2013—2021年东营市急性迟缓性麻痹病例监测工作评价

Evaluation of acute flaccid paralysis cases surveillance in Dongying City from 2013 to 2021

目的评价2013—2021年东营市急性迟缓性麻痹(acute flaccid paralysis,AFP)病例监测工作质量。方法对监测系统报告的AFP病例采用描述性流行病学方法进行分析。结果2013—2021年东营市共报告97例AFP病例,<15岁儿童非脊髓灰质炎(简称“脊灰”)AFP年平均报告发病率为3.21/10万,2013—2019年监测系统各项及时性指标均≥80.00%。2020年的14d双份粪便采集率和合格粪便采集率为66.67%,2021年的粪便标本7d送达率为62.50%,均未达到监测方案要求。AFP病例中5岁及以下儿童组发病最多,构成比为58.76%,男女性别比为1.69∶1。发病月份分布差异无统计学意义(χ^(2)=18.423,P>0.05)。完成脊灰疫苗全程免疫51例,构成比为52.58%,未完成全程免疫46例,构成比为47.42%。合格粪便采集率为89.69%,脊灰病毒分离培养均为阴性。残留麻痹率为7.22%。2015—2021年东营市适龄儿童第1、2、3、4剂次脊灰疫苗常规免疫接种率分别为99.85%、99.86%、99.84%、99.77%。结论2013—2021年东营市AFP监测系统总体达到保持无脊灰状态要求,但监测质量呈下降趋势,应加强AFP病例粪便标本管理,提高监测的及时性。

Objective To evaluate the surveillance quality of acute flaccid paralysis(AFP)cases in Dongying City from 2013 to 2021.Methods Descriptive epidemiological methods were used to analyze the AFP cases reported by the surveillance systems.Results A total of 97 AFP cases were reported in Dongying City from 2013 to 2021,and the average annual reported incidence of non-poliomyelitis AFP in children under 15 years old was 3.21/100000.From 2013 to 2019,all timeliness indicators of the surveillance system were above 80%.In 2020,the rates of double stool collection within 14 days and qualified stool collection were 66.67%,and in 2021,the rate of stool samples delivered within 7 days was 62.50%,both of which did not meet the requirements of the surveillance program.Among the AFP cases,children aged 5 and younger presented the most incidence,with a composition ratio of 58.76%,and a male-to-female gender ratio of 1.69:1.There was no significant dfference in the distribution of onset months(χ^(2)=18.423,P>0.05).A total of 51 cases(52.58%)were fully immunized with the polio vaccine,and 46 cases(47.42%)were not fully immunized.The qualified stool collection rate was 89.69%,and the poliovirus isolation culture was negative.The residual paralysis rate was 7.22%.Routine immunization rates for the Ist,2nd,3rd,and 4th doses of polio vaccine were 99.85%,99.86%,99.84%,and 99.77%for school-aged children from 2015 to 2021,respectively.Conclusion The AFP surveillance system in Dongying City has generally met the requirement of maintaining poliomyelitis-free status from 2013 to 2021,but the quality of surveillance shows a downward trend,and the management of fecal specimens of AFP cases should be strengthened to improve the timeliness of surveillance.