Krízová P, Kríz B
Národní referencní laborator pro meningokokové nákazy, Státní zdravotní ústav, Praha.
Epidemiol Mikrobiol Imunol. 1999 Nov;48(4):140-52.
The nationwide prospective questionnaire study of cases and controls was implemented during the period from October 1996 till May 1998. Thirty-nine districts participated (= 54.2% of district hygiene stations) and 107 invasive meningococcal diseases were included in the study (= 76.9% of diseases recorded during the given period in the Czech Republic by active surveillance). A total of 390 subjects were included in the study-107 with invasive meningococcal diseases, 211 healthy controls and 72 healthy carriers of Neisseria meningitidis. This is the first study in the Czech Republic which analyzes comprehensively socioeconomic, health and stress factors in relation to the genesis and development of invasive meningococcal disease or carriership of N. meningitidis. The relationship between these factors and meningococcal disease or carriership was evaluated by the chi square test: odds ratio (OR) and statistical significance (p for chi square-Yates correction or Fischer's exact test). For the development of invasive meningococcal disease in particular, risk factors are significant (p < 0.05) which at the time weaken the overall resistance of the organism: febrile diseases, respiratory diseases, other diseases, exertion, exposure to cold, mental stress, other stress, injury, staying in places outside the home on brigades, training courses, stay in crowded premises. As to long-term factors the development of the disease is influenced by a contaminated environment, passive smoking and lower education of the mother which indicates a different lifestyle. Conversely, factors negatively correlated with the development of the disease are active participation in sports and favourable economic conditions. For death: significant risk factors (p < 0.05) are also factors which weaken the resistance of the organism: exertion, mental stress, other stress (= alcohol consumption), staying outside the home on brigades, training courses etc. For carriership risk factors are significant (p < 0.05) when the mucosal membranes of the upper airways are impaired (staying in a dusty environment, in smoke-filled rooms, contaminated atmosphere, active smoking, passive smoking) and factors where contact with other people is frequent (overcrowded rooms, multi-generation housing, use of public transport, staying outside the home on brigades, training courses etc.). A risk factor is also lower education of parents which indicates a different lifestyle. Conversely, factors negatively correlated with carriership are favourable economic conditions, frequent outdoor stay and active participation in sports. By comparison of factors significantly associated with the development of invasive meningococcal disease or carriership data are assembled for the implementation of effective preventive measures.
1996年10月至1998年5月期间开展了一项全国性的病例对照前瞻性问卷调查研究。39个地区参与了研究（占地区卫生站的54.2%），研究纳入了107例侵袭性脑膜炎球菌病病例（占捷克共和国同期通过主动监测记录的此类疾病的76.9%）。该研究共纳入390名受试者，其中107例患有侵袭性脑膜炎球菌病，211名健康对照，72名脑膜炎奈瑟菌健康携带者。这是捷克共和国第一项全面分析与侵袭性脑膜炎球菌病的发生和发展或脑膜炎奈瑟菌携带情况相关的社会经济、健康和压力因素的研究。通过卡方检验评估这些因素与脑膜炎球菌病或携带情况之间的关系：比值比（OR）和统计学显著性（卡方检验的p值——耶茨校正或费舍尔精确检验）。特别是对于侵袭性脑膜炎球菌病的发生，风险因素具有显著性（p < 0.05），这些因素会削弱机体的整体抵抗力，包括：发热性疾病、呼吸道疾病、其他疾病、劳累、受寒、精神压力、其他压力、损伤、参加外出的工作队、培训课程、待在拥挤场所。至于长期因素，疾病的发生受环境污染、被动吸烟以及母亲受教育程度较低的影响，这表明生活方式不同。相反，与疾病发生呈负相关的因素是积极参加体育活动和有利的经济条件。对于死亡而言，具有显著性的风险因素（p < 0.05）也是削弱机体抵抗力的因素，包括：劳累、精神压力、其他压力（如饮酒）、参加外出的工作队、培训课程等。对于携带情况，当上呼吸道黏膜受损时（待在多尘环境、烟雾弥漫的房间、污染的大气环境、主动吸烟、被动吸烟）以及与人接触频繁的因素（房间拥挤、多代同堂居住、使用公共交通工具、参加外出的工作队、培训课程等），风险因素具有显著性（p < 0.05）。父母受教育程度较低也是一个风险因素，这表明生活方式不同。相反，与携带情况呈负相关的因素是有利的经济条件、经常户外活动和积极参加体育活动。通过比较与侵袭性脑膜炎球菌病的发生或携带情况显著相关的因素，收集数据以实施有效的预防措施。
