儿童轮状病毒性肠炎季节性分布特征及预防策略探讨OACSTPCD

Objective To investigate the seasonal distribution characteristics and prevention strategies of rotavirus enteritis(RVE)in children.Methods Children with diarrhoea(246 cases)admitted to our hospital from January 2020 to December 2022 were selected as study subjects and included in the training set;they were divided into the RVE group(132 cases)and the non-RVE group(114 cases)according to the results of RV antigen detection.Another selection of children with diarrhoea(82 cases)were included in the validation set according to the same criteria.The clinical data of the children were collected,the distribution of RVE onset season and month were analysed,and the clinical data and biochemical indexes of the children in the two groups were compared.Risk factors were analysed using multifactorial logistic regression,and a nomogram model was constructed and evaluated.Results In this region,RVE was most common in winter and spring,with a high incidence of RVE from December to the following March,and its incidence accounts for 59.09％of the year.Finger-sucking habit,no preprandial hand-washing habit,non-breastfeeding,history of exposure to children with RVE,average daily outdoor activity time≤1h,no history of RV vaccination,during winter and spring,and 25(OH)D＜35.5μg/L were independent risk factors for the occurrence of RVE(x2/t=5.922,24.583,5.125,11.750,4.322,12.670,11.705,and 14.374,respectively,all P＜0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)curves evaluation nomogram prediction model for predicting the incidence of RVE in children showed 0.924(95％CI:0.890-0.951)for the training set and 0.912(95％CI:0.865-0.998)for the validation set;and the decision curve analysis(DCA)showed a net benefit rate was＞0 for threshold probabilities ranging from 1％to 91％.Conclusion RVE in children in this region can occur throughout the year,mostly in winter and spring.Finger-sucking habits,lack of hand-washing before meals,non-breastfeeding,history of exposure to children with RVE,average outdoor activity time≤1h,no history of RV vaccination,during winter and spring,and 25(OH)D＜35.5μg/L were all independent risk factors for the development of RVE.The nomogram model constructed on the basis of the above risk factors had a high predictive value for the incidence of RVE in children.Clinical efforts should continue to be strengthened to prevent and control RVE,focusing on the protection of susceptible individuals.