东莞市某镇2014～2018年狂犬病门诊暴露人群流行病学分析及防控策略

Epidemiological analysis and control strategy of rabies outpatient exposed population in a town of Dongguan City from 2014 to 2018

目的分析东莞市某镇狂犬病门诊暴露人群流行病学特征及暴露后处置情况,为本地区狂犬病防制工作提供科学依据。方法根据《广东省狂犬病门诊暴露人群监测月报表(2011版)》收集数据并进行统计分析。结果 2014~2018东莞市某镇共报告狂犬病暴露人数19 885例,5年来暴露人数呈上升趋势,2018年暴露人数最多,为4 774例。7~10月为暴露的高峰期,占5年暴露人数的39.18%。男女构成比为1.23∶1,15~44岁(占暴露人群的52.28%)是狂犬病暴露的高危人群。暴露部位以上肢(占50.0%)和下肢(占42.9%)居多。暴露以单处(88.55%)、浅表(84.03%)、Ⅱ级暴露(74.63%)居多。犬伤者占60.39%,进行伤口处理的占82.82%,接种狂犬疫苗的占98.38%,Ⅲ级暴露者狂犬病免疫球蛋白注射率为41.86%。Ⅲ级暴露者中,不同职业(χ~2=1384.333,P<0.001)、文化程度(χ~2=494.407,P<0.001)、户籍(χ~2=277.781,P<0.001)、性别(χ~2=15.569,P<0.001)人群的狂犬病免疫球蛋白的接种率有统计学差异。经两两比较显示:职业为企事业单位、文化程度为大专及以上的接种率最高。监测系统未报告狂犬病病例。结论东莞市某镇狂犬病暴露率较高,须广泛开展宣传教育,持续强化犬类免疫、规范犬伤处置,并推动针对狂犬病预防管理立法,营造文明养犬的社会氛围。

Objective To analyze the epidemiological characteristics and post-exposure disposal of the exposed population in the rabies clinics of a town in Dongguan City, so as to provide scientific basis for the prevention and control of rabies in this area.Methods Data were collected and analyzed according to the Monthly Report of Rabies Outpatient Exposure Surveillance in Guangdong Province(2011 edition).Results From 2014 to 2018, a town in Dongguan City reported 19 885 cases of rabies exposure. The number of rabies exposure increased in the past five years, with a maximum of 4774 cases in 2018. July-October was the peak period of exposure, accounting for 39.18% of the total number of exposure in five years. The ratio of male to female was 1.23∶1, and the population aged 15-44(52.28% of the exposed population) was at high risk of rabies exposure. Most of the exposed sites were upper limbs(50.0%) and lower limbs(42.9%). Most of them were single exposure(88.55%), superficial exposure(84.03%) and secondary exposure(74.63%). Dog injuries accounted for 60.39%, wound treatment accounted for 82.82%, rabies vaccination accounted for 98.38%, rabies immune globulin injection rate of grade III exposures was 41.86%. The vaccination rates of rabies immunoglobulin in different occupations(χ~2=1384.333,P< 0.001), educational level(χ~2= 494.407,P< 0.001), household registration(χ~2= 277.781,P<0.001) and gender(χ~2=15.569,P< 0.001) were significantly different among the third-grade exposed persons. Comparisons show that the population with the highest vaccination rate was those who work in enterprises and institutions and their education background were junior college or above. No cases of rabies were reported by the surveillance system.Conclusion The exposure rate of rabies in a town in Dongguan City is relatively high. It is necessary to carry out extensive propaganda and education, continue to strengthen canine immunity, standardize the treatment of canine injuries, and promote legislation on rabies prevention and management, so as to create a civilized social atmosphere for raising dogs.