2010-2014年重庆梅毒与淋病疫情报告影响因素调查分析

Investigation and analysis on influencing factors of syphilis and gonorrhoea epidemic report in Chongqing during 2010-2014

目的了解影响梅毒与淋病疫情报告的因素,为科学分析疫情变化提供依据。方法按照中国疾病预防控制中心性病控制中心提供的方案,调查2010-2014年重庆市医疗机构梅毒与淋病报告病例数、梅毒和淋病实验室筛查检测情况,分析筛查检测结果与疫情报告的关系。结果对符合条件的37家医疗机构开展调查,各年度一期梅毒报告病例数高于二期梅毒,二者差异有统计学意义(P<0.05)。而非皮肤科报告一期梅毒病例数高于皮肤科。梅毒螺旋体血清试验、非梅毒螺旋体血清试验、两类梅毒血清学试验检测数量及阳性数均显著增长,其中两类梅毒血清学试验检测数量年均增长26.48%,与隐性梅毒报告病例增长变化呈高度相关(r=0.988,P=0.002)。2010-2014年各医院报告的淋病病例数未出现明显上升或下降趋势(P>0.05),淋球菌涂片镜检和核酸检测数量均呈现增长趋势,以淋球菌涂片镜检为主,年均增长39.71%。结论梅毒报告病例数增长是由于隐性梅毒增长所致,而隐性梅毒增长与医疗机构扩大梅毒血清学筛查密切相关;非皮肤科医生对于梅毒分期认识不足,分期选择错误导致一期梅毒多于二期梅毒。淋病病例报告数并未因淋球菌检测数量的显著增加而增长。

Objective To understand the factors affecting the epidemic reporting of syphilis and gonorrhea to provide a basis for scientific analysis of epidemic changes. Methods The number of reported cases of syphilis and gonorrhea and their laboratory screening detection situation in Chongqing municipal medical institutions during 2010-2014 were investigated according to the scheme provided by the Sexually Transmitted Diseases Control Center of the Chinese Center for Disease Control and Prevention.The relationship between the screening and detection results with the reported epidemic situation was analyzed. Results Thirty-seven medical institutions conforming to the conditions were investigated,the reported cases number of primary syphilis in each year was higher than that of secondary syphilis,and the difference was statistically significant ( P < 0.05 ).But the reported cases number of primary syphilis in the non-dermatology departments was higher than that in the dermatology department.The test number and positive number of treponema pallidum serum test,non-treponema pallidum serum test,number of two kinds of syphilis serum test and positive number showed a significant increase,in which the test number of two kinds of syphilis serum test was annually increased by 26.48 %,which was highly correlated with the growth change of reported cases of recessive syphilis ( r = 0.988, P = 0.002).In 2010-2014,the number of reported gonorrhea cases did not appear obvious increasing or decreasing trend ( P >0.05).The number of gonococcal smear microscopic examination,and nucleic acid detection showed an increase,which was dominated by gonococcal smear microscopic examination,with an average annual growth rate of 39.71%. Conclusion The increase of reported syphilis cases number is due to the growth of recessive syphilis,and the growth of recessive syphilis is closely related to the expansion of syphilis serological screening in medical institutions.Non-dermatological doctors have insufficient understanding of the syphilis case report staging,and the staging selection error leads to the first stage syphilis more than the second stage syphilis.The reported gonorrhea case number does not increase due to a significant increase in the gonococcal detection.