2005—2015年西藏自治区细菌性痢疾流行特征分析

The epidemiological characteristics of bacillary dysentery in Tibet Autonomous Region during 2005 and 2015

目的分析2005—2015年西藏自治区细菌性痢疾流行特征,为制定细菌性痢疾的防控策略提供科学依据。方法采用Excel整理数据,运用EIPINFO、EIPMAP等统计软件进行分析,采用描述性流行病学方法,对西藏自治区细菌性痢疾流行特征进行分析。结果 2005—2015年全区累积细菌性痢疾报告病例15 610例,死亡9例,年均发病率为51.60/10万,病死率为0.06%,发病率总体呈下降趋势。11年中细菌性痢疾发病有明显的季节性,每年均为2月份发病率开始上升,9月份逐步下降。年龄别累积发病例数以婴幼儿为主,0~3岁婴幼儿占发病人数的20.28%,0~9岁年龄组累积报告发病例数占37.9%。2005—2015年,发病居前三位的职业分别是学生4 470例(28.6%)、农民4 196例(26.9%)、散居儿童3 916例(25.1%)。年均发病率最高的是林芝市,为140.86/10万,其次是山南地区,为125.86/10万。2005—2015年西藏自治区共发生细菌性痢疾爆发疫情19起,其中2006年爆发疫情起数最多达6起。2005—2008年,临床诊断报告病例比例逐年增加,从2005年的70%上升至2008年的92.20%;2009年较前一年临床诊断报告病例比例大幅下降11%,2010年大幅回升至91.07%,随后几年逐年下降,至2015年为75.24%。结论在细菌性痢疾高发季节,加强重点人群健康教育工作,并改善农牧民居住环境及关怀散居儿童居住情况,提高监测质量,是防控细菌性痢疾的主要策略。

Objective To explore the epidemiological characteristics of bacillary dysentery in Tibet Autonomous Region during 2005 and 2015.Methods Data were sorted out with EXCEL and analyzed with EIPINFO and EPIMAP.Descriptive epidemiology was adopted to analyze the epidemiological characteristics.Results A total of 15 610 cases of bacillary dysentery occurred during this period,9 of which died.The annual incidence was 51.60/100 000,and mortality was 0.06%,which showed a decreasing trend totally.There was a significant seasonal trend,the incidence rising from February and decreasing gradually from September every year.Age-specific accumulated incidence was infant-oriented,and 0-3 age group accounted for 20.28%of the reported cases,while 0-9 age group accounted for 37.9%.The top 3 groups of patients were students(4470,28.6%),peasants(4 196,26.9%)and scattered children(3 916,25.1%).Nyingchi City had the highest annual incidence(140.86/100 000),followed by Shannan Prefecture(125.86/100 000).There were 19 outbreaks of bacillary dysentery in Tibet Autonomous Region from 2005 to 2015,and 6 outbreaks in 2006 only.From 2005 to 2008,the proportion of clinically reported cases increased year by year,from 70%in 2005 up to 92.20%in 2008.The proportion of clinically reported cases in 2009 sharply decreased by 11%compared with that in 2008,while the proportion sharply increased up to 91.07%in 2010,and then gradually decreased year by year to 75.24%in 2015.Conclusion During the epidemic season of bacillary dysentery,it is important to strengthen health education program for risk groups,improve the dwelling environment of farmers and herdsmen,care for the living situation of scattered children and improve quality of surveillance.