浙江省社区人群狂犬病暴露与就诊特征分析

Analysis on characteristics of rabies exposure and post exposure treatment of community people in Zhejiang province

目的了解浙江省社区人群狂犬病暴露和暴露后处置情况,分析暴露人群的就诊特征。方法利用整群分层抽样方法,在慈溪、临海、桐庐和江山4个县(市)各随机抽取2个镇(街道),每个镇(街道)再随机抽取2个村(居),入户调查所有居民。采用Ep iData 3.0软件建立数据库,SPSS 16.0软件分析。结果社区人群狂犬病年暴露率为1.59%(122/7674),其中有87.70%(107/122)就诊,伤口处理率为94.26%(115/122),疫苗全程接种率为85.25%(104/122),以7月暴露率最高。未接种疫苗者认为没必要接种的占72.22%(13/18),因经济困难未接种的占27.78%(5/18)。Ⅲ级暴露者有33.33%(14/42)使用抗血清或狂犬病免疫球蛋白。结论浙江省不同地区狂犬病暴露率不同,有部分暴露者未及时进行伤口处理和疫苗接种,应针对暴露的危险因素和未就诊原因采取相关措施进一步预防控制狂犬病。

Objective To analyze the characteristics of rabies exposure and post exposure treatment of the people in community in Zhejiang and provide scientific evidence for rabies control and prevention.Methods By stratified clustering sampling,2 townships（streets） were selected randomly in each of 4 counties（Cixi,Linhai,Tonglu and Jiangshan）,and 2 villages were selected randomly in each townships（streets） to conduct household survey.The database was established by using EpiData 3.0 and analyzed by using SPSS 16.0.Results The annual average exposure rate was 1.59%（122/7674）.Among 122 people exposed,107（87.70%） sought medical care,115（94.26%） received timely wound treatment and 104（85.25%） were fully vaccinated.The exposure rate in July was highest.Among the 18 people receiving no vaccination,13（72.22%） thought it was unnecessary,5（27.78%） could not afford for the vaccination.Among 42 people with III degree exposure,14（33.33 %） received antiserum or immunoglobulin injection.Conclusion The rabies exposure rate varied by areas in Zhejiang province,and some people exposed didn＇t received timely wound treatment and vaccination.It is necessary to take corresponding measures to prevent and control rabies according to risk factors of exposure and reasons for no medical care seeking.