目的探讨江苏省8月龄~14岁儿童（儿童）、≥15岁成人（成人）麻疹传播影响因素,为控制和消除麻疹提供科学依据。方法选择儿童、成人麻疹实验室确诊病例,采用1：3病例对照研究方法开展调查。结果共有24组儿童,74组成人纳入分析,单因素分析结果显示,儿童发病危险因素为出疹前7~21 d医院就诊史（就诊史）、去过人口密集室内场所、最常去医院级别高,保护因素为孩子母亲患过麻疹、含麻疹成分疫苗史（疫苗史）;成人麻疹发病危险因素有就诊史、出疹前7~21 d外出旅行史（旅行史）,保护因素有疫苗史、本地长期居住。多因素分析结果显示,对于儿童,危险因素为就诊史（OR=165.13,95%CI：2.32~3 980.88）,保护因素为疫苗史（OR=0.06,95%CI：0.01~0.86）。对于成人,就诊史（OR=12.71,95%CI：4.25~38.02）、旅行史（OR=6.74,95%CI：1.51~30.18）为危险因素,接种史（OR=0.18,95%CI：0.06~0.49）为保护因素。结论要达到控制消除麻疹目标,应改进院内感染控制措施,提高儿童疫苗覆盖率,对成人也应探索可行的疫苗接种策略。
Objective To explore risk factors of measles infection in children aged 8 months-14 years and adults older than 15 years in Jiangsu province to provide scientific basis for measles prevention and control measures. Methods A 1 ∶ 3 matched case-control study was conducted. Newly reported laboratory confirmed cases from 8 months-14 years and more than 15 years were analyzed,respectively. Results Totally 24 groups of months-14 years children and 74 groups of older than 15 years adults were included in the analysis. For 8 months-14 years old children,visited hospital on 7-21 days before the rash,went to the densely populated sites,and went to the large hospital were risk factors,while mother had measles and measles vaccination history were protective factors of measles infection. For adults,visited hospital on 7-21 days before the rash,travel history on 7-21 days before the rash were risk factors,while measles vaccination history,local inhabitants were protective factors. Conditional logistic analysis showed that for 8 months-14 years old children,visited hospital on 7-21 days before the rash（ OR = 165. 13,95% CI： 2. 32-3 980. 88） was risk factor and measles vaccination history（ OR = 0. 06,95% CI： 0. 01-0. 86） were protective factor. For more than 15 years old adults,visited hospital on 7-21 days before the rash（ OR = 12. 71,95% CI： 4. 25-38. 02） and travel history on 7-21 days before the rash（ OR = 6. 74,95% CI： 1. 51-30. 18）,and measles vaccination history（ OR = 0. 18,95% CI： 0. 06-0. 49） was protective factor. Conclusions To achieve the purpose of the measles control and elimination,nosocomial infection should be strengthened and high measles vaccine coverage should be maintained for the 8 months-14 years old children,and feasible vaccination strategies should be explored for adults.
Chinese Journal of Disease Control and Prevention