Association between Norovirus epidemics and school toilets design and management in Chengdu City
-
摘要:
目的 分析成都市中小学校厕所设计及其卫生情况与诺如病毒感染疫情规模的关系,为学校厕所设计和诺如病毒感染防控提供科学参考。 方法 共纳入2019—2020年成都市78起诺如病毒感染疫情,分别发生在78所中小学校,发生原因为人传人,采用χ2检验和Mann-Whitney U检验分析各变量与疫情规模的关系,采用二元非条件Logistic回归进行多因素分析。 结果 78起疫情主要发生在2019年10—2020年3月(79.49%,62起)、小学(71.79%,56起)和主城区(52.56%,41起)。单起疫情涉及病例中位数为10例。在厕所冲水设计上,56所(71.79%)学校的厕所为独立冲水型,22所(28.21%)为统一冲水型。27所(34.62%)学校厕所水龙头数量设置不达标。多因素Logistic回归分析发现,相较于独立冲水的学校厕所,统一冲水的学校厕所其疫情规模更大(OR=5.53,95%CI=1.63~18.76,P < 0.05)。 结论 为更好地防控肠道传染病疫情,学校在改造或设计厕所时应尽量选择独立冲水式厕所,并配置充足的水龙头。 Abstract:Objective To analyze the relationship between the toilet design and sanitary condition of primary and secondary schools in Chengdu and the epidemic situation of Norovirus infection, so as to provide scientific references for school toilet design and Norovirus prevention and control. Methods A total of 78 cases of norovirus epidemics from 2019 to 2020 were included in this study. These epidemics happened in 78 schools and the causes were indicated as human-to-human transmission. The Chi-square and Mann-Whitney U-test were used to compare categorical and continuous data respectively. Unconditional binary Logistic regression was used to examine the multivariate associations. Results Most epidemics happened from October in 2019 to March in 2020(79.49%, 62 cases), in primary schools (71.79%, 56 cases) and in the center area (52.56%, 41 cases). The median of the case number in each epidemic was 10. Overall, 56 schools (71.79%) were equipped with toilets which were flushed independently, and 22 schools (28.21%) were equipped with toilets which were flushed uniformly. There were 27 schools (34.62%) that did not have enough water taps. Logistic regression analysis found that those with toilets flushed uniformly had a stronger epidemic, compared to the schools with toilets flushed independently(OR=5.53, 95%CI=1.63-18.76, P < 0.05). Conclusion In order to prevent intestinal infectious diseases, it is suggested that schools should design or reconstruct independent flushing toilets with adequate faucets. 1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 学校诺如病毒疫情规模分布的单因素分析
Table 1. Single factor analysis of Norovirus epidemics size distribution in schools
分类 疫情数 小规模 大规模 χ2值 P值 年份 2019 23 10(43.48) 13(56.52) 1.79 0.22 2020 55 33(60.00) 22(40.00) 月份 10—次年3月 62 33(53.23) 29(46.77) 0.44 0.58 4—9月 16 10(62.50) 6(37.50) 学段 小学 56 32(57.14) 24(42.86) 0.33 0.62 中学 22 11(50.00) 11(50.00) 地区 主城区 41 28(68.29) 13(31.71) 6.06 0.02 郊区 37 15(40.54) 22(59.46) 接报情况 主动报告 74 42(56.76) 32(43.24) 0.32* 其他 4 1(25.00) 3(75.00) 首发病例呕吐地点 家 28 17(60.71) 11(39.29) 0.55 0.49 学校 50 26(52.00) 24(48.00) 病毒类型 GⅡ 58 34(58.62) 24(41.38) 1.12 0.31 GⅠ或混合 20 9(45.00) 11(55.00) 厕所类型 独立冲水型 56 36(64.29) 20(35.71) 6.73 0.01 统一冲水型 22 7(31.82) 15(68.18) 厕所窗户 有 77 43(55.84) 34(44.16) 0.45* 无 1 0 1(100.00) 厕所排气扇 有 54 33(61.11) 21(38.89) 2.54 0.14 无 24 10(41.67) 14(58.33) 厕所门帘 有 49 27(55.10) 22(44.90) < 0.01 1.00 无 29 16(55.17) 13(44.83) 坑位间隔 有 19 12(63.16) 7(36.84) 0.65 0.44 无 59 31(52.54) 28(47.46) 每天消毒至少1次 是 72 42(58.33) 30(41.67) 0.08* 否 6 1(16.67) 5(83.33) 水龙头达标 是 51 32(62.75) 19(37.25) 3.46 0.09 否 27 11(40.74) 16(59.26) 厕所保洁人员 学生或学校聘用人员 48 23(47.92) 25(52.08) 2.62 0.16 物业公司 30 20(66.67) 10(33.33) 注:()内数字为构成比/%;*使用Fisher确切概率法。 -
[1] 连怡遥, 骆洪梅, 冉陆, 等. 中国2014—2018年学校和托幼机构诺如病毒疫情流行病学分析[J]. 中国学校卫生, 2019, 40(3): 406-410. doi: 10.16835/j.cnki.1000-9817.2019.03.025LIAN L Y, LUO H M, RAN L, et al. Epidemiologic characteristics of Norovirus outbreak in schools and kindergardens in China during 2014-2018[J]. Chin J Sch Health, 2019, 40(3): 406-410. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.03.025 [2] 戴映雪, 速丽媛, 刘云升, 等. 2018年成都市学校和托幼机构诺如病毒感染性腹泻聚集性疫情及影响因素分析[J]. 预防医学情报杂志, 2020, 36(3): 269-275. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202003004.htmDAI Y X, SU L Y, LIU Y S, et al. Norovirus epidemics cluster infectious diarrhea in kindergartens and schools and its associations factors in Chengdu in 2018[J]. J Prev Med Inf, 2020, 36(3): 269-275. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202003004.htm [3] 唐小清, 朱玲, 吴小花, 等. 重庆市南岸区2018年14起诺如病毒疫情流行病特征分析[J]. 中国学校卫生, 2021, 42(6): 914-916, 921. doi: 10.16835/j.cnki.1000-9817.2021.06.027TANG X Q, ZHU L, WU X H, et al. Epidemiological characteristics of 14 clusters and outbreaks of Norovirus infection in Nan'an District of Chongqing in 2018[J]. Chin J Sch Health, 2021, 42(6): 914-916, 921. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.06.027 [4] 廖巧红, 冉陆, 靳淼, 等. 诺如病毒感染暴发调查和预防控制技术指南(2015版)[J]. 中国病毒病杂志, 2015, 5(6): 448-458. https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX201506004.htmLIAO Q H, RAN L, JIN M, et al. Guidelines on outbreak investigation, prevention and control of Novrovirus infection(2015)[J]. Chin J Viral Dis, 2015, 5(6): 448-458. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZRYX201506004.htm [5] 国家质量监督检验检疫总局. 中小学校设计规范: GB 50099—2011[S]. 2012-01-01.Stute General Administration of the PRC for Quality Supervision and Inspection and Quarantine. Code for design of school: GB 50099-2011[S]. 2012-01-01. (in Chinese) [6] 李洪明. 沟槽式厕所节水控制装置[J]. 建筑知识, 1988(2): 7. https://www.cnki.com.cn/Article/CJFDTOTAL-JZZS198802007.htmLI H M. Water saving control device for grooved toilet[J]. Arch Knowled, 1988(2): 7. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JZZS198802007.htm [7] 张建堂. 高校节约型校园建设研究[D]. 重庆: 西南大学, 2009.ZHANG J T. Research on the construction of economical campus in colleges[D]. Chongqing: Southwest University, 2009. (in Chinese) [8] 陈杰. 高校节水措施简介[J]. 中小企业管理与科技(下旬刊), 2016(10): 120-121. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXQX201610076.htmCHEN J. Introduction to water-saving measures in colleges[J]. Manag Technol SME(Late Issue), 2016(10): 120-121. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXQX201610076.htm [9] 周爱华, 罗燕, 黎冠, 等. 感染性腹泻疫情检测结果分析[J]. 河南预防医学杂志, 2017, 28(5): 380-381, 406. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYF201705021.htmZHOU A H, LUO Y, LI G, et al. The detection results of an epidemic of infectious diarrhea[J]. Henan J Prev Med, 2017, 28(5): 380-381, 406. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNYF201705021.htm [10] 戴映雪, 速丽媛, 刘云升, 等. 2016-2018年成都市GⅠ和GⅡ群诺如病毒感染疫情分析[J]. 预防医学情报杂志, 2020, 36(8): 973-976, 981. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202008007.htmDAI Y X, SU L Y, LIU Y S, et al. Analysis on GⅠ and GⅡ Norovirus epidemics from 2016 to 2018 in Chengdu[J]. J Prev Med Inf, 2020, 36(8): 973-976, 981. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202008007.htm [11] LI J, GAO X, YE Y L, et al. An acute gastroenteritis outbreak associated with person-to-person transmission in a primary school in Shanghai: first report of a GI. 5 Norovirus outbreak in China[J]. BMC Infect Dis, 2018, 18(1): 316. [12] 纪蕾, 祝永英, 陈莉萍, 等. 2017-2018年浙江省湖州市急性胃肠炎病例GⅠ型诺如病毒感染状况及其基因型别特征[J]. 疾病监测, 2019, 34(6): 536-540. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC201906016.htmJI L, ZHU Y Y, CHEN L P, et al. Infection status and genotype characteristics of GⅠNorovirus in acute gastroenteritis cases in Huzhou, Zhejiang, 2017-2018[J]. Dis Surveill, 2019, 34(6): 536-540. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC201906016.htm [13] 贺天锋, 李晔, 杨天池, 等. 宁波市2010—2011年学校传染病暴发危险因素及防控分析[J]. 中国学校卫生, 2013, 34(5): 577-579. http://www.cjsh.org.cn/article/id/zgxxws201305023HE T F, LI Y, YANG T C, et al. Risk factors and evaluation on control and prevention of infectious disease outbreaks in schools in Ningbo, 2010-2011[J]. Chin J Sch Health, 2013, 34(5): 577-579. (in Chinese) http://www.cjsh.org.cn/article/id/zgxxws201305023 [14] 黄彬彬, 江柯, 刘小波, 等. 2018年成都市龙泉驿区托幼机构传染病聚集性疫情影响因素分析[J]. 预防医学情报杂志, 2020, 36(4): 481-485. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202004022.htmHUANG B B, JIANG K, LIU X B, et al. Analysis on influencing factors of infectious diseases clustering in kindergartens of Longquanyi District in Chengdu in 2018[J]. J Prev Med Inf, 2020, 36(4): 481-485. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202004022.htm [15] 符霞, 赵志广, 侯万里, 等. 托幼机构手足口病流行及手部卫生研究综述[J]. 中华疾病控制杂志, 2016, 20(5): 520-523. https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201605025.htmFU X, ZHAO Z G, HOU W L, et al. A review of the epidemic of hand, foot and mouth disease and the hand hygiene in kindergartens[J]. Chin J Dis Control Prev, 2016, 20(5): 520-523. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBKZ201605025.htm [16] 朱连开, 陈纯, 陈宗遒, 等. 广州市托幼机构手足口病流行危险因素分析[J]. 中国学校卫生, 2012, 33(10): 1214-1216. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201210022.htmZHU L K, CHEN C, CHEN Z Q, et al. Risk factors of hand-foot-mouth disease in kindergartens in Guangzhou[J]. Chin J Sch Health, 2012, 33(10): 1214-1216. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201210022.htm [17] ZOMER T P, ERASMUS V, VAN BEECK E F, et al. Hand hygiene compliance and environmental determinants in child day care centers: an observational study[J]. Am J Infect Control, 2013, 41(6): 497-502. -

表(1)
计量
- 文章访问数: 327
- HTML全文浏览量: 132
- PDF下载量: 27
- 被引次数: 0