大同市小学生沙眼流行病学调查
Prevalence and risk factors for trachoma in primary school children in Datong City in China
摘要目的 调查大同市小学生流行性沙眼的患病率,并分析其危险因素.方法 采用随机整群抽样调查方法.抽取大同市小学生共计1236人,其中男生624人,女生612人,年龄6~14岁,平均年龄(10±2)岁.所有被调查对象均进行临床检查,沙眼诊断标准参照世界卫生组织制定的简易沙眼分期标准;对临床诊断为沙眼的患者取结膜标本,进行免疫学与聚合酶链反应(PCR)检测沙眼衣原体.采用χ2检验分析沙眼患病率与学校、性别、年龄的关系,并对实验室检查结果进行统计学分析;采用Logistic回归分析沙眼患病的危险因素,先用Logistic单因素分析相父因素与沙眼患病率之间的关系,以P<0.05作为入选条件,选取相关自变量,然后应用多因素非条件Logistic回归分析提取主要危险因素.结果 调查的:1236名小学生中,135例临床诊断为沙眼,沙眼患病率为10.9%[95%置信区间(CI):9.2%~12.6%],其中滤泡性沙眼(TF)117例,浸润性沙眼(TI)18例.男生沙眼患病率为8.8%,女生沙眼患病率为13.1%,女生沙眼患病率明显高于男生(P=0.016).各年龄组沙眼患病率比较,差异无统计学意义(P=0.801).临床诊断沙眼的135例小学生中,沙眼农原体免疫学检测阳性13例(9.6%),PcR检测阳性86例(63.7%).危险因素分析表明沙眼的发生与家人是否共用毛巾脸盆及是否经常揉眼睛等因素相关.结论 大同市小学生中仍有沙眼流行,需要针对危险因素开展沙眼防治.
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abstractsObjective To assess the prevalence and risk factors for trachoma among primary school children in Datong City, China. Methods An epidemiological survey was carried out in Datong City in 2006. Children aged 6 to 14 years old in primary school were selected by a cluster sampling in which class shift was the sampling unit. Trachoma was clinically assessed according to the simplified classification for trachoma proposed by the World Health Organization (WHO). If the child was clinically diagnosed as trachoma, a conjunctival swab would be taken for detecting C. trachomatis by antigen test and polymerase chain reaction (PCR). Results A total of 1236 children were examined and 135 cases of trachoma were found, the prevalence of trachoma was 10.9% (95% CI: 9.2% -12.6% ). Follicular trachoma was found in 86.7% of the cases and intense trachoma in 13.3%. The overall prevalence of trachoma was higher for females than for males (13.1% versus 8. 8%, P =0.016). Thirteen (9.6% ) cases were positive in C.trachomatis antigen test, and 86 (63.7% ) cases were positive by PCR. Poor ocular hygiene and sharing wash cloth and face basin with households were the main risk factors. Conclusion Trachoma is endemic among primary school children in Datong City in China.
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