广东省汕头市2010—2019年急性驰缓性麻痹病例监测系统运转情况

Analysis of the operation of acute flaccid paralysis case surveillance system in Shantou,Guangdong,2010-2019

目的分析汕头市2010—2019年急性驰缓性麻痹(acute flaccid paralysis, AFP)病例监测系统运转情况,及时发现存在的问题,防范输入性脊髓灰质炎(简称脊灰)野病毒病例发生,为脊灰防控提供科学依据。方法采用描述性流行病学方法、中国免疫规划监测信息管理系统和Excel 2007等软件对汕头市2010—2019年AFP病例监测数据进行分析,并对AFP监测系统运转情况进行评价。结果汕头市2010—2019年共报告AFP病例273例,2010年报告发病率最低,为1.60/10万;2011年报告发病率最高,为3.19/10万;年均报告发病率2.22/10万,报告273例均为非脊灰病例,无脊灰野病毒病例和疫苗衍生脊灰病毒病例;273例AFP病例分布于全市7个区县,病例地区分布没有明显聚集性;273例AFP病例发病年龄最大14岁,最小3个月龄,以1~<5岁组发病率较高,共有142例,占总病例的52.01%;273例AFP病例中男性170例,女性103例,男女比例为1.65∶1,男性报告发病率高于女性,男女发病差异有统计学意义(χ^(2)=16.44、P<0.05);每月均有病例报告,以5月份发病最多,共31例(占11.36%),发病无明显时间聚集性;273例AFP病例中服苗3次以上者263例(占96.34%),服苗未达3次者10例(占3.66%);273例AFP病例中有269例AFP病例采集到双份合格粪便标本,合格粪便标本采集率98.53%,均未分离到脊灰病毒。结论汕头市2010—2019年来的AFP监测系统运转良好,监测系统敏感性和及时性的各项监测指标均达到国家要求,为巩固无脊灰成果,应保持高水平脊灰疫苗免疫接种率,强化医务人员报告意识,提高AFP病例监测系统质量。

Objective To analyze the situation of acute flaccid paralysis(AFP)case surveillance system in Shantou City from 2010 to 2019,find out the existing problems in time,prevent the occurrence of imported polio(referred to as polio)wild virus cases,and provide a scientific basis for polio prevention and control.Methods Descriptive epidemiological methods,China Immunization Program Monitoring Information Management System and excel 2007 were used to analyze the 2010-2019AFP case surveillance data in Shantou City and evaluate the operation of the AFP surveillance system.Results A total of 273AFP cases have been reported in Shantou in the past 10 years.The lowest reported incidence in 2010 was 1.60/100000,the highest reported incidence in 2011 was 3.19/100000,and the average annual reported incidence was 2.22/100000.All of 273cases were non-polio cases,no wild poliovirus cases and vaccine-derived poliovirus cases.All 273 AFP cases were distributed in 7 districts and counties of the city,and there was no obvious clustering of cases in the area.The oldest age of 273 AFP csaes was 14 years old and the youngest was 3 months old.The incidence was higher in the 1-<5-year-old group,with a total of 142cases,accounting for 52.01%of the total cases.In 273 cases of AFP,170 cases were males,and 103 cases were females with the ratio of male to female was 1.65∶1,and the incidence rate of male was higher than that of female.The difference between male and female patients was statistically significant(χ^(2)=16.44,P<0.05).Cases were reported every month.The incidence was highest in May,with 31 cases(accounting for 11.36%).There was no obvious aggregation at the onset time.Among of 273 AFP cases,263(96.34%)received vaccine more than 3 times,and 10(3.66%)received vaccine less than 3 times.Among of 273AFP cases,269 AFP cases were collected with double qualified stool samples with the qualified stool samples collection rate of98.53%,and no poliovirus was isolated.Conclusion The AFP monitoring system in Shantou has been operating well in the past 10 years,and the monitoring indicators of sensitivity and timeliness of the monitoring system have reached national requirements.To consolidate the results of polio-free,we should maintain a high level of polio vaccine immunization rate,strengthen the reporting awareness of medical staff,and improve AFP case monitoring system quality.