新疆喀什地区传染病社区监测与预警系统及公众认知水平快速评估结果

The Rapid Evaluation Results of Community Monitoring and Early-warning System for Infectious Diseases as well as the Level of Perceiving of the Public in Kashgar Region of Xinjiang

目的评估新疆喀什地区传染病社区监测与预警系统及公众传染病认知水平在传染病早期识别、及时上报及应对等方面的能力。方法采用收集现有资料、组织对机构人员进行的个人访谈、以及对学生与居民的专题小组访谈,同时结合现场观察等快速评估方法收集信息,进行定性分析和评估。结果在县乡级卫生系统内已建立了初步的疫情监测与报告系统,针对禽流感等突发疫情,已建立了良好的部门配合、信息沟通与应急机制。社区水平传染病早期识别、及时报告与应对能力较低,表现在乡卫生院医生缺乏对禽流感流行的足够警觉及对诊断标准的了解,缺乏在现有临床及流行病史资料基础上对疾病做出快速诊断与处理的技能。学校缺乏传染病识别、监测与报告机制,当地公众对禽流感等传染病的认知水平非常低,自我保健与发现症状早期求医行为能力不足,公众宣传教育特别是学校健康教育非常薄弱等。结论喀什卫生系统传染病监测与报告系统应该能够至少在县级水平,及时有效应对可能的禽流感及突发疫情发生与蔓延。但由于社区水平传染病监测与应对能力较低,仍存在不能早期识别和报告的可疑的人类禽流感病例及其他传染病的危险,今后要加强农村社区“传染病的社区监测与预警”系统的建设。

Objective The study aimed to evaluate the ability of community monitoring and early-warning system for infectious diseases and the level of perceiving of the public in Kashgar Region of Xinjiang for early recognition of the infectious disease, as well as timely reporting and handling. Methods The qualitative analysis and evaluation were carded out by collecting existing information, organizing personal interviews with members of the institutes and interviews with the special groups of students and residents, together with obtaining information through rapid evaluation, such as on-site observation etc. Results Preliminary monitoring and reporting system for the epidemic situation has been established for the healthcare systems at levels of county and village. Favorable department collaboration, information communication and emergency system have been established for dealing with sudden epidemic situations, such as avian influenza. The capability for early recognition, timely reporting and handling of infectious diseases was low relatively at the community level, which was characterized by the follows： doctors in the village health center were lacking in enough alert to avian influenza epidemic and in understanding of the diagnostic criteria, as well as in the skill of making rapid diagnosis and handling to the diseases according to the existing clinical and epidemic historical data; the schools lacked the mechanism of recognition,monitoring and reporting for the infectious diseases; the level of perceiving of the local public to the infectious diseases, such as avian influenza, was very low, and their ability for self-care and seeing the doctor at early stage according to the symptoms was insufficient; the public propaganda and education, especially the school health education, was rather limited. Conclusion The monitoring and reporting system of infectious diseases in health care system of Kashgar should be able to handle the possible outbreak and spread of avian influenza and sudden epidemic situation timely and effectively at least at the county level. Yet, because the monitoring and handling ability of infectious diseases was low at the community level, the risk of failing to recognize and report suspected human cases of avian flu and other infectious diseases at early stage still exists. The construction of “community monitoring and early-warning system for infectious diseases” should be strengthened at the community levels of rural areas henceforth.