京市昌平区存在恙虫病隐性感染病例且具有显著的人群和地区差异,提示应加强监测与防控并开展进一步的调查研究。
Objective To investigate the current infection status of scrub typhus and the risk factors for scrub typhus in Changping district of Beijing, China, and to provide a basis for the prevention and control strategies of scrub typhus.Methods The residents from 8 towns in Changping district were randomly selected to conduct a seroepidemiological survey from October to December, 2017. The risk factors for scrub typhus were analyzed. Independent chi-square test,stratified chi-square test, and trend chi-square test were used to analyze the infection rate between groups. Results A total of 480 serum samples were tested in this survey, of which 55 were positive for scrub typhus immunoglobulin G(IgG)antibody and the positive rate was 11.45%; there were significant differences in the positive rate between patients with different ages( χ2=57.712, P<0.001), education levels( χ2=35.257, P<0.001), and different occupations( χ2=17.222,P<0.001) and those in different regions( χ2=69.469, P<0.001). For farmers and serving officers, field work and walking or sitting on grass were risk factors for scrub typhus, respectively(odds ratio[OR]=3.03, 95% confidence interval[CI]:1.31-6.98; OR=3.18, 95%CI: 1.07-9.46); spraying insect repellent and bathing or changing clothes after going out were protective factors, respectively(OR=0.45, 95%CI: 0.21-0.98; OR=0.48, 95%CI: 0.25-0.93). Conclusion The covert infection cases of scrub typhus are present in Changping district of Beijing, with significant population and regional differences,suggesting that it is necessary to strengthen surveillance, prevention, and control of scrub typhus and carry out further investigations.
Objective To investigate the current infection status of scrub typhus and the risk factors for scrub typhus in Changping district of Beijing, China, and to provide a basis for the prevention and control strategies of scrub typhus.Methods The residents from 8 towns in Changping district were randomly selected to conduct a seroepidemiological survey from October to December, 2017. The risk factors for scrub typhus were analyzed. Independent chi-square test,stratified chi-square test, and trend chi-square test were used to analyze the infection rate between groups. Results A total of 480 serum samples were tested in this survey, of which 55 were positive for scrub typhus immunoglobulin G(IgG)antibody and the positive rate was 11.45%; there were significant differences in the positive rate between patients with different ages( χ2=57.712, P<0.001), education levels( χ2=35.257, P<0.001), and different occupations( χ2=17.222,P<0.001) and those in different regions( χ2=69.469, P<0.001). For farmers and serving officers, field work and walking or sitting on grass were risk factors for scrub typhus, respectively(odds ratio[OR]=3.03, 95% confidence interval[CI]:1.31-6.98; OR=3.18, 95%CI: 1.07-9.46); spraying insect repellent and bathing or changing clothes after going out were protective factors, respectively(OR=0.45, 95%CI: 0.21-0.98; OR=0.48, 95%CI: 0.25-0.93). Conclusion The covert infection cases of scrub typhus are present in Changping district of Beijing, with significant population and regional differences,suggesting that it is necessary to strengthen surveillance, prevention, and control of scrub typhus and carry out further investigations.
引文
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[8]刘艳慧,李乔玄,景钦隆,等.广州市2006-2015年恙虫病疫情时空分布特征[J].中国媒介生物学及控制杂志,2017,28(4):336-339. DOI:10.11853/j.issn.1003.8280.2017.04.007.
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[10] Yang LP,Liu J,Wang XJ,et al. Effects of meteorological factors on scrub typhus in a temperate region of China[J]. Epidemiol Infect,2014,142(10):2217-2226. DOI:10.1017/S0950268813003208.
[11]杨慧,毕振旺,寇增强,等.山东省2006-2014年秋冬型恙虫病空间流行病学分析[J].中华流行病学杂志,2016,37(5):682-685. DOI:10.3760/cma.j.issn.0254-6450.2016.05.019.
[12] Kuo CC,Huang JL,Ko CY,et al. Spatial analysis of scrub typhus infection and its association with environmental and socioeconomic factors in Taiwan[J]. Acta Trop,2011,120(1/2):52-58. DOI:10.1016/j.actatropica.2011.05.018.
[13]孙烨,方立群,曹务春.山东、安徽、江苏省2006-2013年秋冬型恙虫病流行特征及影响因素研究[J].中华流行病学杂志,2016,37(8):1112-1116. DOI:10.3760/cma.j.issn.0254-6450.2016.08.012.
[14]田丽丽,张秀春,关增智,等.北京市67例恙虫病病例流行病学特征分析[J].疾病监测,2011,26(3):211-213. DOI:10.3784/.j.issn.1003-9961.2011.03.014.
[2]吕燕宁,陈丽娟,窦相峰,等.北京市远郊区恙虫病血清流行病学调查[J].中国媒介生物学及控制杂志,2016,27(3):257-259. DOI:10.11853/j.issn.1003.8280.2016.03.011.
[3]陈永亮,杨育松,贾丽丽,等.北京市北部山区恙虫病血清流行病学调查分析[J].中国媒介生物学及控制杂志,2016,27(6):597-599. DOI:10.11853/j.issn.1003.8280.2016.06.020.
[4]田丽丽,张立芹,吕燕宁,等.北京市恙虫病病例流行病学特征及实际感染病例数估计[J].职业与健康,2013,29(21):2765-2768. DOI:10.13329/j.cnki.zyyjk.2013.21.020.
[5]张萌,王显军,赵仲堂.中国恙虫病流行态势及预防控制[J].中华流行病学杂志,2011,32(4):419-423. DOI:10.3760/cma.j.issn.0254-6450.2011.04.021.
[6]廖云珍,叶晓光,罗润齐.恙虫病误诊原因分析[J].广东医学,2010,31(4):488-490. DOI:10.3969/j.issn.1001-9448.2010.04.036.
[7]张曙光,田丽丽,张丽琴,等.北京市延庆区恙虫病人群感染状况与危险因素研究[J].中国预防医学杂志,2016,17(7):532-534. DOI:10.16506/j.1009-6639.2016.07.012.
[8]刘艳慧,李乔玄,景钦隆,等.广州市2006-2015年恙虫病疫情时空分布特征[J].中国媒介生物学及控制杂志,2017,28(4):336-339. DOI:10.11853/j.issn.1003.8280.2017.04.007.
[9] Walker DH. Rickettsial diseases in travelers[J]. Travel Med Infect Dis,2003,1(1):35-40. DOI:10.1016/S1477-8939(03)00025-5.
[10] Yang LP,Liu J,Wang XJ,et al. Effects of meteorological factors on scrub typhus in a temperate region of China[J]. Epidemiol Infect,2014,142(10):2217-2226. DOI:10.1017/S0950268813003208.
[11]杨慧,毕振旺,寇增强,等.山东省2006-2014年秋冬型恙虫病空间流行病学分析[J].中华流行病学杂志,2016,37(5):682-685. DOI:10.3760/cma.j.issn.0254-6450.2016.05.019.
[12] Kuo CC,Huang JL,Ko CY,et al. Spatial analysis of scrub typhus infection and its association with environmental and socioeconomic factors in Taiwan[J]. Acta Trop,2011,120(1/2):52-58. DOI:10.1016/j.actatropica.2011.05.018.
[13]孙烨,方立群,曹务春.山东、安徽、江苏省2006-2013年秋冬型恙虫病流行特征及影响因素研究[J].中华流行病学杂志,2016,37(8):1112-1116. DOI:10.3760/cma.j.issn.0254-6450.2016.08.012.
[14]田丽丽,张秀春,关增智,等.北京市67例恙虫病病例流行病学特征分析[J].疾病监测,2011,26(3):211-213. DOI:10.3784/.j.issn.1003-9961.2011.03.014.