2011—2021年宁夏回族自治区人狂犬病病例流行特征及暴露处置分析

An analysis of epidemiological characteristics and exposure disposal of huma rabies cases in Ningxia Hui Autonomous Region from 2011 to 2021

目的 了解宁夏回族自治区2011—2021年人狂犬病病例流行特征和暴露处置措施落实情况,及时发现人狂犬病防治工作短板,为适时调整防控策略提供理论依据。方法 收集2011—2021年宁夏回族自治区人狂犬病病例报告和流行病学调查资料,并结合SaTScan软件时空聚集性扫描,采用描述性和空间流行病学方法进行时空特征和暴露处置分析。结果 2011—2021年宁夏回族自治区全区共报告人狂犬病病例41例,2014年达到峰值,2015年大幅下降,夏秋季高发。人狂犬病农村地区发病率高于城市,男性高于女性。发病存在时空聚集性。暴露等级以Ⅲ级暴露为主,头面部暴露潜伏期短于手部。暴露的动物以犬类为主(97.56%),仅1例有明确动物免疫史。结论 宁夏回族自治区人狂犬病防治的重点区域为中南部山区,以农村地区为主,应落实所有可致狂犬病感染的动物免疫并加强属地管理,完善健康教育、规范处置等,降低狂犬病暴露后处置经济负担以提高疫苗接种率,实现2030年人狂犬病零死亡的目标。

Objective To understand the epidemiological characteristics and exposure disposal of human rabies cases in Ningxia Hui Autonomous Region from 2011 to 2021,timely discover the shortcomings of human rabies prevention and control,and provide a theoretical basis for timely adjustment of prevention and control strategies.Methods The data from human rabies case reports and epidemiological surveys in Ningxia Hui Autonomous Region from 2011 to 2021 were collected,and combined with SaTScan software clustering in time and space scanning,descriptive and spatial epidemiological methods were used to analyze the spatiotemporal characteristics and exposure disposal.Results A total of 41 human rabies cases were reported in Ningxia Hui Autonomous Region from 2011 to 2021,with a peak in 2014 and a significant decline in 2015.The incidence peak occurred during summer-autumn.The incidence of human rabies was higher in rural areas than in urban areas,and men than in women.There was a clustering in time and space of the occurrence of cases.The exposure rank was mainly tertiary exposure,and the exposure latency of the head and face was shorter than that of the hands.The exposure animals were mainly dogs,accounting for 97.56%,and only one case had a clear history of animal immunization.Conclusion The key areas for human rabies prevention and control in Ningxia Hui Autonomous Region are the central and southern mountainous areas,mainly in rural areas.It is necessary to implement the immunization of all animals that can cause rabies infection,strengthen territorial management,improve health education,and standardize disposal,etcetera.This will reduce the economic burden of post-exposure rabies management,increase vaccination rates,and achieve the goal of zero human rabies deaths by 2030.