花蓮縣學齡前嬰幼兒桿菌性痢疾之配對病例對照研究

A Matched case-control Study of Shigellosis in Children under the Age of Five in Hualien County

江亭誼(Ting-Yi Chiang) ； 江大雄(Donald Dah-Shyong Jiang) ； 蕭正光(Cheng-Kuang Shaw)

《台灣公共衛生雜誌》 24卷5期 (2005/10) Pp. 431-439

https://doi.org/10.6288/TJPH2005-24-05-07

摘要

目標：本研究探討花蓮地區五歲以下之嬰幼兒罹患桿菌性痢疾的相關危險因子。方法：研究採用配對病例對照研究法和半結構式問卷收集資料，並以條件式邏輯式迴歸進行分析。透過家庭訪視收集人口學特徵、臨床症狀、暴露史與個人衛生習慣等資料，以條件式邏輯式迴歸之粗危險對比值，以及調整後的危險對比值做為瞭解罹患桿菌性痢疾的相關指標。結果：研究發現調整種族與居住地後，單變項分析結果顯示，幼兒習慣吸吮手指、經常性將玩具或物品放入口中、其他幼童取物餵食、未清潔口腔之行為、廁所與非自家人共用、未安裝或使用損壞之紗窗（門）等因素分別和感染桿菌性痢疾有統計上的相關。多變項分析結果顯示，調整種族與居住地後，吸吮手指危險對比值5.75（95%信賴區間1.32~24.53）、廁所與非自家人共用之危險對比值13.74（95%信賴區間為2.56~73.70）兩者皆達統計學上之顯著相關。結論：吸吮手指、廁所與非自家人共用為花蓮地區五歲以下之嬰幼兒感染桿菌性痢疾之主要危險因素，因此改善家庭年幼成員之衛生習慣對於防治桿菌性痢疾是相當重要的。

關鍵字

桿菌性痢疾 ； 配對病例對照研究 ； 危險對比值 ； 危險因子

並列摘要

Objective: This purpose of this study was to investigate the risk factors of shigellosis among children aged under five in Hualien. Methods: A matched case-control method and semi-structured questionnaires were performed to identify risk factors associated with shigellosis. Data included demographic characteristics, clinical symptoms, exposure history, and personal hygiene. Exposure status was determined during a home visit. Both crude and adjusted odds ratios for risk factors associated with shigellosis were estimated respectively using conditional logistic regression analysis. Results: The findings showed that the variables ”finger sucking”, ”put toys and goods into mouth frequently”, ”fed by younger family members”, ”lack of oral-hygiene behavior”, ”sharing latrine or using outdoor toilet”, ”use of screened windows and doors” had significant relationship with the infection of shigellosis respectively. After adjusted for race and living residence, ”finger sucking” (AOR=5.75; 95% CL, 1.32~24.53) and ”sharing latrine or using outdoor toilet” (AOR=13.74; 95% CL, 2.56~73.70) were both associated with shigellosis infection. Conclusion: This study indicated that ”finger sucking” and ”sharing latrine or using outdoor toilet” were two major risk factors related to shigellosis infection among children aged under five in Hualien. Improving personal hygiene practices in young children at home was very important for shigellosis prevention and control.

並列關鍵字

shigellosis ； matched case-control study ； risk factor ； odds ratio

參考文獻

Ashkenazi S, May-Zahav M, Dinari G(1993).Recent trends in Epidemiology of Shigella species in Israel.(Recent trends in Epidemiology of Shigella species in Israel).

Ashkenazi S,May-Zahav M,Dinari G(2004).Recent trends in Epidemiology of Shigella species in Israel.Clin Infect Dis.(Clin Infect Dis).

Black RE(1987).(Diartheal diseases and child morbidity and mortality).

Black RE(1995).Diarrheal diseases and child morbidity and mortality.Pop Develop Rev.(Pop Develop Rev).

Black RE, Lopez de Romana G, Brown KH(1989).(Incidence and etiology of infantile diarrhea and major routes of transmission in Huascar, Peru).