陆川县应用间歇式麻疹减毒活疫苗补充免疫控制麻疹流行效果分析

Analysis on effect of application of intermittent live attenuated measles supplementary immunization in control of measles epidemic,Luchuan county

目的了解陆川县实施麻疹减毒活疫苗（MV）补充免疫活动（Supplementary SIA）前8年（1996~2003）及后11年（2004~2015）麻疹流行状况,评估控制麻疹效果,为消除麻疹提供参考。方法采用描述性流行病学方法,分析和比较陆川县从2004年起应用间歇式开展MV SIA前后麻疹发病资料。结果陆川县实施MV SIA前8年的麻疹年平均发病率为6.54/10万,下降到实施MV SIA后11年的年平均发病率0.78/10万（P〈0.01）,下降88.07%。麻疹流行小高峰周期延长,间隔时间从原来2~3年变为4~5年。实施MV SIA前全县16个乡镇均有病例报告,年平均发病率最高为陆城、珊罗和温泉3个乡镇,分别为20.46/10万、15.46/10万和12.99/10万;实施MV SIA后,年平均发病率最高为珊罗、温泉和横山3个乡镇,分别为2.50/10万、1.26/10万和1.07/10万,与实施前相比大幅降低。结论陆川县从2004年起应用每间隔4~5年一次的间歇式开展MV SIA后,麻疹发病大幅度下降,麻疹流行周期延长,流行期缩短。城镇和城乡结合部为免疫规划工作薄弱地区。

Objective To understand the epidemiological status of measles in Luchuan county during the first 8years（1996-2003）and the last 11years（2004-2015）after measles live attenuated vaccine（MV）supplementary immunization activities（Supplementary SIA）,and evaluate measles control effect,so as to provide reference for measles elimination.Methods The descriptive epidemiological method was used to analyze and compare the data before and after MV SIA.Results The average annual incidence of measles before the implementation of MV SIA in Luchuan county was 6.54/105,which decreased to 88.70% after the implementation（P〈 0.01）.The epidemic period of measles was extended.The interval changed from the original 2-3years to 4-5years.Cases were reported in all 16 townships before the implementation of MV SIA and the top three towns were Lucheng,Shanluo and Wenquan,with the average annual incidence rate of20.46/105,15.46/105 and 12.99/105,respectively.After the implementation of MV SIA,the top three towns were Shanluo,Wenquan and Hengshan,with the average annual incidence rates being 2.50/105,1.26/105 and 1.07/105,respectively,which showed a substantial reduction.Conclusion A significant decline in measles incidence is observed in Luchuan county since the intermittent implementation of MV SIA every 4to 5years since 2004.The measles epidemic cycle is extended and the epidemic period is shortened.The urban and rural fringe areas are the focus areas for immunization planning.