广东省疾控机构食品安全事故流行病学调查能力现况分析

Assessment of epidemiologic investigation capacity to food safety incidents among prefectural and local CDC in Guangdong Province

目的了解广东省各级疾病预防控制中心（疾病预防控制中心以下简称CDC）开展食品安全事故流行病学调查能力的现况,为制定卫生应急管理策略及人才培养计划提供科学依据。方法 2013年9~10月通过问卷函调查各级CDC相关科室负责人,从人、物、力、财等方面设置了人员情况、教育培训、应急现状、经费保障4部分35个条目的问题,对广东省市县两级124个CDC进行食品安全事故流行病学调查能力的普查。结果人员配备基本合理,但普遍反映紧缺。珠三角地区CDC专业人员中受过现场流行病学培训项目（FETP）培训的人员明显多于粤东西北地区;大多数地市级和县区级CDC制定了应急预案,但均未组织学习,而专业技术规范或标准的学习比例较高。全省CDC均储备了个案调查表,但未统一。大部分CDC配备了现场采样工具且定期补充,珠三角地区配置比例略高于粤东西北地区。食品安全事故信息来源主要为医疗机构（74.2%）,任务来源主要为卫生行政部门（79.8%）。模拟案例调查结果提示CDC尤其是县区一级在现场流行病学调查技术能力上,如混杂因素排查、分析性流行病学、统计分析处理、样品采集和检测项目确定等方面还有较大的提升空间;食品安全事故流行病学调查专项经费缺口较大,各地经费差异也较大。地市级CDC流行病学调查经费政府拨款占82.8%,县区占64.1%。结论广东省各级CDC普遍存在人员、经费紧缺问题,流行病学调查技术能力在地市间和县区间存在较大差异,整体能力也亟待提升,各级政府应加强CDC人员和经费的保障,各级CDC应加强食品安全事故流行病学调查技术能力的建设。

Objective To assess the epidemiologic investigation capacity to food safety incidents among prefectural and local CDC in Guangdong Province and provide references for health emergency management strategies and training programs planning. Methods Related institution chiefs of 124 prefectural and local CDCs in Guangdong Province were interviewed by E-mail with a questionnaire, which contained 35 items and four parts including staff composition, education and training, emergency response, and financial support. Results It was shown that the staff composition was basically reasonable, while staff numbers were generally limited. Compared with non-Pearl River Delta region, CDC staffs in Pearl River Delta region had more FETP training opportunities. Most prefectural CDCs and local CDCs had their own emergency plans, but never trained. For technical manuals or standards, the ratio of training would be higher. Case interview questionnaires were all prepared, but not unified. Most CDCs were equipped with sampling tools in the field and supplemented periodically, and Pearl River Delta region CDCs were equipped better. Information resources of food safety incidents were mainly from hospitals （74. 2% ）. Task orders of food safety incidents were mainly from DOH （79. 8% ）. Results of simulating case interview suggested the field epidemiology capacity, such as confounding factors eliminating, analytic epidemiology, statistical analysis and process, specimen collecting and testing items confirming, need to be improved greatly, especially in the local level. Great financial gaps for epidemiologic investigation of food safety incidents generally existed in CDCs. The ratio of financial funding from government in prefectural CDCs was 82.8% and local CDCs was 64. 1%. Conclusion Staff and financial gaps, epidemiology capacity and differences among regions are very common in prefectural and local CDCs of Guangdong Province. The government should enhance the staff and financial support. CDCs should enhance the development of epidemiology investigation capacity to food safety incidents.