河北省正定县农村地区细菌性痢疾发病率分析

Analysis on incidence of shigellosis in rural area of Zhengding county in Hebei province

目的了解河北省正定县农村地区细菌性痢疾的疾病负担。方法于2002年对河北农村地区进行了以人群和医疗机构为基础的细菌性痢疾发病率监测。对同意参与研究的腹泻病例采集大便标本,分离、鉴定志贺菌并确诊菌痢病例。计算年龄别菌痢发病率。并对确诊菌痢病例进行90 d随访,监测菌痢相关的后遗症。结果全年共调查10105例腹泻病例,人群腹泻率为133/千人年。其中,0岁组腹泻率最高为1 388/千人年;其次为5岁以下儿童,发病率为618/千人年。共确诊菌痢331例。3岁组儿童发病率最高,为32/千人年,其次为60岁以上老年人,为7/千人年。发热及脓血便为菌痢的重要临床特征。未发现与菌痢相关的后遗症与死亡。菌痢的发病率与月平均气温及月平均降雨量密切相关。结论细菌性痢疾在正定县农村地区所导致的疾病负担巨大,远远高于传染病报告的发病率。应考虑针对5岁以下儿童及60岁以上老年人实施疫苗免疫,以控制该地区志贺菌感染与流行。

Objective To study the burden of shigdlosis in Zhengding, Hebei province. Methods In 2002, a population and treatment center-based surveillance targeted to treate diarrhea was conducted in Zhengding, Stool sample was collected from each consented diarrhea cases for Shigetta. spp isolatiou. The incidence rates were calculated by age groups. To detect potential sequelae related to Shtgella infection, the confirmed shigeUosis eases were followed-up in 90 days after presentation. Results In 2002, the incidence of diarrhea in catchment area was 133/1 000/year. The highest incidence mte（l 388/1 000/year）was found in infants; the incidence was 618/1 000/year in children under 5 years of age. Shigella, slap was isolated from 331 diarrhea patients. The incidence rote was 4.4/1 000/year. The highest incidence rote was found in children of 3 to 4 years of age. Followed with incidence in people elder than 60 years of age, which was 7/1000/yearo Feve-r and bloody stool were the most important clinical characteristics of shigellosis, No Shigella infection related sequelae or death were found during study period. Significant relationships were found between incidence of shigedosis, average temperature and rainfall. Camelusion Compared with the noticeable infectious diseases report, tremendous disease burden of shigellosis was found in Zhengding. To control the epidemic of shigellosis, mass immunization targeted to children under 5 years old and people eider than 60 years old should be considered.