许昌市2009—2013年麻疹流行病学特征和监测系统运转状况分析

Analysis of epidemiological characteristics of measles and operating quality of the measle surveillance system in Xuchang from 2009 to 2013

目的分析许昌市2009—2013年麻疹流行特征和监测系统运转状况,为加速消除麻疹制定策略及措施提供科学依据。方法利用描述性流行病学方法对许昌市2009—2013年麻疹监测系统资料进行统计分析。结果许昌市2009—2013年累计报告麻疹病例675例,年均报告发病率为3.16/10万。全市8个县、市区均有病例报告,病例数主要集中在禹州市,占总病例数的55.56%;发病呈明显的季节性分布,主要集中在2—5月份,占总病例数的73.48%;病例主要集中于0～6岁儿童,占总病例数的85.63%,其中1岁以下婴幼儿占总病例数的50.22%;8月龄～14岁麻疹病例中有确切免疫史者仅占38.58%。随着监测系统及时性和特异性逐年提高,48 h完整调查率由2009年的88.32%上升至2012年的100%;血标本3 d内送达率由2009年的51.68%上升至2013年的100%;实验室结果 7 d内报告率由2009年的52.80%上升至2013年的100%;血标本采集率从2009年48.86%上升至2013年的100%;暴发血清学确诊率、病原学标本采集率均上升至100%。2009—2013年麻疹监测系统敏感性低,排除病例报告发病率为0.49/10万～1.43/10万。结论 2009—2013年许昌市麻疹发病率下降,小年龄组发病构成增加。监测系统运转综合质量逐年提升,但敏感性低。今后应进一步加强麻疹类疫苗接种与管理,提高人群免疫水平;加强医疗机构传染病报告与管理,提高监测系统敏感性,防止传染源扩散。

Objective To provide the basis of strategies and measures for eliminating measles by analyzing the epidemio- logical characteristics of measles and the operating quality of measles surveilance system of Xuchang from 2009 to 2013. Method Surveilance data of measles system in Xuchang during 2009-2013 were analyzed with descriptive epidemiological method. Result Totally 675 cases of measles were reported in Xuchang in period 2009-2013. The incidence everage rates of case were 3.16/100 000. The cases were reported in 8 counties. The most cases happened in Yuzhou,it accounted for 55.56% of total cases. The measles were marked seasonly. It is maily concentrated in February to May and accounted for 73.48% of total cases. The most cases happened in persons under 6 years old,it accounts for 85.63% of total cases. The cases under 1 year old accounts for 50.22% of total cases. The measles cases that have the exact measles immunization his- tory at 8 month-14 years old accounted for 38.58%. Timeliness and specificity were increased year by year. The investiga- tion rates of suspected cases within 48 hours increased from 88.32% in 2009 to 100% in 2012. The delivering rate of blood samples rate within 3 days increased from 51.68% in 2009 to 100% in 2013. The lab reporting rate of the serum screening test results within 7 days increased from 52.80% in 2009 to 100% in 2013. The suspected case collection rates increased from 48.86% in 2009 to 100% in 2013. The rate of a serologically confirmed case during measles outbreaks and the percentage of collected etiology samples during meales outbreaks were improved to 100%. The sensitivity of measlessurveillance system is low in 2009 to 2013. The incidence rates of excluded case were from 0.49/100 000 to 1.43/100 000. Conclusion The incidence of measles was decline in Xuchang city during 2009-2013. The incidence of small age and adult group increased. The comprehensive quality of measles surveillance system was improved year by year. the sensitivity is low. It is necessary to further strengthen measles vaccine inoculation and management to improve the population immunity level, and strengthen infectious disease reporting anti management to improve the monitoring system sensitivity and to pre- vent infectious source diffusion.