海南省1997～2001年新生儿破伤风病例监测结果分析

Analysis of results of surveillance of infant tetanus in the new-borns in Hainan Province in 1997～2001

目的 为了解海南省新生儿破伤风 (NT)监测系统的运行情况及NT高发地区分布 ,以便调整下一步工作策略。方法 与急性驰缓性麻痹 (AFP)病例监测系统同时运行开展NT监测 ,使用全国统一方法、标准进行病例个案调查和确诊 ,数据录入计算机进行统计分析。结果 1997～ 2 0 0 1年全省各年监测报告发病率均远大于法定传染病报告系统或妇幼系统报告发病率 ,病例个案调查率逐步提高 ;已有 6个消除NT项目市县实现了发病率降至 1‰以下的目标 ,发病集中在陵水、昌江、东方等几个少数民族市县 :5 67例病例 ,在家分娩占 96.5 % ,母亲无破伤风类毒素 (TT)免疫史者占 81.7%。结论 将NT监测纳入AFP专报系统同时运行是有效的 ,监测系统敏感性逐步提高 ,项目工作开展降低了NT发病率 ,部分市县实现了消除NT目标。

Objective To understand the operational results of neonatal tetanus (NT) surveillance system and the distribution of NT in high risk areas in Hainan Province for making effective control measures. Methods The work of NT case surveillance was carried out alongside with the AFP surveillance by using unified national approach andstandard. Individual case was surveyed and confirmed after diagnosis, and the results were analyzed by computer. Results The incidence of NT reported by NT annual case surveillance system in 1997- 2001 was much higher than that reported by the regular infection reporting system or maternal reporting system in this province and the rate of individual case survey gradually enhanced. So far six counties and cities designated for carrying out the program of elimination of NT have attained the objective of reducing the NT incidence to less than 1‰. Presently most NT infections occurred in several ethnic counties and cities, such as the counties of Lingshui, Changjiang, Dongfang, etc.. 96.5% of the 567 cases delivered in their homes and 81.7% of the mothers without inoculation of tetanus toxoids . Conclusion It is effective and practical to put the NT surveillance into the AFP special reporting system and manipulating simultaneously. It shows that the sensitivity of the surveillance system is enhanced and the incidence of NT reduced since the program of elimination of NT has been carried out. The leading factors affecting the infection of NT are delivery at home and the lower inoculation rate of tetanus toxoids in the women of child-bearing age.