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目的分析哈尔滨市急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例流行病学特征及《AFP信息监测管理报告系统》运转情况,为维持无脊灰状态、制定疾病控制策略提供科学依据。方法采用描述流行病学和分析流行病学相结合的方法对AFP病例进行流行病学特征分析,对监测指标进行系统评价。结果 2004-2015年哈尔滨共计报告AFP病例529例,平均报告发病率为4.96/10万,24 h内报告率89.19%,报告后48 h内调查率98.93%,14 d内双份合格便采集率为92.08%,便标本7 d内送达率为98.13%,75 d内随访及时率均为100%。每年3-6月,7-10月为发病高峰;各区、县(市)AFP报告数差异有统计学意义(χ2=133.19,P<0.001);农村病例多于城市(χ2=84.16,P<0.001);病例城乡二元居住状况有统计学差异(χ2=441.33,P<0.001);麻痹后第一次到省市级医院就诊的患者占76.37%,其余以县级及以下医院为主;68.80%的病例临床症状体征不明显;病例经治愈后恢复良好,只有7.94%的患者残留麻痹。就诊次数、就诊医院情况等流行病学特征以及腹泻、颈项强直等临床症状体征均有统计学差异(P<0.001)。结论哈尔滨AFP监测系统运转情况良好,工作质量逐年提高。基层医院对于AFP诊断能力和首诊报告率低,应重点对其开展AFP诊疗培训工作,强化基层医院诊断能力,做到早发现早报告。
Objective To analyze the epidemiological characteristics of Acute Flaccid Paralysis (AFP) cases in Harbin and the operational status of AFP Information Monitoring and Management Reporting System, so as to provide a scientific basis for maintaining disease-free status and formulating disease control strategies. Methods The epidemiological characteristics of AFP cases were analyzed by the method of combining descriptive epidemiology and analytical epidemiology, and the monitoring indicators were systematically evaluated. Results A total of 529 cases of AFP were reported in Harbin from 2004 to 2015, with an average reported incidence of 4.96 / 100 000, a reported rate of 89.19% within 24 h and a 98.93% within 48 h after the report. Was 92.08%, the delivery rate of the samples was 98.13% in 7 days, and the follow-up and timely rates in 75 days were both 100%. The incidence of AFP in each district, county (city) was statistically significant (χ2 = 133.19, P <0.001); the incidence in rural areas was higher than that in urban areas (χ2 = 84.16, P < 0.001). There was a statistically significant difference between urban and rural living conditions (χ2 = 441.33, P <0.001). The first visit to provincial and municipal hospitals accounted for 76.37% after paralysis, with the rest being dominated by hospitals at or below the county level. 68.80% of the patients had no obvious signs of clinical symptoms; the cases recovered well after treatment, and only 7.94% of the patients had residual paralysis. The number of visits, hospital conditions and other epidemiological characteristics as well as diarrhea, neck stiffness and other clinical symptoms and signs were statistically significant (P <0.001). Conclusion The AFP monitoring system in Harbin operated well and the quality of work improved year by year. The primary hospital for AFP diagnostic ability and the first diagnosis of low rate of reports, should focus on its AFP diagnosis and treatment training, strengthen the primary hospital diagnostic capabilities, so early detection and early report.