2013—2022年河南省平顶山市91861例狂犬病暴露者流行特征及处置情况

Epidemic characteristics and management of 91861 individuals exposed to rabies in Pingdingshan of Henan,2013-2022

目的分析河南省平顶山犬伤暴露人群流行病学特征及暴露后处置情况,为制定狂犬病防控策略提供科学依据。方法收集2013—2022年平顶山市疾病预防控制中心犬伤门诊暴露人群就诊资料,对狂犬病暴露人员致伤动物类型、动物免疫情况、暴露等级、暴露部位、暴露时间和暴露后预防接种情况等进行描述性分析。结果2013—2022年共预防处置狂犬病暴露病例91861例,暴露人数逐年增多;男女性别比为1.16∶1;0~<15岁年龄段暴露人数占比最高,为33.26%;5—8月份暴露人数占41.96%;暴露部位主要是上肢,占46.60%;致伤动物犬伤占59.60%,猫伤占39.01%;犬伤呈逐年降低趋势(χ_(趋势)^(2)趋势=1486.077,P<0.05),猫伤呈逐年增长趋势(1534.904,P<0.05);犬的免疫接种率为65.03%,猫的免疫接种率为45.31%;48 h就诊率从2013年的90.32%增高至2022年的98.45%,呈逐年增长趋势(χ_(趋势)^(2)趋势=1262.972,P<0.05);伤口自行清洗率从2013年的48.05%增高至2022的68.57%,呈逐年增长趋势(χ_(趋势)^(2)趋势=1579.405,P<0.05);人狂犬免疫球蛋白(HRIG)使用率由2013年的19.98%降至2022年的11.08%,呈现下降趋势(χ_(趋势)^(2)趋势=263.430,P<0.05)。结论平顶山市居民狂犬病风险逐年增高,虽然狂犬病防护意识有所提高,但防治知识欠缺。需加强宣传教育,重点提高15岁以下儿童监护人的风险防护意识;加强动物管理,提高动物疫苗接种率。

Objective To analyze the epidemiological characteristics and management of the individuals exposed to rabies in Pingdingshan,and provide a scientific basis for control of rabies.Methods Medical data of exposed people in the canine injury outpatient department of Pingdingshan CDC from 2013 to 2022 were collected;a descriptive analysis was conducted including the type of animal having people exposed to rabies,animal vaccination,exposure level,exposure site,exposure time,and post-expo-sure vaccination status.Results A total of 91861 people with rabies exposure were treated from 2013 to 2022,and the number of people exposed to rabies was increasing year by year.The ratio of male to female was 1.16∶1.The exposed people aged 0-<15 years had highest proportion,accounting for 33.26%of the total,and 41.96%of people were exposed from May to Augus.Of the total exposures,46.60%occurred in upper limbs.Of the injury animals,dogs and cats accounted for 59.60%and 39.01%,respec-tively.Dog injury showed a decreasing trend year by year(χ_(trend)^(2)=1486.077,P<0.05),the proportion of cat injuries increased from 30.09%in 2013 to 48.12%in 2022,showing an increasing trend year by year(χ_(trend)^(2)=1579.405,P<0.05).Dogs had a vaccination rate of 65.03%,and cats had a vaccination rate of 45.31%.The 48-hour visit rate showed an increasing trend year by year,from 90.32%in 2013 to 98.45%in 2022(χ_(trend)^(2)=1262.972,P<0.05).The percentage of exposed people having the injuries cleaned by themselves showed an increasing trend year by year,from 48.05%in 2013 to 68.57%in 2022(χ_(trend)^(2)=1579.405,P<0.05).The vac-cination rate of HRIG decreased from 19.98%in 2013 to 11.08%in 2022,showing a downward trend(χ_(trend)^(2)=263.430,P<0.05).Conclusions The risk of rabies in Pingdingshan residents is showing an increasing trend year by year.Although the awareness of the protection of rabies in the residents has increased,the knowledge of rabies disease prevention is still lacking.The health ed-ucation of rabies prevention knowledge should be strengthened,and the focus is to increase the risk awareness of guardians of children under 15 years old.The management of animals should be strengthened,and the vaccination rate of animals should be increased.