2017年湖北省重点急性传染病聚集性/暴发疫情防控措施效果比较

Comparison of effectiveness of prevention and control measures for clusters and outbreaks of priority communicable diseases in Hubei, 2017

目的分析2017年湖北省重点急性传染病聚集性/暴发疫情的分布特征,比较停课、隔离、健康教育、环境消毒措施在传染病暴发早期控制传染病疫情的效果。方法建立全省聚集性/暴发疫情主动监测系统,采用描述性流行病学方法分析2017年湖北省重点急性传染病聚集性、暴发疫情的构成、场所分布等特征,采用logistic回归分析比较疫情控制措施效果。结果 2017年湖北省共监测发现重点急性传染病聚集性/暴发疫情1 128起。聚集性疫情中,手足口病的比例最高(46.6%);暴发疫情中,流行性感冒(流感)的比例最高(46.1%)。学校是疫情发生的主要场所(95.1%)。单因素logistics回归分析显示,聚集性疫情中采取停课、环境消毒或健康教育能有效阻止暴发疫情的发生(OR停课=0.191,95%CI:0.116~0.314;OR环境消毒=0.505,95%CI:0.320~0.798;OR健康教育=0.395,95%CI:0.230~0.679)。多因素logistics回归分析显示,停课或健康教育措施能有效阻止暴发疫情的发生(OR停课=0.187,95%CI:0.111~0.314;OR健康教育=0.439,95%CI:0.233~0.825)。结论 2017年湖北省重点急性传染病聚集性/暴发疫情主要为手足口病、水痘、流行性腮腺炎等通过呼吸道和接触传播为主的传染病,停课或健康教育是控制此类疫情效果最明显的措施,应首先推行,其他防控措施也需要相应并行。

Objective To analyze the characteristics of cluster and outbreaks of major acute communicable diseases in Hubei province in 2017 and compare the effectiveness of different prevention and control measures. Methods An active surveillance system for clusters or outbreaks of communicable diseases in Hubei was established. Descriptive epidemiological analysis was conducted on the constituent and place distribution of cluster and outbreaks of communicable diseases in Hubei and compare the effectiveness of epidemic control measures by logistic regression analysis. Results A total of 1 128 clusters or outbreaks were detected in Hubei in 2017. In clusters, hand foot and mouth disease(HFMD) accounted for highest proportion(46.6%), and in outbreaks, influenza accounted for highest proportion(46.1%). Schools were the main places where the outbreak occurred(95.1%). Univariate logistic regression analysis showed that the effective cluster control measures included school suspension(OR=0.191, 95%CI: 0.116-0.314), environmental disinfection(OR=0.505, 95%CI: 0.320-0.798)or health education(OR=0.395, 95%CI: 0.230-0.679). Multivariate logistic regression analysis showed that the effective outbreak control measures included school suspension(OR=0.187, 95%CI: 0.111-0.314) or health education(OR=0.439,95%CI: 0.233-0.825). Conclusion The priority acute communicable diseases detected in clusters or outbreaks in Hubei in2017 were HFMD, varicella and mumps, which were mainly transmitted through respiratory tract and personal contact. The most effective control measures were school suspension or health education, which should be implemented as early as possible,and other prevention and control measures must also be implemented in parallel.