七种传染病控制图法预警技术研究

A study on early detection for seven infectious diseases

目的 为传染病预警系统提供预警方法和预警界值及提高传染病疫情监测的预警能力。方法 使用历史传染病报告数据建立预警数据库,采用控制图法建立预警模型,专家咨询法确定流行参照标准,通过计算、比较灵敏度、特异度、阳性预测值和绘制ROC曲线,选出合适的预警界值。结果 预警肾综合征出血热(出血热)、甲型肝炎(甲肝)、细菌性痢疾(痢疾)、流行性脑脊髓膜炎(流脑)、疟疾,选用P80作为预警界值预警功效较好,灵敏度和特异度均在90％以上;预警麻疹、肺结核,选用P90作为预警界值预警功效较好,灵敏度和特异度均在85％以上。结论控制图法可以作为该7种传染病预警方法,出血热、甲肝、痢疾、流脑、疟疾合适的预警界值为P80,麻疹、肺结核合适的预警界值为P90。

Objective To provide methods and alert thresholds which are scientific, sensitive, specific and practical for Early Warning System in Public Health Surveillance. Methods Alert data was based on historical infectious diseases reports. Control chart was used to detect outbreaks or epidemics. An epidemic was definited by consoulting Specialists. After calculating sensitivity, specificity,positive predictive value and describing receiver-operating characteristic curve(ROC), the optimal modei and thresholds were chosed. Results At 80 percentile, the sensitivities and the specificities of epidemic haemorragia fever, hepatitis A, dysentery, epidemic cerebrospinal meningitis and malaria were over 90% ,and there was a high efficacy of early warning. At 90 percentile, the sensitivities and the specificities of tuberculosis and measles were over 85% ,and there was a high efficacy of early warning also. Conclusion Control chart based on five years was chosed as a essential method in early warning system. The alert threshold for epidemic haemorragia fever, hepatitis A,dysentery,epidemic cerebrospinal meningitis and malaria was 80 percentile. The alert threshold for tuberculosis and measles was 90 percentile.