辽宁省扩大国家免疫规划实施前后风疹流行病学特征变化趋势分析

Change trend of epidemiological characteristics of rubella before and after implementation of Expanded Program on Immunization in Liaoning Province,China

目的分析辽宁省扩大国家免疫规划实施前后风疹流行病学特征变化趋势,评价含风疹成分疫苗(rubellacontaining vaccine,RCV)纳入国家免疫规划实施效果。方法采用描述流行病学和分析流行病学方法,应用Excel表格软件和统计分析软件SPSS 23对扩大国家免疫规划实施前(2005～2010年)、后(2011～2016年)辽宁省风疹流行病学特征进行分析比较。结果扩大国家免疫规划实施前辽宁省风疹年平均发病率为15. 24/10万,实施后的发病率(5. 88/10万)明显下降(P <0. 05)。扩大国家免疫规划实施前后4～6月病例数比例分别为75. 29%(29 418/39 074)和68. 39%(10 576/15465),两者差异有统计学意义(P <0. 001)。扩大国家免疫规划实施前后辽宁省14个地级市每年均有风疹病例报告,主要集中在辽宁省中部地区,4～6月份为高发月。扩大国家免疫规划实施前后风疹病例男女及学生所占比例差异均有统计学意义(P <0. 001),发病年龄中位数分别为18. 12和17. 83岁。结论扩大国家免疫规划实施后,辽宁省风疹年平均发病率明显下降,但未打破风疹固有流行规律,发病年龄未出现明显后移,未增加先天性风疹综合征(congenital rubella syndrome,CRS)发生的风险,扩大国家免疫规划成果显著。

Objective To analyze the change trend of epidemiological characteristics of rubella before and after implementation of the Expanded Program on Immunization(EPI)in Liaoning Province,China,and evaluate the effect of incorporation of rubella-containing vaccines(RCVs) into the EPI.Methods Descriptive epidemiology and analytical epidemiology were used to analyze and compare the epidemiological characteristics of rubella in Liaoning Province before(2005 ~ 2010)and after(2011 ~ 2016)the implementation of EPI with Excel and SPSS 23 software.Results The average annual incidence of rubella in Liaoning Province was 15.24/100 000 before implementation of EPI,while decreased to 5.88/100 000 after implementation(P< 0.05).The proportion of cases appearing from April to June before and after implementation of EPI were 75.29%(29 418/39 074)and 68.39%(10 576/15 465)respectively,which showed significant difference(P< 0.001),and the median age of onset were 18.12 and 17.83 years respectively.Conclusion After the implementation of EPI,the average annual incidence of rubella in Liaoning Province decreased significantly,but did not break the inherent regularity of rubella epidemic.The age of onset showed no significant backward shift,while the risk of congenital rubella syndrome(CRS) showed no increase,indicating the remarkable achievement of EPI.