1994—2011年梅州市急性弛缓性麻痹病例流行病学分析及监测系统评价

Epidemiological analysis on acute flaccid paralysis cases and evaluation on surveillance system in Meizhou City from 1994-2011

目的分析梅州市急性弛缓性麻痹(AFP)病例流行病学特点,掌握流行规律,评价AFP监测系统。方法对梅州市1994—2011年AFP病例进行回顾性分析。结果 1994—2011年全市共报告AFP病例289例,0～14岁儿童平均报告发病率为1.26/10万;有明显的夏秋发病高峰,以6月份发病较多,占全年病例的15.6%;病例以低年龄为主,5岁以下占65.1%。289例病例中服苗3次以上者244例,占84.4%;服苗1、2次者占11.8%;未服苗及服苗不详者分别占3.8%和9.0%。监测系统的敏感性达标,完整性中个案调查表和随访有缺项,主要是临床症状和免疫史。及时性中大部分指标能达标,麻痹—就诊报告间隔1 d的只占28.7%。结论 AFP监测系统有待进一步完善,监测质量需要进一步提高,应加强对临床医生的培训,增强监测力度。

[Objective]To analyze the epidemiological characteristics of acute flaccid paralysis（AFP） cases in Meizhou City,understand the epidemic law,and evaluate the surveillance system.[Methods]The data of AFP cases in Meizhou City from 1994-2011 were analyzed retrospectively.[Results]During 1994-2011,a total of 289 AFP cases were reported in Meizhou City.The average reported incidence of children aged 0-14 years old was 1.26/lakh.There was an obvious summer/autumn peak,and 15.6% of cases occurred in June.Most of patients were young children,and patients under 5 years old accounted for 65.1%.Among 289 cases,244（84.4%） cases had been vaccinated more than three times,11.8% had been vaccinated once or twice,3.8% were unvaccinated,and 9.0% had dubious immunization history.The sensitivity of surveillance system met the standard.In integrity,there were missing data in case questionnaires and follow-up,which were mainly clinical symptoms and immunization history.In timeliness,most of indexes reached the standard,and only 28.7% reported the case more than 24 hours after paralysis onset.[Conclusion]AFP surveillance system should be further perfected,and the surveillance quality should be further improved.It is important to strengthen the training among doctors and enhance the surveillance.