摘要
目的 分析儿童手足口病再感染危险因素,建立再感染风险预测模型.方法 选取武汉市金银潭医院信息系统中2020年1月-2023年12月儿童手足口病1 200例为研究对象,根据是否再感染分为再感染组80例和非再感染组1 120例.收集所有儿童的人口学资料与临床资料,包含年龄、性别、居住地、主要照顾者文化程度、发病季节、人群分类、疫苗接种、严重程度、初次感染病原、营养不良、并发症及家长知识与行为等.采用Logistic分析统计手足口病儿童再感染的危险因素,建立再感染风险预测模型并评估模型效果.结果 本地区手足口病儿童再感染的发生率为6.67％,年龄≤3岁、男性、散居儿童、儿童偏食和营养不良是本地区手足口病儿童再感染的危险因素(P＜0.05);疫苗接种、家长行为是保护因素(P＜0.05).手足口病再感染列线图预测模型的Hos-mer-Lemeshow拟合效果良好(P=0.495).结论 本地区儿童手足口病仍有一定再感染风险,其中低龄、男性、散居、偏食、营养不良儿童更易发生再感染.临床可早期筛选手足口病再感染高风险群体,对高危儿童进行重点关注,鼓励疫苗接种,为疾病的早期防控提供依据.
Abstract
OBJECTIVE To analyze the risk factors and build the prediction model for the hand,foot and mouth dis-ease(HFMD)re-infection in children.METHODS A total of 1,200 children with HFMD from Jan.2020 to Dec.2023 were selected from Wuhan Jinyintan hospital information system as the study objects,and divided into re-in-fection group with 80 cases and non-re-infection group with 1,120 cases.The demographic and clinical data were collected,including age,sex,residence,education level of primary guardian,season of onset,population classifi-cation,vaccination,severity,pathogen of initial infection,malnutrition,complicationsand parents'knowledge and behavior.The risk factors were analyzed by logistic analysis,and the prediction model was established and evalua-ted.RESULTS The re-infection rate of HFMD in children was 6.67％,and the risk factors were age ≤3 years,male,scattered living,picky eating and malnutrition(P＜0.05).The vaccination and behavior of the primary guardian were protective factors(P＜0.05).Hosmer-Lemeshow test exhibited satisfactory concordance for predic-ting HFMD re-infection(P=0.495).CONCLUSIONS Certain risks for HFMD re-infection in children still exist in this area,among which young age,male,scattered living,picky eating and malnutrition are the major ones.High-risk HFMD re-infection group can be screened early and paid special attention to;and vaccination should be pro-moted so as to provide early prevention and control of the disease.
维普
万方数据