1996-2005年宝鸡市急性弛缓性麻痹病例监测分析

Surveillance analysis on the cases of acute flaccid paralysis in the City of Baoji from 1996 to 2005

目的为了提高监测工作质量,继续维持无脊灰状态。方法对1996-2005年宝鸡市监测急性弛缓性麻痹(AFP)病例进行流行病学和监测系统质量分析。结果10年共报告AFP病例162例,男、女性别比1.53∶1;5岁以下占53.1%;各月均有病例发生;143例AFP病例的标本中,分离出脊髓灰质炎(脊灰)病毒(PV)阳性3例,为疫苗株,1例(PVⅠ+Ⅲ型)诊断为疫苗相关病例(VAPP),其余均为排除脊灰病例;<15岁儿童非脊灰AFP病例年平均报告发病率为1.5/10万,48h内调查率96.3%,合格采样率84.6%,粪便标本7d内送达省疾病预防控制中心脊灰实验室率85.3%,随访及时率80.9%,"零"病例报告及时率84.7%,主动监测及时率92.0%。结论1996-2005年宝鸡市AFP监测系统各项指标逐步提高,达到并维持无脊灰状态。但提高合格标本采集率,落实主动监测,是进一步提高AFP监测质量的重点。

Objective The present study was conducted to gain insight into the quality of surveillance on acute flaccid paralysis and provide information for the maintenance of the polio-free. Methods Analysis was made on the epidemiological characteristics of the acute flaccid paralysis （AFP） cases and the quality of the surveillance system in the City of Baoji from 1996 to 2005. Results A total of 162 cases of AFP was reported in the 10 years with 53.1% of them being children under 5 years of age. Every month in the 10 years could see new AFP cases. Polio viruses （PV）, which were vaccine strains, were isolated in 3 of the 143 AFP specimens with one case （PV Ⅰ ＋Ⅲ type） diagnosed as vaccine-associated paralytic poliomyelitis. Poliomyelitis was rule out in the remaining. The annual average incidence of non-polio AFP among children under 15 years of age was 1.5/lakh. The rate of investigation within 48 hours was 96.3 %, with the rate of satisfactory sampling, the rate of stool samples being sent to the polio lab of the provincial CDC within 7days, the rate of timely follow-ups, the timeliness rate of ＂zero＂ case reporting and the timeliness rate of active surveillance being 96.3%, 84.6%, 85.3%, 80.9%, 84.7%, and 92.0%, respectively. Conclusion The indice of AFP surveillance system from 1996 to 2005 are being improved gradually, and have been reached and kept poliomyelitis free. Active surveillance is the key to further improvement of the quality of AFP surveillanec.