探讨低流行区麻风病疫情监测的策略

Discussion on Tactics of Epidemic Surveillance in Low Leprosy Prevalence Areas.

放松低流行区疫情监测工作 ,麻风病极有可能卷土重来。文章探讨了在麻风病低流行区 ,特别是麻风病处于基本消灭后的地区应采取尽可能利用现有卫生资源、注重成本一效益、主要以被动方式早期发现病人的基本策略。阐述了疫情监测工作要充分利用防病体制改革带来的资源优势 ;基础工作应从专业机构转移到综合性医院 ;注重培训方法 ,提高综合性医院医生参与防病的意识与责任感 ;主动检查家庭内接触者 ;采取被动监测复发的策略并强调消除疫情监测中基本消灭不等于完全控制、L EC不能取代疫情监测以及基层防保人员不再是疫情监测的主力军的认识上的几个误区。

If the work of epidemic surveillance was loosened, the leprosy prevalence would increase again. This paper discusses some basic tactics that are using all available resources, focusing on cost-benefit and earlier finding cares with passive methods in low leprosy prevalence areas, especially in areas where leprosy has been eliminated basically. Some more details are as follows: (1) the epidemic surveillance should make full use of advantage of recourses brought by reform of prevention system; (2) the basic work should be transferred from special organization to general hospital; (3) paying attention to training method to improve doctors' awareness of participation and responsibility in general hospitals; (4) actively surveying family members who are familiarly contact with patients; and (5) monitoring cured cased to prevent relapse with passive way. The author also points out some misunderstandings that are basic elimination does not mean complete control, the epidemic surveillance can't be replaced by the leprosy elimination campaign (LEC) and primary health care and prevention staff is no longer to be the main force of epidemic surveillance.