北京市社区人群急性胃肠炎患病状况流行病学调查
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摘要
目的了解北京市社区人群急性胃肠炎患病状况和流行特征。方法采用多阶段整群随机抽样方法,于2014年4月—2015年3月,抽取北京市6个区120个社区的居民,采用入户调查方法,调查过去4周急性胃肠炎的发生情况、就诊行为和可疑病因等信息。结果共完成调查9 885人,其中110人在调查期间发生急性胃肠炎。根据2010年第六次人口普查北京市人口性别、年龄调整后,急性胃肠炎月患病率为1.01%(95%CI=0.81%～1.21%),年发病率为0.15次/人年(95%CI=0.13～0.16)。不同年龄、区域和季节的急性胃肠炎月患病率存在统计学差异。急性胃肠炎患者的就诊率为31.82%,粪便送检率为20.00%。在自述的可疑病因中,食源性比例为52.73%,可疑食品来源于家庭的比例为44.83%,污染食品类别为果蔬类(34.48%)。结论急性胃肠炎患者的就诊率低,自述食源性较高,应进一步完善监测系统设计,开展有针对性的食品安全教育,有效降低社区人群急性胃肠炎的患病率。
Objective To analyze the incidence and prevalence characteristics of acute gastrointestinal illness(AGI among community residents in Beijing. Methods We selected 10 800 residents in 120 communities of 6 administrative districts in Beijing city using multistage random cluster sampling and then conducted a household interview among the residents on AGI-related symptoms, medication seeking and possible causes during previous 28 days between April 2014 and March 2015. Results Among the 9 885 participants completing the survey, totally 110 were identified as self-reported AGI cases, with the adjusted monthly incidence rate of 1.01%(95% confidence interval [95% CI]: 0.81% – 1.21%) and the estimated yearly incidence density of 0.15(95% CI: 0.13 – 0.16) person-year based on gender and age distribution of Beijing population in 6 th national census in 2010. The monthly AGI incidence rate differed significantly by age, living region and season. Of all the AGI cases identified, 31.82% reported seeking medical service and 52.73% reported suspected intake of contaminated food related to the illness. Of the cases seeking medication, 20.00% had feces examination. Among the 58 AGI cases reporting the AGI-related food intake, 44.83% had the food at home and 34.48% had the intake of probably contaminated fruit or vegetable. Conclusion The community AGI patients in Beijing had a lower ratio of seeking medical service and higher ratio of having contaminated food intake. AGI related surveillance and health education on food safety should be promoted among community residents to reduce AGI incidence.
Objective To analyze the incidence and prevalence characteristics of acute gastrointestinal illness(AGI among community residents in Beijing. Methods We selected 10 800 residents in 120 communities of 6 administrative districts in Beijing city using multistage random cluster sampling and then conducted a household interview among the residents on AGI-related symptoms, medication seeking and possible causes during previous 28 days between April 2014 and March 2015. Results Among the 9 885 participants completing the survey, totally 110 were identified as self-reported AGI cases, with the adjusted monthly incidence rate of 1.01%(95% confidence interval [95% CI]: 0.81% – 1.21%) and the estimated yearly incidence density of 0.15(95% CI: 0.13 – 0.16) person-year based on gender and age distribution of Beijing population in 6 th national census in 2010. The monthly AGI incidence rate differed significantly by age, living region and season. Of all the AGI cases identified, 31.82% reported seeking medical service and 52.73% reported suspected intake of contaminated food related to the illness. Of the cases seeking medication, 20.00% had feces examination. Among the 58 AGI cases reporting the AGI-related food intake, 44.83% had the food at home and 34.48% had the intake of probably contaminated fruit or vegetable. Conclusion The community AGI patients in Beijing had a lower ratio of seeking medical service and higher ratio of having contaminated food intake. AGI related surveillance and health education on food safety should be promoted among community residents to reduce AGI incidence.
引文
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[13]Thomas MK,Murray R,Nesbitt A,et al.The incidence of acute gastrointestinal illness in Canada,Foodbook Survey 2014-2015[J].Canadian Journal of Infectious Diseases and Medical Microbiology,2017,2017(1):1-11.
[14]Jones TF,Mcmillian MB,Scallan E,et al.A population-based estimate of the substantial burden of diarrhoeal disease in the United States;FoodNet,1996-2003,[J].Epidemiology and Infection,2007,135(2):293-301.
[15]王超,曾彪,薛一凡,等.北京市社区居民食源性疾病知信行调查[J].中国健康教育,2017(2):124-127.
[2]Edelstein M,Merk H,Deogan C,et al.Quantifying the incidence and cost of acute gastrointestinal illness in Sweden,2013-2014[J].Epidemiol Infect,2016,144(13):2831-2839.
[3]Thomas MK,Majowicz SE,MacDougall L,et al.Population distribution and burden of acute gastrointestinal illness in British Columbia,Canada[J].BMC Public Health,2006,6(1):307.
[4]马晓晨,曾彪,马蕊,等.北京市社区人群急性胃肠炎患病状况流行病学调查[J].中国食品卫生杂志,2016,28(3):365-368.
[5]田祎,贾蕾,高志勇,等.2013-2015年北京市其他感染性腹泻病例流行病学特征分析[J].首都公共卫生,2016,10(2):58-61.
[6]Chen Y,Yan WX,Zhou YJ,et al.Burden of self-reported acute gastrointestinal illness in China:a population-based survey[J].BMC Public Health,2013,13(1):456.
[7]Zhou YJ,Dai Y,Yuan BJ,et al.Population-based estimate of the burden of acute gastrointestinal illness in Jiangsu province,China,2010-2011[J].Epidemiol Infect,2013,141(5):944-952.
[8]刘爽,李骏,龚晨睿,等.湖北省急性胃肠炎疾病人群负担评估[J].中国公共卫生,2016,32(4):554-557.
[9]Mead PS,Slutsker L,Griffin PM,et al.Food-related illness and death in the United States[J].Emerging Infectious Diseases,1999,5(5):607-625.
[10]张书芳,李杉,袁蒲,等.2014-2015年河南省居民急性胃肠炎流行病学负担研究[J].现代预防医学,2016,43(20):3661-3664.
[11]罗宝章,段胜钢,蔡华,等.上海市非伤寒沙门菌感染的流行病学负担概率估计[J].中国食品卫生,2018,30(1):12-17.
[12]张静,刘民.广东、河南、甘肃三省12县区腹泻病例就诊模式调查[J].中华流行病学杂志,2008,29(10):989-993.
[13]Thomas MK,Murray R,Nesbitt A,et al.The incidence of acute gastrointestinal illness in Canada,Foodbook Survey 2014-2015[J].Canadian Journal of Infectious Diseases and Medical Microbiology,2017,2017(1):1-11.
[14]Jones TF,Mcmillian MB,Scallan E,et al.A population-based estimate of the substantial burden of diarrhoeal disease in the United States;FoodNet,1996-2003,[J].Epidemiology and Infection,2007,135(2):293-301.
[15]王超,曾彪,薛一凡,等.北京市社区居民食源性疾病知信行调查[J].中国健康教育,2017(2):124-127.