2004-2015年哈尔滨市急性弛缓性麻痹流行病学特征及监测系统运转情况分析

发布时间：2018-11-11 18:50

【摘要】：目的分析哈尔滨市急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例流行病学特征及《AFP信息监测管理报告系统》运转情况,为维持无脊灰状态、制定疾病控制策略提供科学依据。方法采用描述流行病学和分析流行病学相结合的方法对AFP病例进行流行病学特征分析,对监测指标进行系统评价。结果 2004-2015年哈尔滨共计报告AFP病例529例,平均报告发病率为4.96/10万,24 h内报告率89.19%,报告后48 h内调查率98.93%,14 d内双份合格便采集率为92.08%,便标本7 d内送达率为98.13%,75 d内随访及时率均为100%。每年3-6月,7-10月为发病高峰;各区、县(市)AFP报告数差异有统计学意义(χ2=133.19,P0.001);农村病例多于城市(χ2=84.16,P0.001);病例城乡二元居住状况有统计学差异(χ2=441.33,P0.001);麻痹后第一次到省市级医院就诊的患者占76.37%,其余以县级及以下医院为主;68.80%的病例临床症状体征不明显;病例经治愈后恢复良好,只有7.94%的患者残留麻痹。就诊次数、就诊医院情况等流行病学特征以及腹泻、颈项强直等临床症状体征均有统计学差异(P0.001)。结论哈尔滨AFP监测系统运转情况良好,工作质量逐年提高。基层医院对于AFP诊断能力和首诊报告率低,应重点对其开展AFP诊疗培训工作,强化基层医院诊断能力,做到早发现早报告。
[Abstract]:Objective to analyze the epidemiological characteristics of acute flaccid paralysis (Acute Flaccid Paralysis,AFP) cases and the operation of AFP Information Monitoring and reporting system in Harbin, so as to provide scientific basis for maintaining poliomyelitis and formulating disease control strategies. Methods Epidemiological characteristics of AFP cases were analyzed by combining descriptive epidemiology with analytical epidemiology, and the monitoring indexes were systematically evaluated. Results A total of 529 cases of AFP were reported in Harbin from 2004 to 2015. The average reported incidence rate was 4.96 / 100 000. The reporting rate was 89.19 in 24 hours. The investigation rate within 48 hours was 98.93% and the rate of double eligible stool collection within 14 days was 92.08%. The delivery rate of fecal specimens within 7 days was 98.13 and the prompt rate of follow-up within 75 days was 100. The incidence peak was from March to June and July to October. There was significant difference in the number of AFP reports in different districts and counties (蠂 2 / 133.19 / P 0.001), and the number of cases in rural areas was more than that in cities (蠂 2 / 84.16 / P 0.001). There was statistical difference between urban and rural dual living conditions (蠂 2 / 441. 3 / 3 P 0.001), 76.37% of the patients were admitted to provincial and municipal hospitals for the first time after paralysis, and the rest were hospitals at or below the county level. 68.80% of the cases had no obvious clinical symptoms and signs, and only 7.94% had residual paralysis. There were significant differences in the frequency of visits, hospital conditions, diarrhea, neck rigidity and other clinical symptoms and signs (P0.001). Conclusion the AFP monitoring system in Harbin is running well and the working quality is improving year by year. The diagnosis ability and the first diagnosis report rate of AFP are low in the primary hospital. It is necessary to focus on the training of AFP diagnosis and treatment, strengthen the diagnosis ability of the primary hospital, and make early discovery and early report.
【作者单位】：哈尔滨市阿城区人民医院儿科;哈尔滨市疾病预防控制中心免疫规划所;黑龙江省第二医院急诊科;黑龙江省疾病预防控制中心公共卫生监测所;哈尔滨医科大学公共卫生学院;
【基金】：黑龙江省博士后科研启动金(LBH-Q12036)
【分类号】：R512.4

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