2008-2011年广东省中山市传染病自动预警系统效果评价

Evaluation on performance of communicable disease automatic early warning system in Zhongshan,Guangdong,2008-2011

目的对广东省中山市传染病自动预警系统(CIDARS)暴发预警效果进行评价,为完善和优化预警系统提供参考依据。方法收集整理中山市2008年4月21日至2011年12月31日移动百分位数法、累计和控制图法预警的数据,以及同期突发公共卫生事件相关信息,对CIDARS预警及时性、灵敏度和特异度进行回顾性评价。结果 CIDARS发出预警信号3543条,信号响应率为100%;经初步核实,13条预警信号被判定为疑似事件,预警信号阳性率为0.37%。其中,高发传染病预警时间(发生暴发到首次发出预警信号的平均时间)为1 d,灵敏度为83.33%,特异度为74.20%;低发传染病预警时间为0 d,灵敏度为100.00%,特异度为96.32%;新纳入法定报告传染病手足口病预警时间为0 d,灵敏度为100%,特异度为76.18%。结论预警系统对于低发传染病的暴发预警及时性、灵敏度和特异度均优于高发传染病,对于低发传染病预警特异度优于新纳入法定报告传染病;预警系统已初步实现传染病暴发的早期探测预警,但仍需进一步完善,设置合理的预警阈值,减少错误预警信号。

Objective To evaluate the performance of communicable disease automatic early warning system in Zhongshan, Guangdong province and provide scientific evidence for the improvement of the system. Methods The analysis was conducted on the early warning data generated by moving percentile method and sum and control method and the incidence data of public health emergency from 21 April 2008 to 31 December 2011 in Zhongshan to evaluate the timeliness, sensitivity and specificity of the early warning. Results Totally 3543 signals were generated by the system. The response rate of the signals was 100%. After preliminary verification, 13 signals were considered to be suspected （0.37%）. The average interval between early warning and outbreak, sensitivity and specificity for the communicable diseases with high incidences were 1 day, 83.33% and 74.20% , the relevant indicators for the communicable disease with low incidences were 0 day, 100% and 96.32%. The early warning-outbreak interval, sensitivity and specificity of the early warning for newly included hand foot and month disease was 0 day, 100% and 76. 18%. Conclusion The timeliness, sensitivity and specificity of the early warning by the system for communicable diseases with low incidences were better than those with high incidences, the specificity of the early warning for the communicable diseases with low incidences was better than that for newly included notifiable communicable disease. The early warning of communicable disease epidemic by this system has been achieved basically, but further improvement is still needed by setting reasonable threshold to reduce false early warning.