西安市周至县2001—2009年麻疹流行趋势和流行特征分析

Analysis on Epidemic Trend and Features of Measles in Zhouzhi County of Xi'an City during 2001 -2009

目的了解西安市周至县2001—2009年麻疹流行趋势和特征。方法疫情资料来自法定传染病网络报告系统和麻疹监测系统,采用ELISA捕捉法检测麻疹IgM抗体,诊断依据《西安市麻疹监测方案》。数据采用Excel 2003、SPSS1 2.0软件处理。结果周至县9年间发病135例,无死亡病例,平均发病率2.36/10万,发病趋势呈现明显周期性,高峰期分别为2001、2005和2009年,最高发病率2009年为9.66/10万,其余年份在0.32/10万～0.64/10万间,周期间隔3a(P<0.05);<8月龄发病24例(17.78%),8月龄～3岁发病最多为61例(45.19%),<15岁发病115例(85.19%),不同年度年龄别发病差异有统计学意义(χ2=91.0350,P<0.01)。男女发病比为2.0∶1;发病以夏季为主(90例,占66.67%),其次为春季(34例,占25.19%)和秋、冬季,不同年度季节分布差异有统计学意义(χ2=35.2620,P<0.01)。全县22乡镇均有发病,发病例数平原区域最多(80例,占59.26%),其次为县城区(50例,占37.04%)和山岭区(5例,占3.70%);而发病率最高为县城区域,其次为山岭区和平原区,χ2检验差异无统计学意义。病例无免疫史、免疫史不详者分别为75和7例,占55.56%和5.19%,全免疫者32例,占23.70%,不同年度免疫史发病率差异有统计学意义(χ2=35.2620,P<0.01)。结论控制和消除麻疹重点是提高麻疹疫苗的接种率和免疫成功率。

[Objective]To understand the epidemic trend and features of measles in Zhouzhi County of Xi＇an City during 2001 - 2009. [ Methods] Epidemic data were collected from Notiflable Diseases Reporting System Network and Measles Surveillance System. Capture ELISA method was adopted to detect measles IgM antibody. The diagnosis was based on ＂ Xihn Measles surveillance Pro- gram＂. The data were analyzed by Excel 2003 and SPSS 12.0. [ Results] A total of 135 cases of measles were reported in Zhouzhi County in 9 years, without death case. The average incidence was 2.36/100 000, and the incidence trend showed significant periodicity. The peak incidence appeared in 2001,2005 and 2009. The highest incidence rate was 9.66/100 000 in 2009, and the incidence fluctuated from 0.32/100 000 to 0.64/100 000 in other years, with cycle interval of 3 years （ P 〈 0. 05 ）. 24 cases （ 17.78% ） were infants 〈8 months; 61 （45.19% ）were children aged 8 months to 3 years; 115 with age 〈 15 years; the difference of age structure between different years was significant （ X^2 = 91. 0350, P 〈 0.01 ）. The ratio of male to female incidence was 2.0：1.90 cases （ 66.67% ） occurred in summer, followed by spring with 34 eases （ 25.19% ） , autumn and winter; the differences between seasons were significant（ X^2 = 35. 2620 ,P 〈 0.01）. All 22 villages and towns had reported measles cases, most eases （80 cases, accounting for 59.26% ） distributed in plain areas, followed by county areas （50 cases, accounting for 37.04% ） and mountainous areas （ 5 cases, accounting for 3.70% ） ; the highest incidence appeared in county areas, followed by mountainous areas and plain areas, the differences were not significant by X^2 test. 75 cases （ 55.56% ） had no history of measles immunization, 7 cases （5.19%） had unknown inoculation history, 32 eases （23.70%） had full course of immunization. The differences of immunization history and incidence between years were significant （ X^2 = 35. 2620,P 〈 0.01）. [ Conclusion] The key to control and elimination of measles is increasing measles immunization rate and successful vaccination rate.