山东省狂犬病暴露人群监测研究

Research and surveillance on population of post-exposure prophylaxis for rabies in Shandong province

目的分析2019-2023年山东省狂犬病暴露预防处置门诊暴露人群监测数据,探讨暴露风险因素,为进一步规范暴露后预防处置提供依据。方法基于山东省2019-2023年狂犬病暴露预防处置门诊预防接种信息系统监测信息、人口、空间行政区划等数据,采用SPSS 18.0进行描述性流行病学分析。结果2019-2023年山东省暴露预防处置门诊每年接受暴露后处置人数均在100万以上,并呈逐年上升的趋势。每年5~8月份就诊人数最多。女性就诊者有逐年上升的趋势。15岁以下年龄组就诊者占31.69%~36.86%,且占比逐年增高。Ⅲ级暴露者占53.40%,暴露部位在四肢的占89.81%,1.94%为多部位暴露。致伤动物以犬为主,其次为猫,猫占比逐年上升。就诊者自行处理伤口的比例由32.32%上升至45.46%,门诊处理伤口的占比由76.07%下降至66.24%。首次暴露后全程接种率63.79%,15~29岁年龄组全程接种率低于其他年龄组;Ⅲ级暴露者被动免疫制剂使用率在35.66%。2019-2023年报告8例狂犬病病例死亡,均未进行暴露后处置。结论山东省动物致伤后疑似狂犬病暴露人群的流行特点和暴露风险发生了变化,需关注女性群体、15岁至29岁全程接种率偏低群体、猫致伤群体等,持续开展暴露人群监测,适时调整防控策略。

ObjectiveTo analyze the surveillance data of population in rabies exposure and post-exposure prophylaxis(PEP)clinics in Shandong province from 2019 to 2023,explore risk factors for exposure,and provide a basis for further standardizing PEP.MethodsBased on surveillance data from the rabies exposure treatment clinic vaccination information system,population,and spatial administrative division data in Shandong province from 2019 to 2023,descriptive epidemiological methods were applied to analyze using SPSS 18.0.ResultsThe number of individuals receiving post-exposure treatment at PEP clinics in Shandong province from 2019 to 2023 was over 1 million annually and showed an increasing trend year by year,with the highest number of visits occurring from May to August each year.The number of female patients is increasing year by year.The 15-year-old and younger age group accounted for 31.69%-36.86%of clinic visits.GradeⅢexposures accounted for 53.40%,and limbs accounted for approximately 89.81%of exposed areas.Approximately 1.94%is multi site exposure.The main injuring animals were dogs,followed by cats,and the proportion of cats is increasing year by year.The proportion of doctor′s office visitors who self-treated wounds increased from 32.32%to 45.46%,while the proportion of outpatient wound treatment decreased from 76.07%to 66.24%.The whole course vaccination rate after initial exposure is 63.79%.The whole course vaccination rate for the 15-29-year-old age group was lower than that for other age groups.The usage rate of passive immune preparations among gradeⅢexposed individuals is 35.66%.From 2019 to 2023,8 cases of rabies were reported,none of whom received standard post-exposure treatment.ConclusionsThe epidemic characteristics and exposure risk of people exposed to suspected rabies animals in Shandong province have changed.It is necessary to pay attention to the female population,the population with low vaccination rate between 15 to 29 years of age,cat bitten people,and carry out continuous monitoring on the exposed population,and timely adjust the prevention and control strategies.