北京市2012-2016年非脊髓灰质炎急性弛缓性麻痹病例报告发病率的敏感度分析

发布时间：2018-04-23 21:26

本文选题：急性弛缓性麻痹 + 脊髓灰质炎　；参考：《中国疫苗和免疫》2017年03期

【摘要】：目的评价不同报告和排除标准的参数设置对15岁以下儿童非脊灰急性弛缓性麻痹(Non-polio acute flaccid paralysis,NPAFP)病例报告发病率的影响。方法采用敏感度分析方法,假设在不同的AFP病例报告和排除标准下,计算NPAFP病例报告发病率的波动情况。结果 2012-2016年北京市NPAFP报告发病率在1.55/10万-2.28/10万之间,平均报告发病率为1.88/10万。若未开展现场核实诊断而未排除任何不符合报告标准的病例,各年报告发病率将上升至2.48/10万-4.09/10万之间,平均报告发病率上升至3.24/10万;若现场核实诊断不准确,未排除部分不符合报告标准的病例,平均报告发病率均上升至2/10万以上。若仅报告同时满足三个急性麻痹症状的病例,各年报告发病率均下降至1/10万以下;若仅报告同时满足两个及以上急性麻痹症状的病例,2012-2015年报告发病率均下降但可达到1/10万的要求,2016年下降至0.83/10万。结论对疑似AFP病例是否开展高质量的现场核实诊断以及采取不同的AFP病例报告标准将大大影响NPAFP报告的敏感性和准确性。医疗机构需严格执行AFP病例报告标准,疾病预防控制机构应重视开展疑似AFP的现场核实诊断,加强非AFP病例的排查工作。
[Abstract]:Objective to evaluate the effect of parameter settings of different reporting and exclusion criteria on the reported incidence of Non-polio acute flaccid paralysis (NPA) in children under 15 years of age. Methods sensitivity analysis was used to calculate the fluctuation of reported incidence of AFP cases under different criteria of AFP case reporting and exclusion. Results the reported incidence of NPAFP in Beijing from 2012 to 2016 was between 15.5 / 100,000-2.28 / 100,000.The average reported incidence was 18.8 / 100000. If no on-site verification and diagnosis are carried out without excluding any cases that do not meet the reporting criteria, the annual reported incidence will rise to between 24,800 / 100 and 4.09 / 100, and the average reported incidence will rise to 32.4 / 100, 000; if the field verification and diagnosis are not accurate, Without excluding some cases that did not meet the reporting criteria, the average reported incidence increased to more than 2 / 100, 000. If only three cases of acute paralysis were reported at the same time, the reported incidence rate decreased to less than 1 / 100,000 per year. If only two or more cases of acute paralysis were reported in 2012-2015, the reported incidence rate would fall to 1 / 100, 000 in 2012-2015, down to 0. 83 per 100, 000 in 2016. Conclusion the sensitivity and accuracy of NPAFP reports will be greatly affected by the high quality field verification and diagnosis of suspected AFP cases and the adoption of different AFP case reporting standards. Medical institutions should strictly implement the AFP case reporting standard. The disease prevention and control organization should pay attention to the field verification and diagnosis of suspected AFP and strengthen the non- case investigation.
【作者单位】：北京市疾病预防控制中心北京市预防医学研究中心;
【分类号】：R181.3;R725.1

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