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目的了解广州市新生儿破伤风(NT)发病情况,确定高危人群,为消除NT策略与措施的调整提供依据。方法对广州市2004-2010年NT监测系统数据进行描述流行病学分析。结果广州市2004-2010年共报告NT病例365例,发病率为0.96‰,发病率呈逐年下降趋势,男女性别比为1.57∶1;死亡40例,病死率为10.96%,发病时间越短,病死率越高;病例主要为流动人口,特别是外省流动人口所占比例较大;全年均有病例发生,6-8月发病较多;发病时间集中在2～10d之间,4～8d为发病高峰;病例以在家由未经培训人员或家人接生为主,大部分为计划外生育,母亲均未接种过破伤风类毒素,只有少数做过产前检查。结论广州市消除NT的重点在于流动人口,要采取加强宣传教育、倡导住院分娩、提倡育龄期妇女接种破伤风类毒素、完善NT监测系统等综合防控措施,并将计划生育和消除NT的行动计划有机结合起来。
Objective To understand the incidence of neonatal tetanus (NT) in Guangzhou and to identify the high-risk groups, so as to provide basis for eliminating the adjustment of NT strategies and measures. Methods The data of NT monitoring system in Guangzhou City from 2004 to 2010 were described in terms of epidemiological analysis. Results A total of 365 NT cases were reported in Guangzhou during 2004-2010, the incidence rate was 0.96 ‰. The incidence rate showed a declining trend year by year. The sex ratio was 1.57:1. The death rate was 40.9%, the mortality rate was 10.96% The higher the case fatality rate is, the higher the case fatality rate is. The majority of cases are migrants, especially the migrants in other provinces. The incidence rates are all in the whole year, with more incidence in June-August. The onset time is between 2 and 10 days, 4 to 8 days The highest incidence; cases at home by untrained persons or their family-based delivery, most of them unplanned childbirth, mothers have not been vaccinated against tetanus toxoid, only a few did prenatal care. Conclusion The focus of eliminating NT in Guangzhou lies in the floating population. It is necessary to take measures to strengthen publicity and education, advocate hospital delivery, promote tetanus toxoid in women of childbearing age, improve comprehensive prevention and control measures such as NT monitoring system, and integrate family planning and NT elimination Plan organic combination.