深圳市2001～2005年新生儿破伤风流行病学分析及干预措施

Epidemiological analysis on neonatal tetanus in Shenzhen in 2001-2005

目的:了解深圳市新生儿破伤风的流行病学特征,为控制和消除新生儿破伤风提供科学依据。方法:用描述流行病学方法,对2001～2005年深圳市妇幼信息系统监测的资料进行统计学分析。结果:深圳市2001～2005年新生儿破伤风的发病率在0.42‰～2.07‰之间,死亡率在0.03‰～0.36‰之间,两率均呈明显的下降趋势,2001年全市6区中有5个区报告新生儿破伤风,2005年仅有3个区报告新生儿破伤风,2001年新生儿破伤风发生率>1‰的有宝安区、龙岗区,2005年新生儿破伤风发生率>1‰的区数已下降为零。宝安区和龙岗区合计占全市总例数的88.35%。流动人口新生儿破伤风发病率高于户籍加暂住人口新生儿破伤风发病率。352例新生儿破伤风均为院外分娩,新生儿破伤风的母亲均未接种破伤风类毒素。结论:新生儿破伤风多发生于流动人口中。不安全接生是新生儿破伤风发病的主要原因。采取综合干预措施可以控制新生儿破伤风的发病,提倡和推广住院分娩,是目前消除新生儿破伤风的主要措施。

Objective： To understand the epidemiological characteristics of neonatal tetanus in Shenzhen and then to provide back-ground information for the formulation of strategies to control and eradicate the disease. Methods： Descriptive study was used to statistically analyze the data collected from Shenzhen maternity ＆ child message system. Results： Statistics showed that the morbidity of NT fluctuated between 2.07‰-0. 42‰, mortality between 0.36‰-0.03‰, exhibiting a general tendency of decreasing. 5 of 6 districts reported NT in 2001. There were only 3 districts reporting NT in 2005. There were 2 districts （Baoan and Longang district） where the incidence of NT was 〉 1‰ in 2001, but There were not district where the incidence of NT was 〉 1‰ in 2005. Of all cases, Baoan and Longang district accounted for 88.35%. The incidence of NT in floating population was higher than the total of that in permanent and lodge population. All cases were not delivered in hospital. All mothers had no definite inoculation history of tetanus toxoid. Conclusion： There is higher incidence in floating population. Unsafe delivery is principal factor leading to NT onset. Promoting hospital delivery is now the main measure eliminating NT. Taking synthetic measures can control NT.