泉州市产妇梅毒感染状况及母婴阻断效果分析

Analysis of maternal syphilis infection status and mother-infant blocking effect in Quanzhou city

目的了解泉州市产妇梅毒感染状况及母婴阻断效果,为制定干预措施提供依据。方法从预防艾滋病、梅毒和乙肝母婴传播管理信息系统中收集2021—2022年泉州市梅毒感染产妇个案信息,采用描述流行病学方法分析数据。结果2021—2022年泉州市住院分娩产妇数133238人,孕产期梅毒检测率为99.87%。2022年梅毒检测率孕产期(χ^(2)=108.284)、孕期(χ^(2)=415.405)和孕早期(χ^(2)=226.093)高于2021年(均P<0.05),而仅产时低于2021年(χ^(2)=335.139,P<0.05);2年间产妇梅毒检测阳性率孕产期(χ^(2)=0.026)、孕期(χ^(2)=0.041)及孕早期(χ^(2)=0.075)差异无统计学意义(P>0.05),仅产时差异有统计学意义(χ^(2)=5.421,P<0.05)。不同地区产妇梅毒检测率孕产期(χ^(2)=711.545)、孕期(χ^(2)=1702.978)、孕早期(χ^(2)=9387.602)及仅产时检测率(χ^(2)=1813.006),差异均有统计学意义(P<0.05);梅毒检测阳性率孕产期(χ^(2)=50.489)、孕期(χ^(2)=45.025)、孕早期检测阳性率(χ^(2)=36.137)和仅产时(χ^(2)=82.574)差异有统计学意义(P<0.05)。梅毒检测阳性率城乡差异无统计学意义(χ^(2)=3.553,P>0.05)。479例梅毒感染产妇中,初中及以下占79.96%,其中隐性梅毒占97.70%;性传播为主、占94.74%,性伴检测率为38.00%。产妇梅毒治疗率和规范治疗率分别为97.70%和66.60%,儿童预防性治疗率为98.34%;先天梅毒报告发生率为4.07/10万活产,儿童随访率为50.72%。结论2021—2022年泉州市预防梅毒母婴传播工作取得阶段性成效,提高性伴检测率、产妇规范治疗率及儿童随访率是今后工作的重点。

Objective To understand the status of puerperae with syphilis infection and blocking effect of mother-infant in Quanzhou city,and provide basis for formulating intervention measures.Methods The cases information of maternal syphilis infection in Quanzhou city from 2021 to 2022 was collected from the Prevention of Mother-infant transmission of HIV,Syphilis and Hepatitis B Management Information System and analyzed with descriptive epidemiological methods.Results There were 133238 pregnant women delivered in hospitals,with the syphilis detection rate of 99.87%in Quanzhou city from 2021 to 2022.In 2022,the syphilis detection rate of puerperae in pregnant and puerperal period(χ^(2)=108.284),pregnancy(χ^(2)=415.405)and early pregnancy(χ^(2)=226.093)was higher than that in 2021(all P<0.05),and lower than that in intrapartum time(=335.139)in 2021,with statistical differences(P<0.05).The differences of syphilis positive rates were not statistically significant(P>0.05)in pregnant and puerperal period(χ^(2)=0.026),pregnancy(χ^(2)=0.041)and early pregnancy(χ^(2)=0.075),but was statistically significant(P<0.05)in intrapartum time(χ^(2)=5.421)between the 2 years.The differences of syphilis detection rates were significant(P<0.05)in pregnant and puerperal period(=711.545),pregnancy(χ^(2)=1702.978),early pregnancy(χ^(2)=9387.602)and intrapartum time(=1813.006)among different areas.And the differences of syphilis positive rates were significant(P<0.05)in pregnant and puerperal period(χ^(2)=50.489),pregnancy(χ^(2)=45.025),early pregnancy(χ^(2)=36.137)and intrapartum time(χ^(2)=82.574)in different areas.There was no statistically difference between the syphilis positive rates in urban and rural(χ^(2)=3.553,P>0.05).Among the 479 puerperae with syphilis infection,the cases with the education background of junior high school and below accounted for 79.96%,and the cases with latent syphilis accounted for 97.70%.Sexual transmission was the main with the proportion of 94.74%.The detection rate of partners was 38.00%.The treatment and standardized treatment rates maternal syphilis were 97.70%and 66.60%,respectively.The prophylactic treatment rate of the infant with syphilis was 98.34%.The reported incidence rate of congenital syphilis was 4.07/100000 live births,and the follow-up rate of children was 50.72%.Conclusions The prevention of mother-infant transmission of syphilis achieves phased result in Quanzhou city from 2021 to 2022.The improvement of sexual partner detection rate,the standardized maternal treatment rate and the follow-up rate of children are the key points of future work.