淄博市1954～2011年布鲁氏菌病流行现状与预测研究

发布时间：2018-07-11 16:09

本文选题：布鲁氏菌病 + 流行现状　；参考：《山东大学》2013年硕士论文

【摘要】：目的：分析、研判淄博市1954～2011年布病流行特征及其动态变化规律,研究探讨影响20世纪九十年代淄博市布病疫情上升的因素,预测预报淄博市人间布病疫情流行趋势,准确掌握淄博市布病的防控状况,科学评价布病防控工作措施效果,为制定并不断完善淄博市布病防控策略提供切实可行的依据,不断改进防控措施,切实巩固淄博市布病防控工作成果。方法：采用SPSS19.0对淄博市1954～2011年人间布病疫情报告资料、1958～2011年人间感染情况调查资料、1989～2011年布病病人个案调查资料以及1958～2011年畜间感染情况调查、畜间主动免疫与检疫资料等相关资料进行统计分析,研究淄博市布病疫情流行现状,并对采用加权算术平均预测法对淄博市布病疫情流行趋势进行预测。结果：淄博市1954-2011年共报告人间布病病例380例,年平均发病率为0.2512/10万,其中37年有疫情报告,无疫情报告的年份全部集中1955～1988年间。1989～2011年期间淄博市人间布病疫情年平均发病率是1954～1988年期间的2.01倍,两个时间段发病频率差异具有统计学意义(χ2=36.51,P0.01)。目前,呈现出历史布病疫区疫情依然严重,新发布病疫区不断出现的局面,淄博市布病疫情上升趋势与全国及部分省市相一致,但其疫情上升趋势早于全国,并且波动性与有关报道不完全一致。1954-2011年,淄博市布病病例分布在五区三县56个乡镇118个村,近年来呈现出逐步增加趋势,主要集中在淄川、临淄两个区,这与当地居民以半农半牧为主有关,张店、周村、桓台、高青等区县由于近年来发展奶牛、奶羊养殖业,报告病例数也在不断增加。淄博市报告的布病病例存在一定的家庭聚集性,并且近年来爆发疫情起数不断增加。对1989～2011年283例病例统计分析,其发病性别、年龄分布符合布病的发病规律,但1989-2002年和2003-2011年两个时期淄博市布病发病年龄分布出现新变化,2003～2011年期间40岁的各年龄组发病例数均少于1989～2002年,40～69岁的各年龄组均多于1989-2002年。发病时间分布与羊种菌布病疫区特点相吻合,6月份为发病高峰,占总病例数的15.55%,病例集中分布在3～7月份,共累计发病177例,占总病例数的62.54%。从淄博市1989～2011年个案调查资料完整的162例病例感染途径(方式)的统计分析结果情况看,病例可能的感染方式或途径仍然以饲养、放牧羊只和屠宰牲畜感染为主,分别占70.99%和11.11%,尤其要值得关注的是近年来8例布病患者系因饮用生羊奶(占总病例数的4.94%)而感染。1958～2011年,淄博市累计开展血清学主动监测39361人(次),其中SAT试验阳性者591人,平均阳性率为1.50%,结合临床症状和流行病学调查结果共确诊296例布病病人,确诊率为50.08%,占总病例数的77.89%,其中有13年未开展人间主动监测工作。1958～2011年,淄博市累计共血清学检疫检测140154只(头)牲畜,检疫阳性1162只(头),阳性率为0.83%,其中16年未开展检疫工作。淄博市1958～2011年期间历年累计免疫接种牲畜88.49万只,历年平均免疫密度为20%～30%,其中29年未开展牲畜免疫接种工作。人、畜间共检菌鉴定21株布氏菌,其中羊Ⅲ型19株,羊Ⅰ型2株。利用yt=(5yt-1+4yt-2+3yt-3+2yt-4+Yt-5)/(1+2+3+4+5),预测2012～2016年淄博市布病发病率依次为0.5991/10万、0.6346/10万、0.6579/10万、0.6704/10万、0.6764/10万。结论：淄博市20世纪70到80年代布病防控工作积累了成功的经验,布病疫情一度得到了有效控制,5个县达到了部颁控制区标准,2个县达到了部颁稳定控制区标准。但近年来由于牲畜养殖模式改变、畜及畜产品交易频繁、畜间防控措施存在不到位问题等原因,导致了人、畜间布病疫情再度肆虐。而且通过疫情预测,未来一段时期,淄博市如不加大防控力度,布病疫情将会呈现进一步扩大的态势。要想根本上彻底肃清布病传染源、净化疫源地,最终达到控制淄博市人间布病疫情发生爆发和流行的目标,必须围绕消灭布病传染源、控制传播途径和保护易感人群这三个流行环节,进一步建立健全机制体制,真正做到群防群治、联防联治,逐步实现法制化、规范化、制度化管理。
[Abstract]:Objective:
Analysis was made to study the epidemic characteristics and dynamic changes of 1954~2011 years in Zibo. The factors affecting the rising epidemic situation in Zibo in 90s twentieth Century were studied, the epidemic trend of human cloth disease in Zibo was predicted, the prevention and control status of Zibo disease was accurately mastered, and the effect of the prevention and control measures of the disease was scientifically evaluated, and the effect of the disease prevention and control measures was scientifically evaluated. We will continue to improve the prevention and control strategy of brucellosis in Zibo and provide practical basis for improving the prevention and control measures in order to consolidate the results of brucellosis prevention and control in Zibo.
Method:
The data of the 1954~2011 years' epidemic situation of human cloth disease in Zibo, the data of 1958~2011 years of human infection, the data of the cases of the sick patients in the past 1989~2011 years and the investigation of the infection among the animals in the past 1958~2011 years, the data of the active immunity and quarantine data among the animals were statistically analyzed to study the epidemic situation of the disease in Zibo. The epidemic situation is forecasted and the epidemic trend of brucellosis in Zibo is forecasted by the weighted arithmetic average prediction method.
Result:
In 1954-2011 years, 380 cases of human disease were reported in Zibo, with an average annual incidence of 0.2512/10 million, of which 37 years had an epidemic report. The annual average incidence of human cloth disease in Zibo, which was not reported in the year of.1989 to 2011, was 2.01 times more than that of 1954~1988 years, and the incidence of the disease was poor in two periods. The difference has statistical significance (2=36.51, P0.01). At present, the epidemic situation in the historical epidemic area is still serious, the situation of the newly issued disease epidemic area is constantly emerging, the trend of the epidemic situation in Zibo is consistent with that of the whole country and some provinces and cities, but the trend of the epidemic situation is earlier than that of the whole country, and the volatility is not exactly consistent with the related reports for.1954-2011 years, Zibo disease cases are distributed in 118 villages of 56 villages and towns in three counties of five districts. In recent years, it has been increasing gradually, mainly in Zichuan and Linzi two districts, which is related to the local residents with half agricultural and semi animal husbandry, and Zhangdian, Zhoucun, Huantai, and Gaoqing County have been increasing the number of reported cases in recent years. There are certain family aggregation in the reported cases of disease in Zibo, and the number of outbreaks has increased in recent years. For 283 cases of 1989~2011 years, the sex and age distribution of the disease conforms to the regularity of the disease, but the distribution of the age distribution of the disease in the city of Zibo in 1989-2002 and 2003-2011 years has been changed, 200 The number of cases of all age groups at the age of 40 years was less than 1989~2002 years, and all age groups at the age of 40~69 were more than 1989-2002 years. The time distribution of the onset was consistent with the characteristics of the disease epidemic area of the sheep. In June, it was the peak of the disease, accounting for 15.55% of the total cases, and the cases were concentrated in 3~7 months, with a total of 177 cases in total, accounting for the total number of cases. 62.54%. according to the statistical analysis results of 162 cases of cases of infection in Zibo, 1989~2011 years of case investigation data, the possible way or way of infection of the cases is still reared, the shepherd sheep and the slaughter cattle are the main infection, accounting for 70.99% and 11.11% respectively. In particular, it is worth paying attention to the causes of 8 cases of disease patients in recent years. Drinking raw sheep milk (4.94% of the total number of cases) and infected.1958 to 2011, 39361 people (Times) were actively monitored by serology in Zibo. Among them, 591 people with positive SAT test were 591, the average positive rate was 1.50%. Combined with clinical symptoms and epidemiological investigation, 296 cases of disease were diagnosed, the rate of diagnosis was 50.08%, which accounted for 77.89% of the total number of cases. For 13 years, no human active monitoring was carried out from.1958 to 2011. In Zibo, 140154 (head) livestock were detected by the total serological quarantine inspection in Zibo. The positive rate was 0.83%. Among them, the quarantine was not carried out in 16 years. 884 thousand and 900 animals were inoculated for 1958~2011 years in the past 1958~2011 years. The average annual immunization density of Zibo was 20% to 30. %, of which 29 years had not carried out the vaccination of livestock. 21 strains of Brucella were identified by the common bacteria among the animals, including 19 sheep and 2 sheep. Using yt= (5yt-1+4yt-2+3yt-3+2yt-4+Yt-5) / (1+2+3+4+5), it was predicted that the incidence of brucellosis in Zibo was 0.5991/10 million, 0.6346/10 million, 0.6579/10 million, 0.6704/10 million and 0.6764/10 million in 2012~2016 years.
Conclusion:
Zibo city has accumulated successful experience in prevention and control of disease from 70 to 80s twentieth Century. The epidemic situation has been effectively controlled, 5 counties have reached the standard of the Ministry of control and 2 counties have reached the standard of the stability control area. However, in recent years, due to the change of livestock breeding mode, the trade of livestock and livestock products is frequent and the prevention and control measures between animals are not in place. Problems and other reasons have led to the recurrence of disease epidemic among people and animals. And through the forecast of the epidemic situation, the epidemic situation in Zibo will be further expanded in the next period of time. The epidemic situation of the disease will be further expanded. It is necessary to thoroughly eliminate the infectious source of the disease and purify the source of the epidemic, and finally achieve the control of the epidemic situation of human cloth disease in Zibo. The target of outbreak and epidemic must revolve around the three popular links of eradication of the infectious source of disease, the control of the way of transmission and the protection of the susceptible population, and further establish and perfect the mechanism system, truly achieve group prevention and treatment, joint prevention and treatment, and gradually realize the legalization, standardization and institutionalized management.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R516.7

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