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中国大陆安徽省宣城市肾综合征出血热(HFRS)危险因素调查。

Investigation on risk factors of haemorrhagic fever with renal syndrome (HFRS) in Xuancheng City in Anhui Province, Mainland China.

机构信息

School of Public Health, Jilin University, Changchun, Jilin Province, People's Republic of China.

Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, People's Republic of China.

出版信息

Epidemiol Infect. 2020 Oct 2;148:e248. doi: 10.1017/S0950268820002344.

Abstract

Haemorrhagic fever with renal syndrome (HFRS), a rodent-borne disease, is a major public health concern in both developed and developing countries. China is the most severe endemic country in the world, constituting 90% of the cases. Although the incidence of HFRS has substantively decreased in most areas of China, HFRS has rebounded remarkably in some epidemic areas. Xuancheng is one of these areas. In this study, we collected the case data reported recently in Xuancheng and designed a 1:3 case-control study. The Chi-square test, univariate and multivariate logistic regression analysis were performed. In all cases, farmers made up the highest proportion of occupations. And there were 20 variables with statistical significance including indoor hygienic conditions; the surrounding environment; whether bitten by rats at work and other criteria. In addition, exposure to rodents and rats bites is a high-risk factor for HFRS. Rodent density was calculated at 20.9% (159/760), the virus carrier rate was 9.4% (15/159) and the index of rats with a virus was about 2.0%. Exposure to rodents and insect bites is also high-risk factors for HFRS among local residents in Xuancheng. More importantly, during the flood years, the increased density of rodents led to an increased risk of human exposure to rodents. As our statistical analysis proves, targeted strategies should be developed and implemented to reduce the incidence of local diseases in the future.

摘要

肾综合征出血热(HFRS)是一种由啮齿动物传播的疾病,是发达国家和发展中国家共同关注的主要公共卫生问题。中国是世界上HFRS 疫情最严重的国家,占全球病例的 90%。尽管中国大部分地区的 HFRS 发病率已大幅下降,但在一些疫区,HFRS 疫情却明显反弹。宣城市就是其中之一。本研究收集了宣城市近期报告的病例数据,并设计了 1:3 的病例对照研究。采用卡方检验、单因素和多因素逻辑回归分析。在所有病例中,农民的职业构成比例最高。有 20 个变量具有统计学意义,包括室内卫生条件;周围环境;工作时是否被老鼠咬伤等标准。此外,接触老鼠和被老鼠咬伤是 HFRS 的高危因素。鼠密度为 20.9%(159/760),病毒携带率为 9.4%(15/159),鼠带病毒指数约为 2.0%。接触老鼠和昆虫叮咬也是宣城市当地居民患 HFRS 的高危因素。更重要的是,在洪水年份,啮齿动物密度的增加导致人类接触啮齿动物的风险增加。正如我们的统计分析证明的那样,未来应制定和实施有针对性的策略,以降低当地疾病的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6167/7592102/3597565f9819/S0950268820002344_fig1.jpg

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