2009-2012年泸州市麻疹监测结果分析

Measles Surveillance in Luzhou,2009-2012

目的了解泸州市麻疹监测质量、疫情发生特征和疫苗接种水平,为麻疹防治策略的调整提供依据,以便如期实现消除麻疹目标。方法采用描述流行病学方法对泸州市2009-2012年麻疹监测资料进行分析。结果 4年间7个县区共报告疑似麻疹313例,个案录入率和48 h完整调查率均为98.72%,经实验室排除297例,排除病例报告率为1.79/10万,达标县覆盖率为53.57%;第1、2份血清标本采集率分别为98.72%、19.32%,标本3日内送检率为91.10%、7 d内检测率为87.12%。报告麻疹确诊病例16例,年均报告发病率为0.97/100万,无死亡,其中本地病例14例;病例高度散发,主要分布在泸县、合江县和江阳区,以8月龄~2岁为主（68.75%）;7例病例无麻疹疫苗接种史,其中流动儿童5例,幼托儿童1例。适龄儿童麻疹疫苗常规接种率第1、2剂分别为94.33%、91.42%。结论泸州市麻疹监测系统的敏感性和特异性不高;报告病例以本地病例为主,0剂次病例中流动儿童占的比例较大,入托入学预防接种证查验工作还存在薄弱环节;常规免疫接种率未达95%,实现消除麻疹目标任重道远。

Objective To investigate the quality of surveillance, epidemic characteristics and vaccination levels of measles and to provide a basis for measles control strategies, and thus to achieve the goal of measles elimina- tion. Methods Measles surveillance data during 2009 -2012 in Luzhou were analyzed by descriptive epidemi- ology methods. Results A total of 313 suspected measles cases were repc,rted in the last 4 years in all the 7 counties. Case entry rate and rate of complete investigation within 48h were respectively 98.72% and 19.32% ; among which, 297 cases were excluded by lab test, reported rate of excluded cases was 17.9/105. The coverage rate of qualified county was 53.57%. The collection rate of first and second serum specimen was 98.72% and 19.32% , respectively. The submission rate of the samples was 91.10% within 3 days and the detection rate within 7 days was 87.12%. A total of 16 lab -confirmed cases of measles were reported, with an average annual incidence rate of 0. 97/106 and no death. All the cases were sporadic in Luxian county, Hejiang county and Jiangyang district. Most （68.75 % ） were at the age of 8 months to 2 years old and 7 cases were absence of measles vaccination history; 5 cases in which were migrant children, one was kindergarten children. Vacci- nation rate of the first dose and the second dose in eligible children was 94. 33% and 91.42% , respectively. Conchmion The sensitivity and specificity of the measles surveillance system is still low in Luzhou. The repor- ted cases are mainly local cases and most zero dose cases were migrant clhildren. Vaccination certificates in- spection work is still weak and the routine vaccination rate is less than 9：5%. Great efforts are warrant to achieve the goal of measles elimination.