广东省市、县级疾控中心突发公共卫生事件应急能力现况分析

Status analysis of response capability for public health emergencies of the municipal and county-level CDCs in Guangdong Province

目的分析广东省市、县级疾病预防控制中心(简称疾控中心)突发公共卫生事件应急能力的现况。方法分别设计针对地市和县区级疾控中心的两种调查问卷,问卷内容包括应急人员基本情况、应急管理机制、监测预警、现场调查处理、实验室检测、应急储备、职工的培训演练、公众宣传和信息通报等8个方面。于2006年问卷调查广东省所有市、县级疾控中心的应急能力(截至2005年12月31日),并用描述性流行病学方法对其进行分析。结果共调查21个地市疾控中心和93个县区疾控中心。调查显示地市级和县区级应急人员中大专及以上学历分别占74.03%(670/905)和53.55%(1116/2084),76.19%的地市级和65.59%的县区级疾控中心有承担应急协调职能的部门,85.71%的地市级和73.12%的县区级疾控中心成立了应急专家组;100.00%的地市级疾控中心和78.49%的县区级疾控中心制定了应急预案;县级以上医疗机构和乡镇卫生院的网络直报率分别达到98.08%和92.21%;接报事件后,88.65%的疾控中心能在6h内前往调查;地市级和县区级疾控中心平均能开展的病原微生物检测项目分别占卫生部《省、地、县级疾病预防控制中心实验室建设指导意见》规定必须开展的工作项目的51.22%(21/41)和24.32%(9/37);疾控中心对消毒剂和消杀药械的储备率普遍大于80%,对应急药品的储备率地市和县区疾控中心分别仅为19.05%和11.83%;85.71%的地市级和81.72%的县区级疾控中心在2005年开展了应急知识培训。结论广东省各级疾控中心应急框架体系已基本建立,但仍存在应急专业人员素质偏低、实验室检测能力不足、缺乏应急储备协调管理、以及地域间发展不均衡等问题。应树立长期建设理念,以"一案三制"为重点加强应急管理体系建设。

Objective To analyze response capacity for public health emergency of the municipal and county -level CDCs in Guangdong Province. Methods Two kinds of questionnaires specified to the municipal and county - level CDCs were designed, including eight groups of score factors ： basic status of personnel responding to emergency, emergency management mechanism, surveillance and early alert, investigation and disposal in the fields, laboratory test, emergency material stockpile, staff training and drilling, public propaganda and information issuance. Response capacities as of December 31,2005 in all municipal and county - level CDCs of Guangdong Province were surveyed in 2006 and descriptive statistical analysis was conducted. Results A total of twenty - one municipal - level CDCs and ninety - three county level CDCs were surveyed. It demonstrated that personnel responding to emergency in all municipal and county -level CDCs with junior college or undergraduate course qualification were 74.03% （670/905）and 53.55% （1 116/2 084）, respectively. Departments for emergency coordination were set up in 76.19% municipal - level CDCs and 65.59% county - level CDCs, respectively. Emergency expert groups were set up in 85.71% municipal - level CDCs and 73. 12% county - level CDCs. 100. 00% municipal - level CDCs and 78.49% county - level CDCs developed contingency plan. Direct network reporting rates were 98.08% and 92.21% in medical institutions above county level and township hospitals, respectively. 88.65% CDCs could go to investigate the event within six hours after receiving the report. Detection items for pathogens that could be carried out in municipal - level CDCs and county - level CDCs accounted for 51.22% （21/41） and 24.32% （9/37） of the total items requested by ministry of health＇ s guidance for laboratory building in province, municipal and county - level CDCs. Reserve rates for disinfectants and equipments were generally above 80% in CDCs. Emergency drug reserve rates were 19.05% and 11.83% in municipal - level and county - level CDCs, respectively. 85.71% municipal - level CDCs and 81.72% county -level CDCs implemented emergency knowledge training in 2005. Conclusion The framework of emergency system had been basically established in CDCs at all levels of Guangdong Province. Problems such as low quality for personnel responding to emergency, insufficient detection capacity in laboratories and lack of coordination management for emergency reservation still exit now.