北京市怀柔区重点传染病预警技术优选研究分析

A study on optimal selection about early warning technology of major infectious diseases in Huairou District of Beijing

目的应用控制图法开展适宜于北京市怀柔区的传染病预警分析研究,选出该地区重点传染病的最优预警模型及最优预警界值。方法通过《传染病信息报告管理系统》收集2005—2014年北京市怀柔区6种重点传染病周发病数据,分别为其他感染性腹泻病、手足口病、水痘、流行性感冒、细菌性痢疾和肺结核,按照控制图预警模型原理建立3年和5年基线控制图预警模型,将预警模型的判断结果与流行标准的判断结果进行比对,通过计算灵敏度、特异度、阳性预测值、阴性预测值、约登指数及绘制受试者工作特征(ROC)曲线,选出6种重点传染病控制图法的最优预警模型及预警界值。结果其他感染性腹泻和水痘分别为3年控制图法的P95和P90,手足口病、细菌性痢疾、肺结核和流行性感冒分别为5年控制图法的P90、P95、P85和P99;相应预警界值预警功效较好,灵敏度均为1,特异度和约登指数均在0.96以上。结论怀柔区6种重点高发传染病预警模型和预警界值灵敏度高,特异度好,但预警界值还需进行调整。

[Objective]To analyze and study the infectious diseases early warning technology which is suitable for Beijing by the control graph method, select optimal early-warning model and alert threshold for major infectious diseases.[Methods]The weekly reported cases of 6 infectious diseases, including other infectious diarrhea, hand-foot-mouth disease（HFMD）, varicella, influenza,bacterial dysentery and tuberculosis, in Huairou District of Beijing from 2005-2014 were collected from the infectious diseases information report management system. According to the principles of control graph method, the early warning models for 3 years and 5 years baseline were established, and the predicted results of early warning models were compared with the golden standards. Finally, the optimal early-warning model and alert threshold for these infectious diseases were selected by comprehensive consideration of the sensitivity, specificity, positive predictive value, negative predictive value, Yueden’s index and receiver operating characteristic（ROC） curve.[Results]The optimal alert threshold for the other infectious diarrhea and varicella was P95 and P90of 3 years baseline warning model respectively, while that for HFMD, bacterial dysentery, tuberculosis and influenza was respectively P90, P95, P85 and P99of 5 years baseline warning model. The alert thresholds had high efficacy of early warning, all of sensitivity were 1, and specificity and Yueden’s index were higher than 0.96.[Conclusion] The early-warning models for six infectious diseases in Huairou District and the alert thresholds have good sensitivity and specificity, but the alert thresholds should be further adjusted.