急性弛缓性麻痹病例中“高危”临床符合病例聚集性分析

Cluster Analysis for High Risk Compatible AFP Cases

中国１９９６年开始使用急性弛缓性麻痹（ＡＦＰ）病例病毒学分类标准，部分未采集到合格粪便标本的ＡＦＰ病例将被分类为临床符合病例。本文试图提供一种方法，对未采集到合格粪便标本的ＡＦＰ病例进行分析，以发现可能潜在的脊髓灰质炎（脊灰）病例，并识别相应的高危地区。全国ＡＦＰ病例监测系统１９９７年共报告ＡＦＰ病例４７７５例（临时数据），根据“高危”病例选择标准，从中选出了５９例“高危”临床符合病例，并通过做标点地图在贵州、云南、重庆、广西４个省（自治区、直辖市）发现了５组呈聚集性分布的“高危”临床符合病例，包括病例调查、病例主动搜索、脊灰疫苗接种率调查、粪便标本采集评价在内的后续现场调查工作正在进行之中。这样的分析和调查，以及根据调查结果采取的相应改进措施。

In 1996, a virological classification of acute flaccid paralysis (AFP) cases was adopted in China to confirm poliomyelitis cases.For AFP cases with inadequate stool samples the question remains how to identify poliomyelitis.This paper attempts to provide a method to analyze the AFP cases without adequate stool specimens to identify potential poliomyelitis cases and to distinguish high risk areas.4775 AFP cases were reported in China in 1997.59 high risk compatible AFP cases were identified from the 1997 national AFP surveillance data and 5 clusters were found using dot maps in 4 provinces.A field investigation,including case-patient examination,oral poliomyelitis vaccine (OPV) coverage survey,stool specimen collection and handling assessment,active search for unreported AFP cases,and AFP surveillance evaluation is conducted in each of the affected counties.Programmatic strategies will be implemented to improve vaccination rate,stool sample collection and AFP surveillance.The results of the cluster analysis and field investigation should be repored in the National Documentation for the absence of wild polio virus in China.