Analysis Of Epidemiological Characteristics And Influencing Factors Of Diarrhea Patients In Sentinel Hospitals

Objective: In order to obtain the background of pathogenic surveillance of infectious diarrhea in China,understand the pattern of epidemic change of pathogen spectrum,grasp the epidemic characteristics and influencing factors of infectious diarrhea in China.And provide scientific basis for health departments to formulate prevention and control measures.Methods: From 2009 to 2018,pathogen surveillance of diarrhea syndrome was carried out in 31 provinces(autonomous regions and municipalities directly under the central government)in China.The information of individual cases was collected,and stool samples were collected for 23 pathogenic tests.The characteristics of pathogen spectrum of infectious diarrhea in patients of different ages were studied.Intergroup rates were compared using the chi-square test or Fisher’s exact probability method.All statistical tests were two-sided,p<0.05 was statistically significant.Results: A total of 152,792 eligible patients were included in the analysis,of whom 58.96% were males.55.63% of children aged 18 years and 11.02% of the elderly aged ≥60 years.76.06% of the patients were from cities.The positive rates of rotavirus and norovirus were the highest,with 20.40% and 12.47%,respectively,followed by adenovirus(3.33%)and astrovirus(2.77%).The positive rates of diarrheagenic Escherichia coli(DEC)and nontyphoid Salmonella (NTS)were the highest,accounting for 6.71% and 4.41%,respectively,followed by Shigella(2.44%)and Vibrio parahaemolyticus(V.parahaemolyticus)(2.08%).Always positive detection rate is highest under the age of 5 patients with viral pathogens,and 18 to 45 patients with bacterial pathogens always positive detection rate is highest,and the different bacterial pathogens of diarrhea happens age risk: the NTS,Shigella,Campylobacter jejuni,Yersinia enterocolitica bending bacteria infection at the "ChildPattern",joinoint regression analysis positive rate in 2?5 years old age was a turning point.While DEC,V.parahaemolyticus,Plesiomonas shigelloides and Vibrio cholerae were infected with "Adult-Pattern",and the turning point of age positive detection rate appeared in joinoint regression analysis at 19?28 years old.The average daily temperature affected most of the viruses and bacteria detected,but in different directions,the incidence ratio(IRR)for viruses ranged from 0.83 to 0.96,while for bacteria ranged from 1.26 to 1.70.The proportion of children had an IRR of 1.03?1.17 on viral infection,while the population density had a greater effect on bacterial infection,and the IRR of C.jejuni was 2.44.Conclusion: The positive rate of group A rotavirus is the highest,followed by norovirus and DEC.Children younger than 5 years of age are more susceptible to viral diarrhea and adults between 18 and 45 years of age are more susceptible to bacterial diarrhea.The current findings advance our understanding of intestinal pathogens in patients with diarrhea in China,providing a scientific basis for health authorities to develop prevention and control measures,and providing technical guidance for clinical diagnosis and treatment.