甘肃省平凉市大骨节病三年攻坚行动防治结果分析

Analysis of prevention and control results of three-year campaign for Kashin-Beck disease in Pingliang City,Gansu Province

目的了解甘肃省平凉市大骨节病三年攻坚行动防治现况,为大骨节病防治提供科学依据。方法采用回顾性分析,自"全国地方病防治综合管理系统(三年攻坚行动管理系统)"收集2019-2020年甘肃省平凉市所有大骨节病病区县(市、区)辖内全部病区村的大骨节病监测数据,包括7~12周岁儿童病情,防控措施落实情况,现症患者个案调查、健康档案建立与管理及治疗情况。结果平凉市大骨节病患者分布在6个县(市、区)、64个乡(镇)、690个病区村,且全部为重病区。2019、2020年分别临床检查7~12周岁儿童40537、41053人,临床检出率分别为0.08%(31/40537)和0.03%(12/41053),X线检出率均为0。2018-2020年平凉市居民膳食结构中,大米、面粉、其他膳食的食用比例依次为15.03%、76.63%、8.34%,主食购入比例为19.28%;3年间累计搬迁病区群众9564户、36282人,7~12周岁儿童易地育人4831人,改种经济作物占原耕地的14.81%(420914/2842939),退耕还林(草)占原耕地的21.81%(620045/2842939),发放6~24月龄儿童营养包231811人份。共调查登记大骨节病现症患者6269例,其中男性3722例、女性2547例,男女性别比为1.00∶0.68;临床分度以Ⅰ度患者最多,占78.00%(4890/6269),其他依次为Ⅱ度(15.89%,996/6269)、Ⅲ度(6.11%,383/6269);发病年龄为(64.57±10.01)岁,范围为16~87岁,以50岁以上为主,占86.57%(5427/6269)。2019年治疗成人大骨节病患者1659例,显效率、有效率、无效率分别为25.38%(421/1659)、52.92%(878/1659)、21.70%(360/1659);2020年治疗成人大骨节病患者1395例,显效率、有效率、无效率分别为19.50%(272/1395)、61.65%(860/1395)、18.85%(263/1395)。结论平凉市所有大骨节病病区村均达到消除标准,实现了消除目标;应继续做好病情动态监测,加强防控措施落实和大骨节病现症患者康复干预,提高患者生存质量。

Objective To learn about the current situation of prevention and control results of three-year campaign for Kashin-Beck disease(KBD)in Pingliang City,and to provide scientific basis for prevention and control of KBD.Methods A retrospective analysis was carried out to collect the KBD surveillance data of all villages in the counties(cities,districts)affected by KBD in Pingliang City,Gansu Province during 2019-2020 from the"National Integrated Management System for Endemic Disease Prevention and Control(Three-year Campaign Action Management System)",including,the prevalence of children aged 7 to 12 years old,the implementation of prevention and control measures,and the case investigation,the establishment,management of health files and treatment of current patients.Results Patients with KBD were distributed in 6 counties(cities,districts),64 townships(towns),and 690 villages in Pingliang City,and all of them were seriously ill area.In 2019 and 2020,40537 and 41053 children aged 7 to 12 years old were examined,respectively,and the clinical detection rate was 0.08%(31/40537)and 0.03%(12/41053),respectively;the X-ray detection rate was 0 in each year.In the dietary structure of residents in Pingliang City from 2018 to 2020,the consumption proportions of rice,flour and other diets was 15.03%,76.63%and 8.34%,respectively,and the purchase proportion of staple food was 19.28%.From 2018-2020,9564 households and 36282 people had been relocated from the affected areas,4831 children aged 7 to 12 years old had been raised in different places,14.81%(420914/2842939)of the original cultivated land had been converted to cash crops,21.81%(620045/2842939)of the original cultivated land had been converted from farmland to forest(grass),and 231811 nutrition package for children aged 6 to 24 months had been given.A total of 6269 KBD patients were investigated and registered,including 3722 males and 2547 females,with a gender ratio of 1.00∶0.68.The most clinical grading was gradeⅠ,accounting for 78.00%(4890/6269),followed by gradeⅡ(15.89%,996/6269)and gradeⅢ(6.11%,383/6269);the age of onset was(64.57±10.01)years old,ranging from 16 to 87 years old;most patients were over 50 years old,accounting for 86.57%(5427/6269).In 2019,1659 KBD patients were treated.The apparent efficiency,effective efficiency and ineffective efficiency were 25.38%(421 cases),52.92%(878 cases)and 21.70%(360 cases),respectively.In 2020,1395 KBD patients were treated;the apparent efficiency,effective efficiency and ineffective efficiency were 19.50%(272 cases),61.65%(860 cases)and 18.85%(263 cases),respectively.Conclusions All villages in KBD area in Pingliang City have reached the elimination standard and achieved the elimination goal.We should continue to do a good job in the dynamic monitoring of the disease,strengthen the implementation of prevention and control measures and rehabilitation intervention for patients with KBD,and improve the quality of life of patients.