2008-2013年四川省传染病自动预警系统应用效果分析

发布时间：2018-11-03 12:49

【摘要】：目的了解国家传染病自动预警系统(CIDARS)在四川省的运行情况以及传染病暴发早期探测中发挥的作用,为系统应用改进提供依据。方法对2008年4月21日-2013年4月20日预警系统发出的预警信号数、信号响应率、响应时间、预警信号初步核实结果,以及预警相关病种的报告病例数、暴发事件探测灵敏度进行描述性分析。结果预警系统在四川省共发出93 520条预警短信,平均每县每周接收1.95条预警短信。其中移动百分位数法共对17种传染病发出预警信号85 422条,信号响应率为96.51%,五年度间预警信号响应率呈逐年上升趋势(趋势χ2=2471.19,P0.001);信号响应时间的中位数为2 h(P25~P75:0.81~9.89 h,响应时间与年度间成负相关(rs=-1,P0.05);17种传染病中,10种通过突发公共卫生事件管理信息系统报告170起暴发事件,其中160起暴发事件有预警信号发出,灵敏度为94.12%;预警信号数与该病种在大疫情系统中的报告数成正比(F=43.10,b=0.119,P0.001)。固定阈值法共对13种传染病、不明原因肺炎和手足口病重症病例发出预警信号8 089条,信号响应率为99.09%,五年度间预警信号响应率呈逐年上升趋势(趋势χ2=47.57,P0.001);信号响应时间的中位数为4.08 h(P25~P75:0.60~20.88 h),响应时间与年度间成负相关(rs=-1,P0.05);共有3 024例经固定阈值法预警的传染病被确诊,确诊病例较多的有:麻疹、手足口重症病例,占确诊总数的94.31%。确诊病例总数占预警信号总数的37.34%,其中手足口病重症病例、间日疟、恶性疟确诊比例较高,分别为86.33%、78.57%和76.79%。传染性非典、脊髓灰质炎、人禽流感、肺炭疽、白喉和不明原因肺炎的确诊数均为0。结论传染病自动预警系统在四川省运行的五年间,预警信号的响应率逐年升高,响应时间逐年降低,预警信号数与该病种在大疫情系统中的报告数成正比,总体试用推行较好。同时为了更加科学准确的进行传染病预警,系统部分功能还有待进一步完善,提高传染病报告的质量是根本。
[Abstract]:Objective to understand the operation of national infectious disease automatic warning system (CIDARS) in Sichuan Province and its role in early detection of infectious disease outbreak, so as to provide the basis for the improvement of the system. Methods from April 21, 2008 to April 20, 2013, the number of early warning signals, the response rate, the response time, the initial verification results of early warning signals, and the number of reported cases of diseases related to early warning were analyzed. The detection sensitivity of outbreak events was analyzed in a descriptive way. Results the early warning system sent out 93,520 early warning messages in Sichuan Province, and received 1.95 early warning messages per county per week on average. Among them, the mobile percentile method issued 85,422 early warning signals for 17 kinds of infectious diseases, and the signal response rate was 96.51. The response rate of early warning signals increased year by year (trend 蠂 2 2n 2471.19 / P0.001). The median signal response time was 2 h (P25~P75:0.81~9.89 h), and the response time was negatively correlated with the annual response time (rs=-1,P0.05). Of the 17 infectious diseases, 10 reported 170 outbreaks through the emergency public health event management information system, 160 of which had early warning signals with a sensitivity of 94.1212; The number of early warning signals was directly proportional to the number of reports of the disease in the large epidemic system (FF43.10bP0.001). The fixed threshold method issued 8 089 warning signals for 13 cases of infectious diseases, unexplained pneumonia and hand, foot and mouth diseases, and the signal response rate was 99.09. The response rate of early warning signals increased year by year (trend 蠂 2: 47.57). (P0.001); The median of signal response time was 4.08 h (P25~P75:0.60~20.88 h), response time was negatively correlated with annual response time (rs=-1,P0.05); A total of 3 024 cases of infectious diseases early warning by fixed threshold method were diagnosed. The most confirmed cases were measles, severe cases of hand and foot, accounting for 94.31% of the total confirmed cases. The confirmed cases accounted for 37.34% of the early warning signals. The proportion of confirmed cases of hand, foot and mouth disease, vivax malaria and falciparum malaria was 86.337.57% and 76.79% respectively. Infectious SARS, poliomyelitis, human avian influenza, lung anthrax, diphtheria and unexplained pneumonia were all diagnosed at 0. 5%. Conclusion during the five years of operation of the automatic early warning system for infectious diseases in Sichuan Province, the response rate of the early warning signal increased year by year, and the response time decreased year by year. The number of early warning signals was proportional to the number of reports of the disease in the large epidemic situation system, and the overall trial implementation was better. At the same time, in order to carry out early warning of infectious diseases more scientifically and accurately, some functions of the system need to be further improved, and it is essential to improve the quality of infectious disease reports.
【作者单位】：四川省疾病预防控制中心;
【分类号】：R184

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