Study on Risk Factors of Enteroviral Meningitis and Encephalitis and Dignostic Methods of Laboratory in Jiangsu Province
|Course||Epidemiology and Biostatistics,|
|Keywords||Enteroviruses Case-control study Non-conditional Logistic Generalized estimating equations Nested PCR Real-time PCR|
Objective: (1) a detailed description of the past three years, Jiangsu Province, enterovirus encephalitis, meningitis outbreak three popular distribution, and to explore Xuzhou, Yangzhou City intestinal virus encephalitis, meningitis outbreak risk factors. Jiangsu Province in the future to prevent and control intestinal viral encephalitis, meningitis the epidemiological foundation (2) clear enterovirus encephalitis, meningitis popular type of Jiangsu Province nearly three years, explore enterovirus experiments chamber detection method for the province intestinal virus encephalitis, meningitis outbreak early diagnosis. Research methods: (1) a random collection of Xuzhou City, Jiangsu Province, Yangzhou City, 10 schools or regional intestinal viral encephalitis, meningitis outbreak popular during viral encephalitis, 203 cases of meningitis in children in case group to the same region 406 or with the school in the last two months, no fever and healthy children as a control group, using epidemiological questionnaire conducted an epidemiological study of 609 children, single factor and multi-factor analysis method (non-conditional Logistic and generalized estimating equations) statistical analysis of survey data, screening Jiangsu Province enterovirus encephalitis, meningitis epidemic factors. (2) clinical diagnosis of viral encephalitis, meningitis, cerebrospinal fluid cell culture method were used, Nest-PCR, real-time quantitative PCR, and comparative analysis of the clinical value of the three detection methods. Results: (1) a single factor non-conditional logistic regression analysis, α = 0.05 initial screening with the viral encephalitis outbreak of the popular factors: eat melon, two weeks before the onset of contact with patients, neighbors or relatives in diseased brain patients, before meals, after hand washing habits, yarn doors and windows, indoor mosquito indoor flies Density, health status within the family, the family raised poultry and livestock. (2) single-factor analysis of epidemiological factors were screened and a multitude of non-conditional logistic regression analysis, the results showed that: eat melon, two weeks before the onset of contact with sick patients, neighbor or relative brain patients, before meals, they after hand washing habits, indoor flies density, health status within the family into the regression model (p <0.05). (3) generalized estimating equation results: no significant differences between the various regions, eat melon, two weeks before the onset of contact with patients, neighbors or relatives sick brain patients, before meals and after hand washing habits, indoor flies density, family health status was statistically significant (p <0.05). (4) Laboratory results: the province the past three years, the popular type 2001 Coxsackie B5, ECHO 30 in 2002, 2003. Real-time quantitative PCR detection rate was 43.14% (44/102), a specificity of 100%, sensitivity 0.01TCID50; Nest-PCR detection rate was 71.57% (73/102), and the sensitivity of 0.001TCID50 and a specificity of 100%. Conclusion: (1) Jiangsu Province enterovirus encephalitis, meningitis outbreak the most effective prevention and control measures to reduce and close contacts of the patient, pay attention to personal and family health. (2) Xuzhou, Jiangsu Province in 2001 enterovirus encephalitis, meningitis outbreak mainly to Coxsackie B5 type do, Yangzhou City in 2002, 2003 Yancheng to ECHO 30 main. (3) Real-time PCR with rapid, specific, quantitative detection, etc., can be used for the rapid diagnosis of disease outbreaks, but the sensitivity is still not as good as nested PCR to be further improved.