海南省1999～2003年新生儿破伤风病例流行病学分析

Epidemiological analysis of neonatal tetanus during 1999～2003 in Hainan Province.

目的了解海南省新生儿破伤风的发生原因和病例的流行学特征,为调整工作策略提供依据. 方法与急性弛缓性麻病例监测系统运行同时开展新生儿破伤风监测,按国标GB诊断病例,所有监测病例进行个案调查,所有资料数据录入计算机进行EPLlinfor软件统计分析. 结果 1999～2003年,海南新生儿破伤风监测系统报告病例共403例,其中发病主要集中在历年发病率≥1‰的陵水、东方、保亭、三亚、琼中、五指山、屯昌等少数民族地区.本地居民产妇在家不洁分娩,经未接受培训的人员接生是造成发病的主要原因,占89.8%,流动人口发病占18.36%.所有母亲几乎均未接种过破伤风类毒素(TT). 结论海南省经过开展消除新生儿破伤风项目,有效降低了发病率,但实现消除新生儿破伤风任务仍十分艰巨.因此,提倡住院分娩,加强产妇对生育知识的健康教育是消除新生儿破伤风最有效措施.

Objective To understand the reason of neonatal tetanus and epidemiological characteristics of cases and adjust the strtategy for control work at next stages. Methods The surveillance work of neonatal tetanus was earried simultaneously with running of acute flasccid paralysis （AFP） surveillance system. The cases were diagnosed the cases according to the national standards （GB）. All of the cases were investigated and the data were analyzed with software of EPIinfor. Results The neonatal tetanus cases were concentrated in areas inhabited by the minority nationadities. The morbidity was in the city/county of Changjiang, Lingshui, Dongfang, Baoting, Sanya, Qiongzhong, Wuzhishan and Tunchang. Most of the case were local inhabitants. 89.9% of the infection was due to unsanitary delivering of lying - in women at their own homes and the without training of the midwives. In Han nationality area many of the cases occurred in floating population, occupied 18.36%. All of the mothers of the cases had not inoculated with tetanus toxoids （TT）. Conclusion Although the incidence of neonatal tetanus has been reduced after implementation of neonatal tetanus elimination program in Hainan Province, it is still a hard task to eliminate neonatal tetanus in this province. The most effective measures for eliminating neonatal tetanus are advocating delivering in hospitals and conducting health education and spreading child - bearing knowledge among child- bearing women.