泰安市1961-2005年传染病流行特征分析

发布时间：2018-05-19 16:46

本文选题：传染病 + 流行特征　；参考：《山东大学》2007年硕士论文

【摘要】： 研究目的通过对泰安市1961～2005年传染病监测资料的分析，全面了解不同时期传染病的发病水平及构成，探索影响传染病消长的相关因素，为制定卫生政策提供科学依据，为其他相关政策的制定提供基础资料。研究方法运用描述性流行病学的方法对资料进行分析。传染病发病分析：通过1961～2005年各年份的传染病发病率曲线、动态数列分析传染病发病强度的变化趋势及变化速度；将1961～2005年传染病发病分成三个时期，通过比较不同时期各传染病构成比，分析不同时期传染病疾病谱的改变。重点传染病发病分析：选择每类传染病中的代表性疾病进行分析。通过每种传染病各年份发病率，分析该疾病的长期变化趋势；通过不同年份各地区、各月份传染病发病率，以及年龄、性别、职业发病构成比分析各传染病的流行特征。研究结果 (1) 1961～2005年泰安市累计报告传染病24种，年平均发病率为700.67／10万，年平均死亡率为3.76／10万，年平均病死率为0.54％。发病呈下降趋势，发病率从1961年2865.87／10万下降至2005年的173.66／10万，下降了93.94％。在1961～1979年传染病的年平均发病率为1369.22／10万，居发病前五位的疾病主要有疟疾、麻疹、流脑、百日咳、痢疾、肝炎；在1980～1989年传染病的年平均发病率为336.04／10万，居发病前五位的疾病主要有痢疾、肝炎、疟疾、出血热、百日咳，在1990～2005年传染病的年平均发病率为136.27／10万，居发病前五位的疾病主要有肝炎、痢疾、出血热、肺结核、淋病。 (2) 1961～1971年病毒性肝炎发病呈现下降的趋势，年平均发病率为18.19／10万，无明显的高发月份；1972～1994年病毒性肝炎发病率分布在87.01／10万～355.64／10万之间，出现了6次流行高峰，一般每3～5年出现一次，8～12月份发病较多：1995～2005年间病毒性肝炎发病表现为先缓降后上升的态势，年平均发病率为69.54／10万，无明显的高发月份。在病毒性肝炎发病构成中，1990～1994年甲肝占病毒性肝炎病例的73.79％，乙肝占21.67％，1995～2005年乙肝发病占病毒性肝炎的86.86％，未分型肝炎占病毒性肝炎的6.35％，甲肝发病占病毒性肝炎的6.12％。 (3) 1961～2005年疟疾发病呈下降趋势；1961～1986年的本地病例流行期，年平均发病率为289.46／10万，年平均死亡率为0.004／10万，年平均病死率为0.001％，出现了1961年、1971年两个发病高峰年，病例主要分布在7～10月份；1987～2005年，病例均为输入性，年均发病率为0.036／10万，无死亡病例，无明显的高发月份。 (4) 1984～2005年肾综合症出血热发病呈下降趋势，出现1985～1987年、1994～1996年两次发病高峰，2003年发病大幅下降，至2005年降至1.22／10万；病例主要分布在3～6月份和9～10月份；发病较多的职业为农民、学生、工人。 (5) 1997～2003年肺结核发病比较平稳，2004年之后发病呈明显上升趋势。各年份的1月份发病最多，发病较多的年龄为15～24岁组、45～64岁组，发病较多的职业为农民，其次为学生、工人。 (6) 1961～2005年麻疹年发病呈下降趋势。1961～1975年麻疹发生了4次流行，，每间隔2～3年出现一次流行高峰，病例主要集中在冬春季节，15岁以下少年儿童发病较多；1985年以来，大年龄组的发病有明显增多趋势。 (7) 1961～2005年流脑发病呈下降趋势。1961～1979年间出现了1965～1969年、1976～1978年两次流行高峰；1980年后，流脑发病持续下降，近10年，流脑的发病一直处于较低水平。发病主要集中在冬春季节，以15岁以下年龄居多，近年高发年龄有明显后移趋势；发病较多的职业为散居儿童、中小学生，但近年发病构成有降低的趋势。 (8) 1961～2005年痢疾发病呈下降趋势；病例主要分布在7～9月份，5岁以下儿童发病较多，其次为20～40岁青壮年。散居儿童居痢疾发病首位，其次为农民、工人、学生。 (9) 1961～2005年伤寒发病呈下降趋势，发病率由1961年的16.22／10万，降至2005年的0.04／10万。各月份均有病例，8～11月为发病较多：10～39岁青壮年农民发病较多。结论1961-2005年泰安市传染病发病呈下降趋势，在上世纪六七十年代，传染病流行水平高，发病以麻疹、流脑、百日咳等呼吸道传染病、疟疾为主的虫媒传染病为主；八十年代及九十年代上半期，传染病流行强度降低，发病以病毒性肝炎、痢疾等肠道传染病为主；九十年代后半期至今传染病发病处于较低水平，发病呈现稳中微升的趋势，传染病发病以乙型肝炎为主的血传疾病、肺结核为主的呼吸道传染病为主。对于疫苗可控制疾病应在确保适龄人群预防接种的同时，加强疫情、病原或血清学监测，适时调整接种策略，控制疾病流行或反弹。对于以管理传染源为主的疟疾、肺结核等传染病的控制，应积极开展疫源检索，以及时发现、及早隔离治疗感染者，防止传播的发生；对于以出血热为主的自然疫源性传染病的防治应采取以切断传播途径为主的综合性措施，加强疫情、鼠情、鼠带毒率监测，大力进行防鼠灭鼠。加强食品卫生监督管理，改善公共卫生设施，大力开展爱国卫生运动及健康教育，以降低痢疾、伤寒副伤寒等肠道传染病的发病。对于乙型肝炎、丙型肝炎等血传疾病应采取以切断传播途径为主的综合性防治措施，防止流行的发生。
[Abstract]:research objective
Through the analysis of the surveillance data of infectious diseases in Tai'an for 1961~2005 years, we fully understand the incidence and composition of infectious diseases in different periods, explore the related factors that affect the growth of infectious diseases, provide scientific basis for the formulation of health policies, and provide basic information for the formulation of other related policies.
research method
Descriptive epidemiology was used to analyze the data.
Analysis of the incidence of infectious diseases: through the curve of the incidence of infectious diseases in 1961~2005 years, dynamic series analysis of the trend and speed of changes in the intensity of infectious diseases; the incidence of infectious diseases in 1961~2005 years was divided into three periods, and the changes in the spectrum of infectious diseases at different periods were analyzed by comparing the proportion of the various infectious diseases in different periods.
Analysis of the key infectious diseases: select the representative diseases of each type of infectious disease. Through the incidence of each year, the long-term trend of the disease is analyzed. The incidence of infectious diseases in different regions and months, and the incidence of age, sex and occupational disease are analyzed, and the epidemic characteristics of each infectious disease are analyzed.
Research results
(1) 24 kinds of infectious diseases were reported in Tai'an in 1961~2005 years. The average annual incidence rate was 700.67 / 100 thousand. The annual average mortality rate was 3.76 / 100 thousand. The average annual mortality rate was 0.54%. decline. The incidence rate decreased from 2865.87 / 100 thousand in 1961 to 173.66 / 100 thousand in 2005, decreasing the annual average of the infectious disease in 1961~1979 years. The incidence of the disease was 1369.22 / 100 thousand. The first five diseases in the first place were malaria, measles, meningitis, pertussis, dysentery, and hepatitis; the average annual incidence of infectious diseases in 1980~1989 years was 336.04 / 100 thousand. The main five diseases before the onset were dysentery, hepatitis, malaria, hemorrhagic fever, pertussis, and the average annual incidence of infectious diseases in 1990~2005 years. The rate was 136.27 / 100 thousand, and the main diseases of five were hepatitis, dysentery, hemorrhagic fever, pulmonary tuberculosis and gonorrhea.
(2) the incidence of viral hepatitis was declining in 1961~1971 years, with an average annual incidence of 18.19 / 100 thousand and no obvious month of high incidence. The incidence of viral hepatitis in 1972~1994 years was between 87.01 / 100 thousand to 355.64 / 100 thousand, and there were 6 peaks of epidemic, usually once every 3~5 years, and 8~12 months were more: 1995~20. In the past 05 years, the incidence of viral hepatitis was first slowly and then rising, with an average annual incidence of 69.54 / 100 thousand, no obvious high month. In the constitution of viral hepatitis, 1990~1994 years of hepatitis A accounted for 73.79% of viral hepatitis cases, hepatitis B accounted for 21.67%, and 1995~2005 years of hepatitis B accounted for 86.86% of viral hepatitis. Hepatitis accounts for 6.35% of viral hepatitis, and hepatitis A accounts for 6.12%. of viral hepatitis.
(3) the incidence of malaria was declining in 1961~2005 years; the average annual incidence rate of 1961~1986 years was 289.46 / 100 thousand, the annual average mortality was 0.004 / 100 thousand and the average mortality rate was 0.001%. In 1961, there were two peak years in 1971, and the cases were mainly in 7~10 months; in 1987~2005 years, the cases were all The annual incidence rate was 0.036 / 100 thousand, with no mortality and no significant monthly incidence.
(4) the incidence of hemorrhagic fever with renal syndrome in 1984~2005 years was declining, 1985~1987 years and two times in 1994~1996 years. In 2003, the incidence of hemorrhagic fever was reduced greatly, to 1.22 / 100 thousand in 2005; the cases were mainly in 3~6 months and 9~10 months; the majority of the cases were farmers, students and workers.
(5) the incidence of pulmonary tuberculosis was more stable in 1997~2003 years. After 2004, the incidence of disease showed an obvious upward trend. In January, the incidence of the disease was the most. The age of the disease was 15~24 years old, 45~64 years old, the more diseases were farmers, followed by students and workers.
(6) the incidence of measles was declining in 1961~2005 years from.1961 to 1975, and measles occurred in 4 times. One epidemic peak appeared at each interval of 2~3 years. The cases mainly concentrated in winter and spring season, and children under 15 years of age had more disease. Since 1985, the incidence of the large age group was obviously increasing.
(7) the incidence of the onset of the 1961~2005 years had a downward trend of 1965~1969 years from.1961 to 1979 and the peak of two times in 1976~1978 years. After 1980, the incidence of flow of the brain continued to decline, and the incidence of the brain was at a low level for nearly 10 years. The incidence of the disease was mainly in the winter and spring season, with the majority of the age below 15 years, and the age of high incidence in recent years. The trend of morbidity is more. The most common occupation is scattered children, primary and secondary school students, but in recent years, the incidence of diseases is decreasing.
(8) the incidence of dysentery was descending in 1961~2005 years; the cases were mainly distributed in the month of 7~9, the children under 5 years of age had more morbidity, followed by 20~40 year old young adults. The scattered children were the first among the dysentery diseases, followed by farmers, workers and students.
(9) the incidence of typhoid fever was declining in the last 1961~2005 years. The incidence was from 16.22 / 100 thousand in 1961 to 0.04 / 100 thousand in 2005. There were cases in each month, and 8~11 months were more: there were more diseases in the young adults of 10~39 years old.
Conclusion the incidence of infectious diseases in Tai'an was declining in the last 1961-2005 years. In the 60s and 70s of last century, the epidemic level of infectious diseases was high. The incidence of infectious diseases was measles, meningitis, pertussis and other infectious diseases of the respiratory tract. In the first half of 80s and 90s, the epidemic intensity of infectious diseases was reduced, viral hepatitis and dysentery were found. Infectious diseases such as disease were the main diseases, and the incidence of infectious diseases was at a low level in the second half of 90s. The incidence of infectious diseases showed a trend of steady and micro rise. The infectious diseases were mainly blood borne diseases of hepatitis B, and the main respiratory infectious diseases of tuberculosis were mainly tuberculosis.
At the same time, the vaccine control disease should be taken to ensure the vaccination of the age population, to strengthen the epidemic situation, the pathogen or the serological monitoring, the timely adjustment of the vaccination strategy, control the epidemic or the rebound. For the control of infectious diseases such as malaria and tuberculosis, the control of the infectious diseases, such as the management of infectious sources, should carry out the search of the epidemic source, and find out the early isolation treatment. Infection, prevent the occurrence of transmission; for the prevention and control of natural epidemic infectious diseases based on hemorrhagic fever, the prevention and treatment of infectious diseases should be taken mainly by the comprehensive measures of cutting off the transmission route, strengthening the epidemic situation, the rat situation, the monitoring of the virus rate of mice and the anti rat deratization, strengthening the supervision and management of food hygiene, improving the public health facilities and vigorously carrying out the patriotic health movement. And health education, in order to reduce the incidence of intestinal infectious diseases such as dysentery, typhoid and paratyphoid fever. For hepatitis B, hepatitis C and other blood borne diseases, comprehensive prevention and control measures should be taken to prevent the prevalence of epidemic.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R181.3

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