2016年莱芜市麻疹传播影响因素及控制措施分析

Factors and control measures of measles in Laiwu City

目的麻疹是儿童最常见的急性呼吸道传染病,具有传染性,易发生流行。本研究探讨麻疹传播的可能影响因素,评价其防控措施。方法选取莱芜市(现济南市莱芜区和钢城区)2016年全年麻疹病例,对病例的可疑暴露史、免疫状况、疫苗未种原因、并发症、发病年龄和发病报告时间间隔等内容进行个案调查,用χ^(2)检验及秩和检验进行统计分析。结果不同出生年代人群麻疹发病水平不同,出生于1970、1980及2010年代是主要的发病人群,共占发病总数的75.91%。303例麻疹患者中,未接种含麻疹成分疫苗者占89.11%;免疫状况与病后严重并发症差异有统计学意义,χ^(2)=4.66,P=0.03;发病距离接种疫苗的时间间隔可以反映疫苗接种后的保护效果,χ^(2)=18.42,P<0.01;麻疹病例发病前7~21d医疗机构就诊率为49.17%;病例发热距就诊时间间隔为5.66d。结论含麻疹成分疫苗的及时接种可以减少麻疹病例,降低麻疹严重并发症;院感控制对麻疹防控意义重大。

Objective Measles was the most common acute respiratory infectious disease in children.It had the characteristics of rapid transmission and easy spread.This study was to investigate and analyze the influence factors on spread of measles cases,evaluation the current effect factors of prevention and control measures,to discuss the measures of measles control.Methods Measles cases in Laiwu City in 2016 were selected,and the suspicious exposure history,immune status,reasons for non vaccination,complications,age of onset and reporting time interval were investigated.χ^(2)test and rank sum test were used for statistical analysis.Results The incidence of measles was different among people in different birth ages.Born in the 1970 s,1980 sand 2010 swere the main incidence groups,accounting for 75.91%of the total incidence.Among the 303 measles patients,89.11%were not vaccinated with measles component vaccine.There was statistically significant difference between the immune status and serious complications after the disease(χ^(2)=4.66,P=0.03).The time interval between the onset and vaccination could reflect the protective effect after vaccination(χ^(2)=18.42,P<0.01).The rate of visits to medical institutions 7 to 21 days before the onset of measles was 49.17%.The interval between fever and treatment was 5.66 days.Conclusion Timely measles vaccination can reduce measles cases and reduce measles serious complications;The control of hospital infection is significant to measles control.