Objective To provide reference for precise prevention and control of diseases in schools through the analysis of sick leave and common features in schools in Hangzhou.Methods A total of 2 823 145 monitoring records from Hangzhou School Symptom Monitoring System based on smartphones were collected and sorted out.Schools as the basic units were analyzed by ecological research method.School absence due to illness,7 common symptoms including fever,cough,rash,red eye,diarrhea,parotid gland swelling and vomiting among different types of schools and regions were analyzed by one-way ANOVA and general linear model multivariate analysis.Results Among students on leave in Hangzhou,65.78％(1 868 293/2 840 421)took sick leave,with cough being the most common symptom,accounting for 49.51％(924 947/1 868 293),followed by fever of 28.78％(537 630/1 868 293),and red eyes being the least prevalent,accounting for 0.41％(7 591/1 868 293).Fever and red eyes were more common in winter and spring,accounting for 48.03％(258 961/539 170)and 64.48％(3 193/4 952)of the similar symptoms reported throughout the year,respectively,showing a decreasing trend with rising temperatures(Zfever=-94.04,Zred eyes=-18.10,both P＜0.001).Vomiting was more common in winter,accounting for 61.94％(77 925/125 813)of reports throughout the year.School type(F=181.15,P＜0.001),region type(F=8.56,P＜0.001),and their interaction(F=4.47,P＜0.001)were all statistically significant.Controlling for other variables,absence due to illness and 7 common symptoms were different in different school types,while fever,rash,diarrhea,parotid gland swelling,and vomiting showed regional differences.Marginal estimates of the general linear model showed that the proportion of sick leave in rural kindergartens was higher than that in urban ones(64.89％vs.61.50％,F=8.24,P＜0.001),the proportion of fever in primary and middle schools were significantly lower in rural areas than those in urban areas(primary school:33.78％vs.43.09％,middle school:25.68％vs.28.49％,F=17.58,P＜0.001),the proportion of rash in middle schools was significantly higher in rural areas than that in urban areas(6.80％vs.4.68％,F=4.41,P=0.012),and the proportions of diarrhea in primary and middle schools were significantly higher in rural areas than those in urban areas(primary school:4.06％vs.3.12％,middle school:6.93％vs.4.94％,F=4.58,P=0.010).Conclusions Primary school students and students in rural areas should be the focus of disease surveillance and control in Hangzhou.Efforts should be made to monitor and prevent infectious diseases such as influenza,conjunctivitis,and norovirus infections during winter and spring,while preventive measures such as indoor and outdoor mosquito control should be strengthened in rural areas during summer and autumn.
SchoolSymptom monitoringAbsence from school through illnessBig dataGeneral linear model multivariate analysis
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万方数据
