江苏省AFP病例残留麻痹相关因素分析

Correlative risk factors of residual paralysis among acute flaccid paralysis cases in Jiangsu province

目的分析江苏省186例急性弛缓性麻痹（AFP）病例残留麻痹的流行特征及其相关影响因素,寻找早期预防措施。方法对2004-2009年江苏省残留麻痹的AFP病例的186例流行特征进行描述流行病学分析,对相关影响因素进行单因素和多因素非条件Logistic回归分析。结果江苏省2004-2009年AFP病例残留麻痹率为12.02%,2007-2009年残留麻痹率较2004-2006年下降50.46%;宿迁县和徐州市AFP残留麻痹率高于全省平均水平;186例残留麻痹AFP病例中,男性多于女性,每年4-7月发病数较多,65.59%的病例集中在0~4岁儿童;多因素非条件Logistic回归分析显示,年龄、性别、免疫史、粪便标本实验室结果、初始麻痹程度、粪便标本质量和AFP报告单位级别等与AFP病例残留麻痹的发生有关联。结论将乡镇卫生机构纳入AFP主动监测医院范围,提高监测系统敏感性、脊灰疫苗接种率和儿童就诊及时率,是降低AFP病例残留麻痹率的有效措施。

Objective To analyze epidemiological characteristics and correlative risk factors of sequela of paralysis in 186 acute flaccid paralysis（AFP） cases and to explore relevant prevention and treatment measures. Methods Description epidemiological method was used to analyze the epidemiological characteristics of AFP cases with residual paralysis during 2004 -2009. The correlative risk factors of sequela of paralysis were analyzed with univariate and multivariate non-conditional logistic regression. Results During the period the prevalence of sequela of paralysis in the AFP cases was 12. 02%, and the prevalence in 2007 -2009 decreased by 50.46% compared to that during 2004 -2006. The prevalence of residual paralysis in Suqian and Xuzhou cities were higher than that of in Jiangsu province. In the 186 AFP cases,the male had a higher prevalence of residual paralysis than the female. The most of the residual paralysis cases occured between April and July and 65.59% of the residual paralysis cases were the children aged 0 - 4 years. The results of multivariate non- conditional logistic regression analyses showed that residual paralysis of AFP cases were associated with age, gender, history of immunization,laboratory result of stool specimen, initial paralytic degree, quality of stool specimen, and different grades of hospitals. Conclusion To reduce the incidence of residual paralysis in AFP cases, the township health institutions shouuld be bought into active monitoring system for high quality of AFP surveillance and a high immunization coverage rate and timely treatment of AFP cases should be promoted.