2011—2020年北京市海淀区狂犬病暴露门诊处置人群流行病学特征分析

Epidemiological characteristics of outpatients in rabies post-exposure prophylaxis clinics in Haidian district of Beijing from 2011 to 2020

目的分析2011—2020年北京市海淀区狂犬病暴露门诊处置人群流行病学特征,为狂犬病防控工作提供依据。方法收集北京市海淀区狂犬病暴露者个案登记表中就诊人群的暴露和处置信息,采用描述性流行病学方法进行分析。结果2011—2020年北京市海淀区共收集暴露后免疫患者281332例。2011—2019年5月至8月为动物致伤高峰,2020年5月至10月为高峰;20~29岁年龄组致伤比例最高(30.30%);0~9岁年龄组的儿童暴露率最高(1483.99/10万),各年龄组暴露率差异具有统计学意义(P<0.01);男女性别比为0.83:1,各年度女性暴露率均高于男性,且差异具有统计学意义(P<0.01);在职人员所占的比例最高(60.62%)。致伤部位以手部(56.98%)和下肢(26.08%)为主。暴露人群主要以Ⅱ级(74.18%)、Ⅲ级(25.23%)暴露为主,判定为Ⅲ级暴露者中被动免疫制剂使用率为31.43%。暴露后24 h内接种疫苗的比例占73.50%。伤人动物主要以犬为主,占61.11%。有主犬中近1年接种过狂犬病疫苗的比例占55.07%。结论需针对重点人群、重点季节开展广泛的宣传,进一步规范狂犬病暴露预防处置,提高Ⅲ级暴露者中被动免疫制剂使用率,加强犬只管理,提高犬只疫苗接种率。

Objective To analyze the epidemiological characteristics of population receiving treatment in rabies post-exposure prophylaxis clinics in Haidian district from 2011 to 2020,so as to provide the basis for prevention and control of rabies.Methods The data on exposure and treatment of the population visiting the clinics in Haidian district were collected from the individual case records of rabies exposure and analyzed by descriptive epidemiological method.Results There were 281332 cases of exposure to rabies received post-exposure immunization in Haidian district from 2011 to 2020.The peak of injury by animals occurred from May to August during 2011-2019,while the peak of the injury in 2020 occurred from May to October.The rate of injure was the highest in 20-29 years old group(30.30%).The exposure rate was the highest in children of 0-9 years old(1483.99/100000).The differences in exposure rate among different age groups were statistically significant(P<0.01).The male to female ratio was 0.83:1.The annual exposure rates of women were higher than those of men,and the differences were statistically significant(P<0.01).The proportion of occupational individuals(60.62%)was the highest.The majority of injury sites were hands(56.98%)and lower extremities(26.08%).Among the exposed persons,grade Ⅱ(74.18%)and grade Ⅲ(25.23%)exposure were the main type of injure.The utilization rate of passive immune preparation was 31.43% of individuals identified as grade Ⅲ exposure.The rate of vaccination within 24 hours after exposure accounted for 73.50%.The most common animal causing injuries was dogs,accounting for 61.11%.The vaccination rate against rabies among claimed dogs within the previous year was 55.07%.Conclusions Extensive publicity to key population and seasons would be necessary.It is necessary to standardize the preventive and disposal measures after exposure to the rabies and the utilization rate of passive immune preparations among patients with grade Ⅲ exposure should be increased.The management of dogs should be strengthened and the immunization rate of dogs should be increased.