| 林声,潘浩,肖文佳,宫霄欢,匡小舟,滕峥,张曦,吴寰宇.上海市2013-2018年成年人诺如病毒引发感染性腹泻的流行特征研究[J].中华流行病学杂志,2019,40(8):883-888 |
| 上海市2013-2018年成年人诺如病毒引发感染性腹泻的流行特征研究 |
| Epidemiologic characteristics of Norovirus among adult patients with infectious diarrhea, in Shanghai, 2013-2018 |
| 收稿日期:2019-03-11 出版日期:2019-08-19 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.08.003 |
| 中文关键词: 感染性腹泻 诺如病毒 监测点医院 流行特征 |
| 英文关键词: Infectious diarrhea Norovirus Sentinel hospital Epidemiology |
| 基金项目: |
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| 中文摘要: |
| 目的 了解上海市成年人感染性腹泻患者中诺如病毒的流行特征，为上海市诺如病毒感染性腹泻防控策略的制定提供科学依据。方法 在上海市22家监测点医院的肠道门诊中开展腹泻症状监测，收集患者人口学信息、流行病学资料和主要症状，同时采集患者粪便标本，送至医院所在区CDC检测诺如病毒，分析2013-2018年不同人群和季节的诺如病毒检出率，利用logistic回归分析探讨人群感染诺如病毒的影响因素。结果 在12 083例感染性腹泻患者中，诺如病毒阳性检出率为19.28%（2 330/12 083），主要型别为GⅡ群（83.63%）。其中男性检出率（20.78%）高于女性（17.73%），30~44岁组人群诺如病毒检出率最高（21.51%），2015年检出率最高（23.60%），以上差异均有统计学意义（P<0.05）。诺如病毒感染以10月至次年4月为高发季节。诺如病毒阳性患者以水样便居多（75.94%），35.84%患者伴有呕吐症状。多因素logistic回归分析显示，男性、30~44岁组、干部职员、冬季及外出史是感染诺如病毒的危险因素。结论 上海市成年人腹泻患者诺如病毒感染率高，引起的感染性腹泻全年均可发生，冬、春季高发，在诺如病毒引发的感染性腹泻的防控工作中应针对不同年龄、性别、季节采取特异性防控措施。 |
| 英文摘要: |
| Objective To investigate the epidemiologic characteristics of Norovirus among adult patients suffering from infectious diarrhea in Shanghai, so as to provide evidence for developing related strategies on prevention and control of the disease. Methods Diarrheal outpatients were monitored at the ‘Intestinal clinic’ from 22 hospitals involved in the sentinel surveillance program in Shanghai. Information on demographic and epidemiologic features of the patients was collected while data and clinical, fecal specimens were collected and sent to the district CDC for Norovirus detection. Positive rates of Norovirus were also compared in various populations and seasons during 2013-2018. Multivariate logistic regression model was adopted to fit into the comparisons between non-Norovirus and Norovirus groups. Results 19.28% of the 12 083 diarrheal cases were found to have carried the Norovirus, with GⅡgroup the most commonly identified genotype. Rates of detection was seen higher in males (20.78%) than in females (17.73%). 30-44 year-old were found having the highest positive rate (21.51%). The positive rates were found the highest (23.60%) in the year of 2015. All the above shown differences were statistically significant (P<0.05). Diarrheal patients affected with Norovirus would present watery stool (75.94%) and vomiting (35.84%). Data from the multivariate logistic analysis showed that factors as:being males, 30-44 years old, officials/clerks, in winter season and with histories of travelling etc., were related to higher risks on Norovirus infection. Conclusions Infectious diarrhea caused by Norovirus occurred all year round, with seasonal peaks seen in winter and spring, in Shanghai. Specific prevention and control measures should be taken on Norovirus-caused infectious diarrhea, according to the difference on age, gender and season. |
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