上海市诺如病毒感染性腹泻病例对照调查危险因素研究

目的识别诺如病毒感染性腹泻发生的危险因素,为预防控制诺如病毒感染性腹泻的发生提供科学依据。方法应用1∶1匹配的病例对照调查方法开展调查,病例来源于哨点医院监测的实验室确诊病例,对照来源于与病例在性别、年龄和居住地相匹配的社区对照;调查问卷包括社会经济学情况、既往病史、外出史、发病/调查前3 d饮食饮水史和家庭卫生习惯等内容。结果调查期间,共收集130对病例/对照调查对象,通过多因素回归分析方法,发现国内旅行比值比(OR):8.94, 95%可信区间(95%CI):1.18～67.48]、食用海水贝类(OR:6.04, 95%CI:1.23～29.76)、食用猪肉(OR:0.32,95%CI:0.12～0.89)及在不正规和流动摊点就餐(OR:4.93, 95%CI:1.01～24.17)同诺如病毒感染性腹泻的发生存在统计学关联性。结论针对公众,应加强食用海水产品烧熟煮透和防止交叉污染的宣传,尽量不要在非正规/流动摊点就餐,外出旅行时尤其注意个人卫生和饮食卫生;建议监管部门应加强对不正规和流动摊点的卫生监管。

Risk factors of infectious diarrhea caused by Norovirus by matched case-control study in Shanghai, China

Objective This study aimed to identify the risk factors of infectious diarrhea caused by Norovirus, and propose recommendations to protect susceptible population. Methods Using a matched case-control approach, cases from sentinel hospitals in Shanghai and controls were matched with gender, age and residential location. Questionnaire included social and economic status, medical history, outgoing history, diet and drinking water in the past 3 days and family health habits. Results 130 pairs of cases and controls were enrolled. The multivariable regression analysis showed that domestic travel (OR:8.94,5%CI:1.18-67.48), sea shell consumption (OR:6.04,5%CI:1.23-29.76), pork consumption (OR:0.32,95%CI:0.12-0.89) and illegal restaurants/ mobile stalls eating (OR:4.93,5%CI:1.01-24.17) were associated with infectious diarrhea caused by Norovirus. Conclusion It is important to educate the public to cook seafood thoroughly and prevent cross-contamination. It is also important not to eat at illegal restaurants/mobile stalls and to pay special attention to personal hygiene and dietary hygiene when travelling. The authorities should strengthen the health supervision of irregular and mobile stalls.