2009-2019 年广州市白云区麻疹流行特征分析及影响因素

Epidemiologic characteristics of measles and influencing factors in Baiyun district,Guangzhou,2009-2019

目的通过分析2009—2019年广州市白云区麻疹流行特征及相关影响因素,科学指导麻疹防控工作。方法利用麻疹专项监测系统对广州市白云区麻疹确诊病例进行描述性分析及麻疹发病影响因素探讨。结果2009—2019年广州市白云区共报告麻疹确诊病例1430例,年平均发病率6.74/10万,集中分布在4—7月,季节性近年来有所削弱;发病年龄以<2岁的散居儿童和20~29岁成人病例为主;户籍来源以外市和省外为主;麻疹病例中含麻疹成分疫苗(MCV)0剂次、1剂次、≥2剂次、不详免疫史病例分别占61.73%、7.26%、17.46%、29.12%;非本市户籍、发病前7~21 d有就诊史是<18岁人群感染麻疹的危险因素(P<0.05),非流动人口及有MCV接种史为其保护因素;非本市户籍是≥18岁人群感染麻疹的危险因素(P<0.05)。结论广州市白云区麻疹病例分布呈现单峰下降趋势,以散发为主,<2岁的新迁入儿童及20岁以上务工者是防控重点人群,应加强流动人口主动搜索、民办学校验证入学管理、医疗机构麻疹主动监测等工作,鼓励MCV免疫不详的青年务工者自愿接种,精准查漏补种,多管齐下,警惕麻疹周期性流行。

Objective To analyze the epidemiologic characteristics of measles and related influencing factors in Baiyun district of Guangzhou from 2009 to 2019 and provide evidence for measles prevention and control.Methods The measles surveillance system was used to carry out descriptive analysis on confirmed measles cases in Baiyun district from 2009 to 2019 and discuss the influencing factors.Results From 2009 to 2019,a total of 1430 confirmed measles cases were reported in Baiyun district,with an average annual incidence of 6.74/100000,the cases mainly occurred during April–July,but the seasonality has been less obvious in recent years.The cases were mainly children aged<2 years and adults aged 20—29 years.The cases were mainly distributed in population from other cities or provinces.The cases with 0 dose,1 dose,≥2 doses,and unknown immunization history of measles-containing vaccines(MCV)accounted for 61.73%,7.26%,17.46%,and 29.12%,respectively.The risk factors for measles in<18 years old group included being in floating population and medical treatment seeking history 7—21 days before onset(P<0.05),and being on local population and history of MCV vaccination were the protective factors.Being in floating population was a risk factor for measles in people aged≥18 years(P<0.05).Conclusion Measles mainly occurred sporadically in Baiyun district,the incidence showed a single peak pattern and decline trend.Children aged<2 years and adults aged>20 years in floating population were the key populations in measles prevention and control.It is necessary to strengthen the active case finding in floating population,vaccination certificate check for the entrancement of private schools,active measles surveillance in medical institutions and encourage young migrant workers with unknown measles vaccination history to receive MCV,conduct accurate supplementary vaccination and take multiple measures to prevent periodic measles epidemic.