上海市诺如病毒感染性腹泻病例对照调查危险因素研究

目的识别诺如病毒感染性腹泻发生的危险因素,为预防控制诺如病毒感染性腹泻的发生提供科学依据。方法应用1∶1匹配的病例对照调查方法开展调查,病例来源于哨点医院监测的实验室确诊病例,对照来源于与病例在性别、年龄和居住地相匹配的社区对照;调查问卷包括社会经济学情况、既往病史、外出史、发病/调查前3 d饮食饮水史和家庭卫生习惯等内容。结果调查期间,共收集130对病例/对照调查对象,通过多因素回归分析方法,发现国内旅行[比值比(OR):8.94, 95%可信区间(95%CI):1.18～67.48]、食用海水贝类(OR:6.04, 95%CI:1.23～29.76)、食用猪肉(OR:0.32,95%CI:0.12～0.89)及在不正规和流动摊点就餐(OR:4.93, 95%CI:1.01～24.17)同诺如病毒感染性腹泻的发生存在统计学关联性。结论针对公众,应加强食用海水产品烧熟煮透和防止交叉污染的宣传,尽量不要在非正规/流动摊点就餐,外出旅行时尤其注意个人卫生和饮食卫生;建议监管部门应加强对不正规和流动摊点的卫生监管。     

病例对照研究和Logistic回归分析在食源性疾病爆发事件中的应用

目的：查明2014年10月10日甘肃省定西市一起食源性疾病爆发事件的发生原因、范围和途径,为采取有效的预防及控制措施提供科学依据。方法：对病例进行现场流行病学调查,通过描述性流行病学和分析性流行病学查找可疑食物。结果：共计发病26人,罹患率28.9%;临床症状主要以腹泻、腹痛、头痛为主;根据罹患率卡方检验（χ2=52.373,P=0.000）、病例对照研究和Logistic回归分析（OR=14.000,95%CI：2.324~84.321）,显示农夫折骨鸡为最可疑食物。结论：食用被细菌污染的农夫折骨鸡是导致本次食源性疾病爆发事件的主要原因,建议加强对餐饮机构厨师的监督管理,提高卫生安全意识,防止类似事件再次发生。     

2017—2021年安徽省食源性腹泻病例病原学分析

目的 分析安徽省2017—2021年食源性腹泻病例病原学特征,为制定相关防控措施提供依据。方法采用横断面研究方法,收集2017—2021年安徽省22家食源性疾病病原学监测医院上报被采集肛拭子/粪便的腹泻病例信息,并按要求对采集的患者标本开展病原学检测。分类资料采用χ_趋势²或χ²进行组间比较。结果 2017—2021年共采集标本15 484份,病原体总检出率为23.75%(3 678/15 484)。其中,诺如病毒检出率最高,为10.01%(1 550/15 484);其次是沙门菌(6.16%,954/15 484)、致泻大肠埃希菌(6.10%,944/15 484)、副溶血性弧菌(1.66%,257/15 484)、志贺菌(1.00%,155/15 484)。不同年份(χ_趋势²=11.249,P<0.05)和不同季度(χ_趋势²=146.119,P<0.05)病原体的检出率,均差异有统计学意义。各年龄段人群中,年龄<1...     

北方地区成人脂肪肝危险因素的病例对照研究

目的：探索北方地区成人脂肪肝的危险因素。方法：采用病例对照研究对294名病例和655名对照的相关资料进行非条件Logistic回归分析。结果：超重（OR=6．3,95％CI=4．4,8．9）、肥胖（OR=16．9,95％CI=9．9,28．9）、腹型肥胖（OR：2．9,95％CI=1．9,4．5）、血脂异常（OR=2．1,95％CI：1．5,3．0）及ST．T改变（OR=1．6,95％CI=1．0,2．3）与脂肪肝的患病明显相关（P〈0．05）。摄入肉类较多、高盐饮食及自觉压力较大均为脂肪肝的危险因素,其OR值分别为1．5（95％CI,1．0,2．1）、1．5（95％CI,1．1,2．1）及1．4（95％CI,1．0,2．2）。在家就餐超过5d为脂肪肝的保护因素,OR为0．6（95％CI,0．4,0．9）。结论：脂肪肝的发生与代谢性疾病及生活方式密切相关。     

2010年全国其他感染性腹泻报告病例信息分析

目的 了解我国2010年感染性腹泻报告病例的流行特征,为感染性腹泻的防控提供依据.方法 对全国2010年疾病监测信息报告管理系统中报告的感染性腹泻病例进行流行病学描述性分析.结果 2010年全国共报告感染性腹泻病例746 551例,年发病率为55.93/10万,与2009年比较呈上升趋势.≤5岁儿童占报告发病数的53.57％.实验室确诊病例占病例报告总数的6.46％,其中病毒性感染占92.65％,细菌性感染占7.18％.结论≤5岁儿童是感染性腹泻的高发人群.应鼓励和促进对感染性腹泻病人进行病原学诊断,并将诊断结果报告至中国疾病控制信息系统“疾病监测信息报告管理系统”中.有病原学诊断结果的感染性腹泻病例报告的信息可作为全国临床就诊的食源性感染腹泻病病人的参考信息源.     

一起肠炎沙门菌引起的校园食源性疾病暴发事件调查溯源分析

目的 调查一起肠炎沙门菌引起的学校食源性疾病暴发事件,并对危险因素开展分析溯源,为预防类似事件的发生提供科学依据。方法 运用描述性流行病学方法分析事件的流行病学特征;运用病例对照研究调查可疑食物;通过环境卫生学方法调查追溯食品污染的过程;对病例、食物、环境样品进行病原菌分离、血清分型和脉冲场凝胶电泳（PFGE）检测。结果 本起暴发事件共报告病例71例,流行曲线符合持续同源暴发模式的特点。病例对照、环境卫生调查和病因溯源研究提示学校超市售卖的三明治是引起本次事件的危险食品（OR=302.09,95%CI=75.18~1 213.97）。采集的病例、食品、环境样品中有8份（12.70%,8/63）检出了肠炎沙门菌,分离菌株的PFGE图谱条带完全一致,证实了学校超市出售的三明治使用的沙拉酱在制作过程中被肠炎沙门菌污染,是导致这次食源性疾病暴发的原因。结论 本次事件是由肠炎沙门菌污染食品引起的食源性疾病暴发,可疑食品为被自制沙拉酱污染的三明治。建议禁止各类未经充分热处理的含生鲜鸡蛋成分的食品进入学校,相关行政部门应加强对该类食品的卫生监督。     

上海市急性腹泻及饮食行为危险因素现况调查

目的 了解上海市急性腹泻现况及饮食行为危险因素.方法 采用多阶段随机抽样,进行横断面入户问卷调查.结果 上海市居民急性腹泻年发生率0.68次/人年.男性0.75次/人年、女性0.62次/人年,0～7岁、8 ～17岁、18 ～33岁、34 ～59岁、≥60岁分别为0.96、0.54、0.71、0.71、0.64次/人年.有24.34％人自诉有可疑食物史、40.03％的人就诊.单因素及Logistic回归多因素分析显示:食用散装熟食者的急性腹泻OR值为1.37、95％CI (1.13～1.67),冷藏食物、饮食偏咸者的急性腹泻OR值分别为0.66、95％ CI(0.49 ～0.88)及0.76、95％CI(0.62～0.94).结论 急性腹泻是上海市社区居民的常见病,男性发生率略高于女性,8岁以后发生率下降、成年以后上升、60岁以后又下降,食用散装熟食可能是急性腹泻的危险因素,冷藏食物、饮食偏咸可能是急性腹泻的保护因素.     

2014—2016年湖州市水产品与临床腹泻病例中副溶血性弧菌的分布特征

探讨湖州市水产品副溶血性弧菌(VP)污染与临床腹泻病例间的关联性。方法 收集2014—2016年湖州市653份水产品和8 112例临床腹泻病例,分别对水产品与临床腹泻病例粪便或肛拭子标本进行定性VP检测、O群血清分群及tdh与trh毒力基因型检测。比较分析VP在水产品与临床腹泻病例中的流行分布特征。结果 水产品的VP检出率为28.02%(183/653),其中淡水产品检出率为33.67%(132/392),海产品检出率为19.54%(51/261),差异有统计学意义(χ²=14.823,P＜0.001)。临床腹泻病例粪便或肛拭子标本的VP检出率为4.87%(395/8 112),其中暴露于水产动物及其制品的检出率达15.40%(170/1 104)。在时间分布上,水产品与粪便或肛拭子标本的检出率基本一致,均在7～9月检出率相对较高;在血清型分布上,二者均以O3、O4血清型为主;在毒力基因型分布上,临床腹泻病例以tdh(+)/trh(+)为主(60.51%,239/395),而水产品以tdh(-)/trh(-)为主(42.08%,77/183)。结论 湖州市水产品副溶血性弧菌污染与临床病例感染在时间分布和生物学特征上具有一定关联,应进一步加强水产品中副溶血性弧菌的监测与管理。     

2022年呼和浩特市食源性疾病监测病例流行特征分析

目的:了解呼和浩特市食源性疾病流行特征,为食源性疾病的防控策略提供依据。方法:收集呼和浩特市2022年食源性疾病监测病例数据,分别进行不同地区、年龄、职业及可疑食品的发病分析。结果:呼和浩特市2022年食源性疾病全年报告病例2957人,粗发病率为8.58?,超过10?的共有武川县、清水河县、和林格尔县和托克托县四个县,发病率分别为23.16?、22.30?、17.66?及15.95?;病例从4月份明显增加,8月份达到高峰,10月份后维持在较低的水平;高发年龄别发病率居前三位的分别为0-3岁组、4-6岁组及7-14岁组,发病率分别为56.80?、34.24?及11.55?;14岁以下人群发病人数占到所有病例的43.32%;散居儿童、农民、学生占所有病例的构成分别为21.91%、19.07%及15.66%;暴露可疑食品主要为水果及其制品、混合食品、粮食类及其制品、肉与肉制品。结论:2022年呼和浩特市食源性疾病报告发病,农区高于城区;有明显的夏秋季节高发特点;发病年龄以14岁以下人群为主,可疑暴露食品重点为水果及其制品、混合食品、粮食类及其制品、肉与肉制品。     

一起旅游团聚集性腹泻疫情回顾性队列流行病学调查

目的分析一起旅游团聚集性腹泻疫情的致病因素,提出旅游团聚集性疫情的防控措施。方法应用回顾性队列流行病学研究方法,开展个案访谈,采集有关生物标本和样品开展实验室检测,对相关危害因素进行调查。结果本起疫情的罹患率43.4%(23/53),临床症状以腹泻(95.6%)、腹痛(60.9%)、呕吐(56.5%)为主。发病时间集中在8月20日0～1时之间,平均潜伏期为6.5 h。采集12份样品和4份生物标本,其中1份便标本中检出副溶血弧菌。回顾性队列研究提示某美食城19日晚餐提供的套餐是可疑危险食物[相对危险度(relative risk,RR)=2.844,95%可信区间(confidence interval,CI):1.232～6.562]。结论该起旅游团聚集性腹泻符合细菌性食源性疾病特点。可疑食物是8月19日晚餐时在某美食城食用的套餐,致病因素可能与食物交叉污染、室温下放置较长时间导致细菌增殖有关。     

Risk factors in facial hyperpigmentation in Maghrebian population - a case-control study

Triggering factors seem to be multiple in the pathogenesis of facial hyperpigmentation (FH), as dark skin types, pregnancy, sun exposure… The aim of this study was to investigate the risk factors for FH in Maghrebian population. Patients with FH were included in a case‐controlled study. Following data were recorded: age, sex, parity, phototype, FH and hormonal‐related history, endocrinological features, sunlight exposure, specific cultural behaviours, use of topic corticosteroids and sunscreens. One hundred women (mean age 29.5 ± 13.7 years) were included with 200 age‐matched controls. Duration of FH was 32.9 ± 42.2 months. There was a statistically significant relation between FH and hirsutism (P = 0.009), troubles of menstruations (P = 0.008), but not with acne (P = 0.23) and contraceptive oral (P = 0.06) drugs or with history of thyroid disorders (P = 0.13). For cultural factors, there were a statistical significant relation with rubbing by flannel glove (P < 0.05), use of dark soap (P = 0.009) and traditional masks (P < 0.05) but both groups were used to go to hammam. A strong relation was observed between FH and use of topical corticosteroids: 40% in the FH group vs. 5% in the control group (P < 0.05). Both groups used to apply sunscreens: 70% in the FH group and 67% in the control group where as there were no differences in the two groups for sun exposure. No statistical differences were observed regarding to age, phototypes and grade of parity. Our study demonstrated a relation between FH and hyperestrogenemia, rubbing with a friction glove, use of moroccan traditional masks and application of topical steroids. The eviction of all these triggering factors could be an adjuvant recommendation in the assessment of FH.     

Farm characteristics and calf management practices on dairy farms with and without diarrhea: A case-control study to investigate risk factors for calf diarrhea

Calf diarrhea is one of the most important problems in calf rearing on dairy farms worldwide. Besides pathogens, several noninfectious management factors, especially management around birth, colostrum management, calf housing, feeding, and hygiene are important in the pathogenesis of diarrhea. To date, few data are available concerning calf rearing management on small and medium-sized dairy farms that are typical for Austria and the alpine region. Consequently, the objectives of this case-control study were to evaluate routine calf management practices on Austrian dairy farms and to examine differences in management between farms with and without the presence of calf diarrhea to identify risk factors. Overall, 100 dairy farms were visited. Of these farms, 50 were chosen based on the history and presence of calf diarrhea (case farms). Another 50 farms with no presence of calf diarrhea were chosen to serve as a standard of comparison (control farms). On farms, management was evaluated by face-to-face interview, and health status and hygiene were surveyed. Several calf rearing management procedures were similar on all of the visited farms, especially in areas regulated by national and European law. These factors include colostrum management and feeding. Consequently, no influence of these factors on the appearance of calf diarrhea could be detected. In contrast, other areas such as hygiene measures differed between farms and showed a partial association with the presence of calf diarrhea on farm. Variables related to diarrhea on farm were farm size; that is, the number of cows on farm. Farms with diarrhea cases were larger (median 40 cows, interquartile range 24.5 to 64.0) compared with farms with no presence of diarrhea (median 28 cows, interquartile range 18.8 to 44.0). Other risk factors that influenced the presence of diarrhea were the presence of other farm animal species on the farm [odds ratio (OR) 26.89, 95% confidence interval (CI): 2.64 to 273.5], frequency of cleaning of the calving area (OR 0.12, 95% CI: 0.02 to 0.79), the placement of individual calf housings (barn vs. outdoors; OR 0.02, 95% CI: 0.00 to 0.47), and the presence of respiratory tract disease (OR 52.49, 95% CI: 1.26 to 2,181.83). The possible influence of these factors on the appearance of calf diarrhea should be considered when farmers are advised.     

Association between exposure to environmental tobacco smoke and the development of acute coronary syndromes: the CARDIO2000 case-control study

OBJECTIVE: To investigate the association between environmental tobacco smoke (ETS) exposure (at least 30 minutes a day) and the risk of developing acute coronary syndromes (ACS). DESIGN AND SETTING: The CARDIO2000 is a case-control study which was conducted in Greece from 2000 to 2001. Cases included 847 individuals with a first event of ACS and 1078 cardiovascular disease-free controls. Cases and controls were frequency matched on age (within three years of age), sex, and region. MAIN OUTCOME MEASURES: ACS was defined as a diagnosis of first acute myocardial infarction or unstable angina. Main independent variable: Exposure to ETS was measured by self report as follows: after the second day of hospitalisation for the cases, and at the entry for the controls, participants were asked whether they were currently exposed to tobacco smoke from other people (home and/or work) for more than 30 minutes a day. The responses were categorised into three levels: no exposure, occasional exposure (< 3 times per week), and regular exposure. In addition participants were asked how many years they had been exposed. Because these were self reported assessments and prone to bias, the results were compared to reports obtained from subjects' relatives or friends, using the Kendal's tau coefficient that showed high agreement. RESULTS: 731 (86%) of the patients and 605 (56%) of the controls reported current exposure of 30 minutes per day or more to ETS. Among current non-smokers, cases were 47% more likely to report regular exposure to ETS (odds ratio (OR) 1.47, 95% confidence interval (CI) 1.26 to 1.80) compared to controls. Exposure to ETS at work was associated with a greater risk of ACS compared to home exposure (+97% v +33%). The risk of ACS was also raised in active smokers (OR 2.83, 95% CI 2.07 to 3.31) regularly exposed to ETS. CONCLUSIONS: This study supports the hypothesis that exposure to ETS increases the risk of developing ACS. The consistency of these findings with the existing totality of evidence presented in the literature supports the role of ETS in the aetiology of ACS.     

Psychosocial factors related to adolescent smoking: a critical review of the literature

OBJECTIVE: To extend the analysis of psychosocial risk factors for smoking presented in the United States surgeon general's 1994 report on smoking and health, and to propose a theoretical frame of reference for understanding the development of smoking. DATA SOURCES: General Science Index, Medline, PsycLIT, Sociofile, Sociological Abstracts, and Smoking and Health. Holdings of the Addiction Research Foundation of Ontario Library as well as the authors' personal files. STUDY SELECTION: Reviewed literature focused on studies that examined the association of sociodemographic, environmental, behavioural, and personal variables with smoking. DATA SYNTHESIS: Adolescent smoking was associated with age, ethnicity, family structure, parental socioeconomic status, personal income, parental smoking, parental attitudes, sibling smoking, peer smoking, peer attitudes and norms, family environment, attachment to family and friends, school factors, risk behaviours, lifestyle, stress, depression/distress, self-esteem, attitudes, and health concerns. It is unclear whether adolescent smoking is related to other psychosocial variables. CONCLUSIONS: Attempts should be made to use common definitions of outcome and predictor variables. Analyses should include multivariate and bivariate models, with some attempt in the multivariate models to test specific hypotheses. Future research should be theory driven and consider the range of possible factors, such as social, personal, economic, environmental, biological, and physiological influences, that may influence smoking behaviour. The apparent inconsistencies in relationships between parental socioeconomic status and adolescent disposable income need to be resolved as does the underlying constructs for which socioeconomic status is a proxy.     

Risk assessment of dietary exposure to aluminium in the Chinese population

In order to address the issue of excessive intake of aluminium (Al) from Al-containing food additives in the Chinese diet, this study conducted a dietary exposure assessment of Al in the general population based on the national surveillance data of Al content in foods and national food consumption data. It was found that the mean dietary exposure of the whole Chinese population to Al from Al-containing food additives was 1.795 mg kg^?1 bw week^?1, not exceeding the PTWI, while high dietary exposures (e.g., 97.5^th percentile) to Al were 7.660 and 2.103–2.903 mg kg^?1 bw week^?1 for children, respectively, both exceeding the PTWI. It was found that the dietary exposure to Al for 32.5% of the total Chinese population and 42.6% of children aged 4–6 years exceeded the PTWI. Wheat flour and wheat-based products are the main source of dietary A l exposure (85% of the total intake); and puffed foods are the major source of Al intake for children. These findings suggested that consumption of Al-containing food additives could be a health concern for consumers with high food consumption (97.5^th percentile) and children under the age of 14 years.     

Risk factors associated with mortality at a milk-fed veal calf facility: A prospective cohort study

The veal industry experiences calf losses during the growing period, which represents a challenge to animal welfare and profitability. Health status at arrival may be an important predictor of calf mortality. The objectives of this prospective cohort study were to describe the health status of calves arriving at a veal farm and determine the risk factors associated with early and late mortality. Using a standardized health scoring system, calves were evaluated immediately at arrival to a commercial milk-fed veal facility in Ontario, Canada. Weight at arrival and supplier of the calf were recorded. The calves were followed until death or the end of their production cycle. Two Cox proportional hazard models were built to explore factors associated with early (≤21 d following arrival) and late mortality (>21 d following arrival). A total of 4,825 calves were evaluated from November 2015 to September 2016. The overall mortality risk was 7%, with 42% of the deaths occurring in the first 21 d after arrival. An abnormal navel, dehydration, housing location within the farm, arriving in the summer, and the presence of a sunken flank were associated with increased hazard of early mortality. Drover-derived calves and calves with a greater body weight at arrival had lower hazard of early mortality. Housing location within the farm, being derived from auction facilities, and an abnormal navel were associated with higher hazard of late mortality. These results demonstrate that risk factors for mortality can be identified at arrival, which represents a potential opportunity to selectively intervene on these calves to reduce mortality. However, methods of preventing the development of these conditions before arrival need to be explored and encouraged to improve the welfare of the calves entering the veal industry.