海南省新生儿破伤风监测系统的建立及运行效果分析

Evaluation on the establishment and operation on neonatal tetanus surveillance program in Hainan Province

目的 掌握新生儿破伤风（ Ｎ Ｎ Ｔ） 实际发病水平及发病因素，以便为制定消除策略提供依据，海南省于１９９７ 年开展了 Ｎ Ｎ Ｔ 监测工作。方法 监测运用急性弛缓性麻痹（ Ａ Ｆ Ｐ） 监测方法，并与之同时运行。结果 全年共监测病例２１６ 例，远高于疫情报告７８ 例。监测结果表明：在家分娩、旧法接生是发病主因。病儿母亲８８ ．８９ ％ 无破伤风类毒素（ Ｔ Ｔ） 免疫史。三亚市、琼中县的监测资料表明，由于育龄妇女 Ｔ Ｔ 免疫率提高， Ｎ Ｎ Ｔ 发病率较１９９６ 年分别下降６１ ．２９ ％ 、８２ ．０５ ％ 。结论 提高育龄妇女 Ｔ Ｔ 接种率是实现消除 Ｎ Ｎ Ｔ 最经济简便的措施，将 Ｎ Ｎ Ｔ 监测工作纳入 Ａ Ｆ Ｐ监测系统同时运行是行之有效的。

Objective In order to learn the actual morbidity and influencing factors of neonatal tetanus(NNT) and to provide scientific basis for NNT elimination. Methods A surveillance program was set up in 1997 in Hainan Province and to operate at the same time. Results 216 NNT cases were investigated in 1997. The number was higher than reported 78 cases. The result from surveillance showed that parturition at home and the old delivering method were the main influencing factors. 88.89 % of mothers of NNT cases had no TT immunization history. The surveillance data of Sanya City and Qiongzhong County indicated the NNT morbidity in 1997 had declined 61.29%, 82.05% than that in 1996 respectively due to the improvement of TT immunization rate. Conclusion The study result proved that the most economical and effective measure to eliminate NNT is to increase TT immunization rate of women at child-bearing-age. It was practical to integrate the NNT surveillance program into AFP surveillance system and operate along with it.