Establish of the risk predictive model for varicella outbreaks in primary and middle schools

ZHENG Yongtao; YE Chunmei; NI Zuowei; ZHANG Jiani; LAI Fenhua; GAO Yanmin; YANG Dongbo; WANG Yanmei

doi:10.16835/j.cnki.1000-9817.2024191

Volume 45 Issue 6

Jun. 2024

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Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2024 > 45(6): 873-877

ZHENG Yongtao, YE Chunmei, NI Zuowei, ZHANG Jiani, LAI Fenhua, GAO Yanmin, YANG Dongbo, WANG Yanmei. Establish of the risk predictive model for varicella outbreaks in primary and middle schools[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2024, 45(6): 873-877. doi: 10.16835/j.cnki.1000-9817.2024191

Citation:

ZHENG Yongtao, YE Chunmei, NI Zuowei, ZHANG Jiani, LAI Fenhua, GAO Yanmin, YANG Dongbo, WANG Yanmei. Establish of the risk predictive model for varicella outbreaks in primary and middle schools[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2024, 45(6): 873-877. doi: 10.16835/j.cnki.1000-9817.2024191

Citation:

ZHENG Yongtao, YE Chunmei, NI Zuowei, ZHANG Jiani, LAI Fenhua, GAO Yanmin, YANG Dongbo, WANG Yanmei. Establish of the risk predictive model for varicella outbreaks in primary and middle schools[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2024, 45(6): 873-877. doi: 10.16835/j.cnki.1000-9817.2024191

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Establish of the risk predictive model for varicella outbreaks in primary and middle schools

doi: 10.16835/j.cnki.1000-9817.2024191

1.
Xiaoshan District Center for Disease Control and Prevention, Hangzhou (311203), Zhejiang Province, China

Received Date: 2024-03-29
Rev Recd Date: 2024-04-23

Available Online: 2024-06-27

Publish Date: 2024-06-25

Abstract

Abstract

Objective To investigate the epidemiological characteristics of varicella outbreaks in primary and middle schools, and to establish a risk predictive model, so as to provide scientific guidance for the prevention of varicella outbreaks in schools. Methods Based on a nested case-control study, primary and middle schools in 4 districts of Shanghai (Yangpu District and Jingan District) and Hangzhou (Xiaoshan District and Linping District) from January to December 2023 were selected to observe the status of varicella outbreaks. Associated factors of varicella outbreaks were investigated and used for establishing the predictive model, which was evaluated by the Hosmer-Lemeshow(H-L) goodness of fit test, receiver operating characteristic (ROC) curve, Calibration curve, decision curve analysis (DCA). Results A total of 98 varicella outbreaks were included, with 195 schools without varicella outbreaks during the same period as controls. Eight factors, including the availability of warm water in restroom, availability of hand soap in restroom, average class size, duration of student attendance at school per day, presence of a full-time school doctor, hesitancy of the school principal towards varicella vaccination, and rates of first and second doses of varicella vaccination, were identified as potential factors for school varicella outbreaks, with statistically significant differences (χ²/Z=10.01, 20.49, 17.43, 9.74, 32.17, 6.60, 2.20, 3.39, P < 0.05). The 8 variables above were employed to construct a risk predictive model, and Hosmer-Lemeshow goodness of fit test yielded a χ² value of 5.863 (P>0.05); the area under the ROC curve (AUC) was 0.846 (95%CI=0.799-0.893); Calibration curve analysis indicated good consistency between predicted and actual values of the model. DCA demonstrated favorable predictive performance of the model over a wide range. Conclusions The predictive model for school varicella outbreaks demonstrates satisfactory accuracy and efficacy. It suggested to make good use of this prediction model and take relevant measures to reduce the risk of varicella transmission in schools.
- Chickenpox,
- Disease outbreaks,
- Nomograms,
- Student health services

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References(18)

References

[1]	中华人民共和国国家卫生健康委员会办公厅, 中华人民共和国国家中医药局综合司. 水痘诊疗方案(2023年版)[J]. 中国实用乡村医生杂志, 2024, 31(1): 4-7. https://www.cnki.com.cn/Article/CJFDTOTAL-FACT202401002.htm General Office of the National Health Commission of the PRC, General Department of the National Administration of Traditional Chinese Medicine of the PRC. Varicella diagnosis and treatment protocol (2023 Edit)[J]. Chin Pract J Rural Doct, 2024, 31(1): 4-7. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-FACT202401002.htm
[2]	高芳旭. 2005—2014年天津市和平区学校传染病暴发疫情流行特征分析[J]. 现代预防医学, 2016, 43(4): 598-600. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201604009.htm GAO X F. Epidemiological characteristics of infectious disease outbreak at schools in Heping District of Tianjin during 2005-2014[J]. Mod Prev Med, 2016, 43(4): 598-600. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF201604009.htm
[3]	沈秀莲, 周勤, 贾豫晨. 云南省2004—2021年学校传染病暴发疫情事件流行特征[J]. 中国热带医学, 2023, 23(11): 1180-1186. https://www.cnki.com.cn/Article/CJFDTOTAL-RDYX202311010.htm SHEN X L, ZHOU Q, JIA Y C. Epidemiological characteristics on outbreaks of infectious diseases in schools in Yunnan Province, 2004-2021[J]. China Trop Med, 2023, 23(11): 1180-1186. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-RDYX202311010.htm
[4]	DUDLEY M Z, PRIVOR-DUMM L, DUBÉ È, et al. Words matter: vaccine hesitancy, vaccine demand, vaccine confidence, herd immunity and mandatory vaccination[J]. Vaccine, 2020, 38(4): 709-711. doi: 10.1016/j.vaccine.2019.11.056
[5]	TIANSHUO Z, HANYU L, BINGFENG H, et al. Evaluation of the reliability and validity of a Vaccine Hesitancy Scale on Knowledge, Attitude, Trust and Vaccination Environment (KATE-S) in Chinese parents[J]. Vaccine, 2022, 40(21): 2933-2939. doi: 10.1016/j.vaccine.2022.03.068
[6]	BONANNI P, BREUER J, GERSHON A, et al. Varicella vaccination in Europe: taking the practical approach[J]. BMC Med, 2009, 7(1): 26. doi: 10.1186/1741-7015-7-26
[7]	潘金仁, 邓璇, 何寒青. 浙江省水痘病例经济负担和生命质量评估[J]. 中国疫苗和免疫, 2019, 25(5): 509-513. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201905006.htm PAN J R, DENG X, HE H Q. Economic burden and quality of life of varicella cases in Zhejiang Province[J]. Chin J Vaccines Immun, 2019, 25(5): 509-513. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJM201905006.htm
[8]	中华人民共和国卫生部. 突发公共卫生事件与传染病疫情监测信息报告管理办法[J]. 中国卫生法制, 2004, 12(1): 23-25, 27. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF200804030.htm Ministry of Health of the PRC. Regulations on the administration of the reporting and monitoring of public health emergencies and infectious disease epidemics[J]. China Health Law, 2004, 12(1): 23-25, 27. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF200804030.htm
[9]	AIELLO A E, COULBORN R M, PEREZ V, et al. Effect of hand hygiene on infectious disease risk in the community setting: a Meta-analysis[J]. Am J Public Health, 2008, 98(8): 1372-1381. doi: 10.2105/AJPH.2007.124610
[10]	WHEELER C C, JEHN E M L. Effect of school closure on the incidence of influenza among school-age children in Arizona[J]. Public Health Rep, 2010, 125(6): 851-859. doi: 10.1177/003335491012500612
[11]	郭俊杰. 中小学校公共卫生人力资源的开发与管理[J]. 中国校医, 2005, 19(2): 194-195. https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI200502064.htm GUO J J. Development and management of public health human resources in primary and secondary schools[J]. Chin J School Doctor, 2005, 19(2): 194-195. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI200502064.htm
[12]	GALAGALI P M, KINIKAR A A, KUMAR V S. Vaccine hesitancy: obstacles and challenges[J]. Curr Pediatr Rep, 2022, 10(4): 241-248. doi: 10.1007/s40124-022-00278-9
[13]	吴晓婷, 汪曦, 梅克雯, 等. 上海市闵行区2015—2018年校园水痘聚集性疫情流行病学特征分析及不同应急接种方案效果[J]. 中国生物制品学杂志, 2021, 34(9): 1076-1079, 1084. https://www.cnki.com.cn/Article/CJFDTOTAL-SWZP202109010.htm WU X T, WANG X, MEI K W, et al. Epidemiological characteristics of varicella outbreaks at schools in Minhang District of Shanghai City from 2015 to 2018 and effects of various emergency vaccination schemes[J]. Chin J Biol, 2021, 34(9): 1076-1079, 1084. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SWZP202109010.htm
[14]	MACDONALD N E, BUTLER R, DUBE E. Addressing barriers to vaccine acceptance: an overview[J]. Hum Vaccin Immunother, 2018, 14(1): 218-224. doi: 10.1080/21645515.2017.1394533
[15]	IYABODE A, Advisory Committee on Immunization Practices (ACIP), ACIP Child/Adolescent Immunization Work Group, et al. Advisory committee on immunization practices recommended immunization schedules for persons aged 0 through 18 years: United States, 2014[J]. Morb Mortal Wkly Rep, 2014, 63(5): 108-109.
[16]	SHU M, ZHANG D, MA R, et al. Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: a retrospective observational study[J]. Front Public Health, 2022, 10: 1039537.
[17]	董晓春, 李琳. 基于高危暴露人群的2剂次水痘疫苗保护效果的配对病例对照研究[J]. 中华微生物学和免疫学杂志, 2021, 41(8): 5. DONG X C, LI L. A matched case-control study on protective effect of two doses of varicella vaccine in high-risk population[J]. Chin J Microbiol Immunol, 2021, 41(8): 5. (in Chinese)
[18]	MARIN M, MEISSNER H C, SEWARD J F. Varicella prevention in the United States: a review of successes and challenges[J]. Pediatrics, 2008, 122(3): e744-e751.