海口市传染病预警效果评价及其影响因素研究

发布时间：2019-02-16 12:30

【摘要】：目前,以传染病实时报告的信息为依据和以历史疫情资料为基础建立的传染病自动预警系统,提高了我国传染病疫情监测的预警能力,从而减少了传染病对人民健康和社会经济发展造成的影响;但相关的探索和回顾性验证研究未深入地分析预警效果可能的影响因素。另外,预警系统评价研究已取得一定进展,但如何将各项评价内容及其指标进行综合分析与平衡,并有效地应用于我国现有的传染病暴发早期预警系统的评价,尚需进行深入的实践与探索。本文通过对2004-2009年海口市传染病信息报告质量、与事件相关传染病的病例报告质量及其历史报告水平、突发公共卫生事件报告人的职业特征以及预警系统应用的基本情况等5个方面进行描述性分析,结合预警图特例研究,探索预警系统的影响因素,并使用灵敏度、阳性预测值和领先时间作为评价指标对现行使用的预警系统进行评价。本文通过实证研究,得出以下八个结论:1、报告质量是预警效果的重要影响因素。2、传染病历史的报告水平在一定程度上也影响了预警的效果,但单病例自动预警病种的预警效果不受历史基线水平的影响。3、学校传染病防控工作水平对预警效果有一定的影响,应加强学校突发事件报告人员的配备和培训,提高报告及时性。4、目前预警系统对数据的空间属性特征考虑不够,无法同时实现时间和空间两个维度的预警,成功预警的准确性不高。5、根据不同地区和不同传染病的需要,不断完善参数设置和预警实现的模式,以提高系统的灵敏度。6、水痘由于是非法定传染病而未纳入传染病自动预警系统,但该传染病具有很强的传染性,特别是在学校等特殊环境容易引起暴发事件,因此很有必要将此类传染病添加入预警系统进行预警。7、对于当地罕见、少发的传染病或近5年从未报告的传染病如登革热,应根据该地区的实际情况,建议在该地区的预警系统中将该传染病调整为单病例预警病种。8、目前预警系统无效预警过多,增加了基层工作人员不必要的工作量。本次研究为优化预警系统提供了一定的科学依据,并可以为相关学者在这方面开展相关的研究提供参考和借鉴。
[Abstract]:At present, an automatic early-warning system for infectious diseases, which is based on the information of real-time reporting of infectious diseases and on the basis of historical epidemic information, has improved the ability of surveillance and early warning of infectious diseases in China. Thus reducing the impact of infectious diseases on people's health and socio-economic development; However, the relevant exploratory and retrospective verification studies have not thoroughly analyzed the possible factors affecting the early warning effect. In addition, some progress has been made in the study of early warning system evaluation. However, how to analyze and balance the evaluation contents and indicators, and how to effectively apply them to the evaluation of the existing early warning system of infectious disease outbreaks in China. Still need to carry on deep practice and exploration. In this paper, the quality of infectious disease information reporting in Haikou City from 2004 to 2009, the case report quality and its historical reporting level of event-related infectious diseases were analyzed. The professional characteristics of public health emergency reporter and the basic situation of application of early warning system are described in five aspects. Combining with the special case study of early warning map, the influencing factors of early warning system are explored, and the sensitivity of the early warning system is used. Positive predictive value and lead time are used as evaluation indicators to evaluate the current early warning system. This paper draws the following eight conclusions through empirical research: 1. The quality of report is an important factor influencing the effect of early warning. 2. To some extent, the reporting level of history of infectious diseases also affects the effect of early warning. However, the early warning effect of single case automatic early warning disease is not affected by the historical baseline level. 3. The level of prevention and control of infectious diseases in schools has a certain impact on the early warning effect, so we should strengthen the equipment and training of school emergency report personnel. To improve the timeliness of the report. 4. At present, the early warning system does not consider the spatial attributes of the data sufficiently, and can not realize the early warning of time and space at the same time, and the accuracy of the successful early warning is not high. According to the needs of different regions and different infectious diseases, the models of parameter setting and early warning realization are constantly improved to improve the sensitivity of the system. 6. Chickenpox is not included in the automatic early warning system for infectious diseases because it is a non-statutory infectious disease. However, the infectious disease is highly contagious, especially in special environments such as schools, which are prone to outbreaks, so it is necessary to add such infectious diseases to the early warning system for early warning. A rare infectious disease or an infectious disease that has not been reported in nearly five years, such as dengue fever, should be reclassified as a single case early warning disease in the early warning system of the region, in the light of the actual situation in the region. At present, there are too many ineffective early-warning systems, increasing the unnecessary workload of basic-level staff. This study provides a scientific basis for the optimization of early warning system, and can provide reference and reference for relevant scholars to carry out relevant research in this area.
【学位授予单位】：天津大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R181.8

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