大理白族自治州2016年上半年麻疹疫情风险评估

Risk assessment of measles outbreaks in Dali Bai Autonomous Prefecture(China) in early 2016

目的对大理白族自治州麻疹疫情进行风险评估,识别风险薄弱地区和环节,提出针对性措施,防范麻疹疫情暴发和流行。方法依据《云南省2016年上半年麻疹疫情风险评估方案》,对免疫水平、麻疹监测质量、疫情易于发生扩散、院内感染风险、边境输入风险及实际工作自评等指标进行风险评估,并根据风险评估综合得分以四分位数法判定风险等级。结果大理白族自治州免疫水平薄弱的是大理市(20.75分)、弥渡县(9.50分)和祥云县(7.50分);麻疹监测质量不高的是弥渡县和南涧县(均为3.50分);疫情易于扩散的是大理市(15.00分);院内感染风险高的是大理市(5.50分),实际工作自评得分最高的是大理市、云龙县、洱源县和鹤庆县(均为7.00分);总体麻疹疫情风险较高的是大理市(49.75分)、弥渡县(22.00分)和祥云县(21.00分),其余县市为中风险和低风险地区。结论各县市应根据不同的风险级别,查找薄弱环节。大理市、弥渡县和祥云县应采取措施提高人群免疫水平,弥渡县和南涧县应加强麻疹病例监测,大理市应严格控制院内感染,大理市、弥渡县和祥云县应重点开展风险评估和补充免疫等有效措施,降低麻疹感染及传播风险。

Objective The objective of this study was to assess the risk of measles epidemic in Dali Bai Autonomous Prefecture, China, reveal the vulnerable areas and links, and propose appropriate measures to prevent outbreaks and epidemic spread of the measles. Methods Based on the Risk Assessment Scheme for Measles Epidemic in Yunnan Province for the First Half Year of 2016, such factors as immune level, quality of surveillance, spread of the epidemic, risk of hospital infection, risk of border entry and self-ratings were evaluated, and risk grades was determined using the quantile method. Results Dali city （scoring 20.75）, Midu county （scoring 9.50） and Xiangyun county （scoring 7.50） were weak in immune level in Dali Bai Autonomous Prefecture. In terms of surveillance level, Midu county （scoring 3.50） and Nanjian county （scoring 3.50） performed poor. The measles epidemic was easy to spread in Dali city （scoring 15.00）. The risk of hospital infection was high in Dali city （scoring 5.50）. Dali city, Yunlong county, Eryuan county and Heqing county scored the highest in the self-rating, all scoring 7.00. Dali city, Midu county and Xiangyun county were more vulnerable to the measles （scoring 49.75, 22.00 and 21.00 respectively）, and the remaining counties were medium-risk and low-risk areas. Conclusions The weak links should be identified according to the different risk levels. Dali city, Midu county and Xiangyun county should take appropriate strategies to improve the immunity level; Midu county and Nanjian county should strengthen the surveillance of measles cases; Dali city should strictly control hospital infection; Dali city, Midu county and Xiangyun county should carry out timely risk assessment and supplementary immunization, in order to reduce the risk of measles infection and transmission.