广州市非伤寒沙门菌感染流行病学负担分析

发布时间：2019-04-02 20:00

【摘要】：目的评估广州市非伤寒沙门菌感染流行病学负担,提出食源性疾病监测策略。方法在广州市6区设9家食源性疾病主动监测医院,调查12个月腹泻病例采样率、沙门菌检测率、实验室检测敏感度,进而推算全市医疗机构相应数据;在广州市3区开展人群腹泻随机抽样入户调查,调查腹泻病例就诊率;通过传染病报告信息管理系统获得监测医院和全市医疗机构沙门菌感染性腹泻报告率;利用食源性疾病流行病学负担金字塔模型,通过倍数校正和不确定性分析估计沙门菌感染实际发病数,比较食源性疾病主、被动监测数据用于疾病负担分析的优劣。结果监测医院12个月腹泻病例平均采样率38.34%,沙门菌检测率28.24%,实验室检测敏感度87.5%,人群腹泻病例就诊率23.91%,沙门菌感染性腹泻报告率42.98%;全市医疗机构推算采样率38.34%,检测率28.24%,实验室检测敏感度47.5%,报告率20.94%,估计广州市沙门菌感染病例64 586例(95%CI:44 136~101 921),年发病率508.5/10万(95%CI:347.5~802.5/10万),全年全市被动报告病例仅171例,报告年发病率1.3/10万;经估算5岁以下年龄组(3 583.2/10万)年发病率最高,15~24岁年龄组(23.5/10万)最低。结论首次验证疾病负担金字塔模型在我国食源性疾病负担研究领域的适用性;表明主动监测一定程度上提升了食源性疾病尤其是特定病原体感染采样率、检测率、实验室检测敏感度和报告率,有助于对负担作出更准确和积极有效的估计;结果提示广州市非伤寒沙门菌感染负担较重,5岁以下年龄组人群负担水平尤其显著。
[Abstract]:Objective to evaluate the epidemiological burden of non-typhoid Salmonella typhimurium infection in Guangzhou and to propose surveillance strategies for food-borne diseases. Methods 9 active surveillance hospitals for food-borne diseases were set up in 6 districts of Guangzhou. The sampling rate of diarrhoea cases, the detection rate of Salmonella and the sensitivity of laboratory tests were investigated in 12 months, and the corresponding data of medical institutions in the whole city were calculated. Random sampling of diarrhoea was carried out in 3 districts of Guangzhou to investigate the rate of diagnosis of diarrhoea cases, and the reporting rate of salmonella infectious diarrhea in hospitals and medical institutions was monitored by information management system of infectious disease reporting. Using the pyramid model of epidemiological burden of food-borne diseases, the actual incidence of Salmonella infection was estimated by multiple correction and uncertainty analysis, and the advantages and disadvantages of food-borne disease active and passive surveillance data for disease burden analysis were compared. Results the average sampling rate of diarrhea cases in 12 months was 38.34%, the detection rate of Salmonella was 28.24%, the sensitivity of laboratory test was 87.5%, the diagnosis rate of diarrhea cases was 23.91%, and the reporting rate of salmonella infectious diarrhea was 42.98%. The sampling rate is 38.34%, the detection rate is 28.24%, the sensitivity of laboratory test is 47.5%, and the reporting rate is 20.94%. It is estimated that 64,586 cases of salmonella infection in Guangzhou (95%CI:44 136 / 101,921). The annual incidence rate was 508.5 / one hundred thousand (95%CI:347.5~802.5/ one hundred thousand), only 171 cases were reported passively in the whole city in the whole year, and the annual incidence rate was 1.3 / one hundred thousand. It was estimated that the incidence was the highest in the under-5 age group (3 583.2 / one hundred thousand) and the lowest in the 15-year-old 24-year-old group (23.5 / one hundred thousand). Conclusion it is the first time to verify the applicability of the pyramid model of disease burden in the field of food-borne disease burden research in China. The results show that active surveillance improves the sampling rate, detection rate, laboratory sensitivity and reporting rate of food-borne diseases, especially specific pathogens, which is helpful to make more accurate and effective estimation of burden. The results showed that the burden of non-Salmonella typhimurium infection was heavy in Guangzhou, especially in the population under 5 years old.
【作者单位】：中山大学公共卫生学院;广东省疾病预防控制中心;皖南医学院;
【基金】：中美新发再发传染病合作项目子项目6(1U2GHH00018-01) 广东省医学科研基金立项课题(A2013069)
【分类号】：R181.3

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