福州市2005～2010年急性弛缓性麻痹病例监测分析

Epidemiological analysis on acute flaccid paralysis cases and surveillance system evaluation in Fuzhou city from 2005 to 2010

目的分析福州市急性弛缓性麻痹（AFP）病例流行病学特征,评价AFP监测系统。方法用描述流行病学方法分析全市AFP病例监测系统上报的个案调查表和病毒检测结果,按照国家监测指标评价间隙系统的敏感性。结果福州市2005~2010年共报告AFP病例125例,15岁以下儿童AFP平均报告发病率为1.53/10万;福州市所辖13个县（市、区）均有病例报告,乡镇卫生单位的报告病例仅占4%;病例以低年龄组为主,5岁以下占68.8%;125例病例中未服苗者和免疫史不详着占4.8%;AFP报告发病率、病例调查、75d随访、粪便及时送检等指标均达到国家规定要求,合格粪便采集率仅2008年未达到国家要求;病毒分离6株为疫苗相关株（Ⅰ型1例,Ⅱ型2例、Ⅱ＋Ⅲ型3例）。结论福州市监测质量需进一步提高,加强医疗机构,特别是乡镇医疗机构AFP监测培训,提高乡镇级AFP病例报告率。

Objective To understand the epidemiological characteristics of acute flaccid paralysis（AFP）and evaluate the surveillance system.Methods The AFP cases reported by AFP surveillance system of Fuzhou City and the result of poliovirus survelliance were analyzed.Results 125 local AFP child cases under 15 years old were reported in Fuzhou from 2005 to 2010.The annual average incidence of AFP was 1.53/100 000.All the cases were distributed in 13 counties and cases reported from health units below levels of village and town occupied only 4%.The cases occurred mainly in chirdren below 5 years old,accounted for 68.8%.4.8% of the cases were either unvaccinated or unclear.The morbidity of children in age group of 0～14 years,survey of cases,feces sampling（except 2008）test,follow-up of 75 days after cure of disease,etc.met relevant requirements of national regulations.6PV positive cases were vaccine-related strains.（50% belonged to typeⅠandⅡ,the rest belonged to typeⅡ＋Ⅲ）.Conclusion The surveillance system needs further improveed and the AFP case report rate at township level should be strengthened.