宁夏2004-2007年急性弛缓性麻痹监测系统运行状况的评价

Evaluation of AFP case surveillance system between 2004 and 2007 in Ningxia

目的掌握宁夏回族自治区急性弛缓性麻痹病例的流行病学特征,及时发现监测系统存在的问题,为提高监测质量提供依据。方法对2004-2007年全区报告的AFP病例的个案调查表、随访表进行统计分析。结果2004-2007年宁夏回族自治区共诊断AFP病例95例,<15岁儿童非脊灰AFP病例年报告发病率分别为1.58/10万、1.23/10万、1.77/10万、2.03/10万;五个市均有病例发生,发病以0-4岁小年龄组为主,占54.7%,男性高于女性;免疫史<3次的16例,占16.9%;95例均为脊灰排除病例,病例最终分类中,格林巴利综合征38例,占40.0%;95例AFP病例的粪便标本经自治区CDC脊灰实验室进行病毒培养,分离到非脊灰肠道病毒(NPEV)11株,NPEV分离率为11.6%;共分离脊灰病毒5株,分离率为5.3%,其中Ⅰ型1株,Ⅱ型1株,Ⅲ型3株,经国家脊灰实验室复核,均为脊灰疫苗株;除2004年吴忠市、2005年石嘴山市、2006年中卫市报告发病率、2004年双份粪便标本采集率未达到要求以外,其它指标均达到了国家的的标准。结论全区控制脊灰工作今后要继续加强OPV免疫接种工作,提高监测质量,特别是提高病例发现、报告的及时性和提高合格粪便标本的采集。

Objective To understand the epidemiologieal characters of acute flaccid paralysis （AFP） in Ningxia and to find the problem and improve the surveillance system. Methods The date of AFP cases which were reported by AFP surveillance system was analyzed by SPSS software between 2004 and 2007 in Ningxia. Results 95 AFP cases were reported from 2004 to 2007 in Ningxia, and the reported incidence of non - polio AFP cases was 1.58, 1.23, 1.77 and 2.33 every 100000 children under 15 years old. These AFP cases were distributed in 5 cities; the age of AFP cases was mainly 0 -4 years old （54.7%）, higher incidence in male than that that in female. Of all AFP cases, the immunization rate of OPV 〈 3 times was 16.9%. The 95 AFP cases were all discarded pilio cases. The rate of Guillain - Barre Syndrome （GBS） of these cases was 40.0%. All the AFP cases stool specimens was detected by the polio laboratory of Ningxia, the result showed that 11 （11.6% ） strains of non - poliomyelitis entervirus （NPEV） were isolated and 5 （5.3%） poliomyelitis entervirus （PV） were isolated, all the AFP surveillance indicators have already reached and kept above the target of the WHO＇s pilio- free certification standard except the reported incidence of non -polio AFP eases in Shizuishang, Wuzhong, Zhongwei, adequating stool specimen collection in 2004. Conclusion The province makes a significance achievement in control the poliomyelitis. We should enhanced OPV routine immunization, improve the surveillance systems, especially in find out the patients, report and rates of adequating stool specimen collection.