辽宁省扩大国家免疫规划前后流行性腮腺炎流行病学特征变化分析

Change of epidemiological characteristics of mumps before and after implementation of the Expanded Program on Immunization in Liaoning Province,China

目的分析辽宁省扩大国家免疫规划实施前后流行性腮腺炎流行病学特征变化趋势,评价麻腮风疫苗纳入国家免疫规划实施效果,为流行性腮腺炎的防控提出建议。方法采用流行病学方法,对扩大国家免疫规划实施前后(2005～2010和2011～2016年),辽宁省流行性腮腺炎流行病学特征进行分析比较。结果扩大国家免疫规划实施前后,流行性腮腺炎年平均发病率分别为24. 83/10万和18. 38/10万,差异有统计学意义(P <0. 05);2005～2016年每年各月份均有流行性腮腺炎病例报告,1、5、6和12月为高发月,扩大国家免疫规划实施前后,高发月病例数占比分别为45. 76%和44. 30%;全省有10个地级市(占71. 43%)扩大国家免疫规划实施后流行性腮腺炎年平均发病率较实施前有一定程度的下降;扩大国家免疫规划实施前后,发病前三位的职业均为学生、幼托儿童和散居儿童,占比分别为90. 08%和84. 63%,差异有统计学意义(P <0. 05);扩大国家免疫实施前后,15岁以下病例数占比分别为78. 25%和73. 30%,差异有统计学意义(P <0. 05)。结论扩大国家免疫规划实施后,辽宁省流行性腮腺炎发病率下降显著,但持续下降的趋势不明显,且14岁以下儿童发病率仍维持在较高水平。建议对适龄儿童开展2剂次麻腮风疫苗接种,同时采取综合性措施,借消除麻疹的契机,进一步降低流行性腮腺炎发病率。

Objective To analyze the change trend of epidemiological characteristics of mumps before and after the implementation of the Expanded Program on Immunization(EPI) in Liaoning Province, China and evaluate the effectiveness of introduction of mumps vaccine into the EPI so as to put forward suggestions on the prevention and control of mumps. Methods The epidemiological characteristics of mumps in Liaoning Province before(2005 ~ 2010)and after(2011 ~ 2016) implementation of EPI were analyzed and compared by epidemiological methods. Results Before and after the implementation of EPI,the annual average incidences of mumps were 24. 83/100 000 and 18. 38/100 000 respectively,which showed significant difference(P < 0. 05). Cases were reported in each month during 2005 ~ 2016,while the peak of incidence appeared in January,May,June and December. The proportions of cases in the months in which the peaks of incidence appeared before and after implementation of EPI were 45. 70% and 44. 30% respectively.The annual average incidences of mumps in 10 prefecture-level cities(71. 43%) decreased at a certain extent after implementation of EPI. The top three incidences appeared in students,children in nurseries and kindergartens and scattered children both before and after implementation of EPI,which accounted for 90. 08% and 84. 63% of total cases respectively(P < 0. 05). However,the proportions of cases in children at ages of less than 15 years were 78. 25% and73. 30% before and after implementation of EPI,which showed significant difference(P < 0. 05). Conclusion After the implementation of EPI,the incidence of mumps in Liaoning Province decreased significantly,though the trend of continued decline was not obvious. However,the incidence in children at ages of less than 14 years remained at a high level. It is suggested that two doses of measles,mumps and rubella combined vaccine(MMR)should be inoculated to the children at school age,and comprehensive measures should be taken to further decrease the incidence of mumps by eliminating measles.