2009-2013年广州市职业人群布鲁氏菌病监测结果及防控策略分析

The control strategy and surveillance analysis of occupational crowd brucellosis in Guangzhou from 2009 to 2013

目的掌握广州市职业人群布鲁氏菌病流行现状,为制定防治策略提供科学依据。方法采用问卷调查和虎红平板凝集试验(RBPT)及试管凝集试验(STA)对2009-2013年广州市从事羊、牛、猪畜养殖、交易、屠宰、畜产品加工销售、兽医等职业人群进行血清学检测,通过χ2检验等统计学方法分析其流行病学特征。同时对职业人群和劳动场所管理人群进行健康教育,对医务人员进行防控知识培训,分析防控策略效果。结果 5年共监测重点人群3 747人,其中男2 662人,女1 085人,阳性85人,阳性率为2.27%,其中隐性感染44例,发病41例。不同职业布鲁氏菌病感染率差异有统计学意义(P<0.05),以牲畜销售、肉类加工销售(3.67%)和屠宰(2.81%)等职业感染率较高,养殖业(0.58%)较低。感染者主要分布在白云区,男女比例为5∶1,各年龄段均可发病,各年份之间感染率差异无统计学意义(P>0.05)。结论广州市人群布鲁氏菌病感染率居高不下,职业人群发病率较高,布鲁氏菌病防治工作的重点应为加强牲畜流通环节的检疫和管理,做好职业人群的主动监测、开展健康教育,提高防病意识,做好自我防护。

Objective To understand the epidemic characteristics of brucellosis among occupational crowd in Guangzhou,and assist to establish the strategy for its prevention and treatment. Methods The occupational people who were engaged in livestock farming of sheep, cattle and pigs, trading, slaughtering, animal products processing and sales, veterinary professional groups in Guangzhou were monitored by testing serological antibody using the rose bengal plate test（RBPT） and standard tube agglutination test（STAT） during 2009-2013. The results were analyzed by chi-square test etc. At the same time, we educated the occupational groups, market supervisors and medical staff with prevention and control knowledge, and also analyzed the effect of prevention and control strategy for brucellosis. Results 3 747 occupational people（ 2 662 male and1 085 female） were monitored and 85 showed brucellosis infection. The positive rate was 2.27%. Among the 85 cases, 44 cases were latent infected and 41 cases were brucellosis. There were statistical significant differences among different occupations（P〈 0.05）. The infection rates were higher among people engaging in livestock sales, meat processing, meat sales（positive rate was 3.67%） and slaughter（positive rate was 2.81%）.The infected people were mainly in Baiyun district. The ratio of male to female was 5 ∶ 1. Brucellosis can occur at all ages. There was no statistical significant difference among each year（P〉0.05）.Conclusion In recent years, the epidemic of human brucellosis in Guangzhou were still high. The occupational crowd had a high probability of infection. The prevention and control of brucellosis infection in future should focus on the strengthening of quarantine and management in livestock circulation, completing the active monitoring of occupational people and carrying out health education to arise their awareness of brucellosis prevention and self-protection.