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目的通过对琼海市狂犬病暴露人群进行流行病学分析,掌握暴露人群的流行特征,为狂犬病预防控制提供依据。方法收集琼海市2012~2013年狂犬病暴露处置门诊登记的7 393例狂犬病暴露者流行病学资料,用描述流行病学方法分析。结果琼海市2012~2013年共发生狂犬病暴露者7 393例,年暴露率分别为793/10万、710/10万,年均暴露率为752/10万。暴露者以农村居多,农村与城市之比为4.01:1;农村与城乡结合部之比为2.67:1。男性多于女性,15岁以下儿童最多,占23.35%,其中5岁以下儿童占8.78%;其次为45-59岁组,占23.10%;各月均有暴露者发生,为6~10月高峰,占46.46%;主要的伤人动物为犬,占68.78%,其中自养犬占37.78%,其次是鼠伤占16.45%;露部位最多为下肢占44.08%(3269/7419),其次为手部占28.09%(2 083/7 419);暴露后到狂犬病暴露处置门诊处理占82.39%;暴露者中Ⅲ级暴露者4704例,占63.63%,使用人源免疫球蛋白434例,仅占9.23%,狂犬疫苗未全程接种者占30.06%。结论琼海市人群对狂犬病的防控知识尚还缺乏,暴露后伤口未处理、疫苗全程接种率低、Ⅲ级暴露后抗狂犬病血清使用率极低,存在极大发病风险。建议加强狂犬病科普知识的宣传,并将抗狂犬病血清纳入农村医保,以降低暴露者的发病率。
Objective To study the epidemiological characteristics of rabies exposed people in Qionghai and to grasp the epidemiological characteristics of exposed people and to provide basis for the prevention and control of rabies. Methods Epidemiological data of 7 393 rabies exposed subjects exposed in rabies exposures in Qionghai from 2012 to 2013 were collected and analyzed by descriptive epidemiological method. Results A total of 7 393 rabies-exposed patients were found in Qionghai from 2012 to 2013, with an annual exposure rate of 793/100000 and 710/100000, respectively. The annual average exposure rate was 752/100000. The majority of rural residents were exposed, with a rural-urban ratio of 4.01: 1 and a rural-urban-rural ratio of 2.67: 1. The number of males is more than that of females, with the largest number of children under 15 years old, accounting for 23.35%, of which 8.78% of children under 5 years of age, followed by 45-59 years old, accounting for 23.10%; , Accounting for 46.46%. The main animals were dogs, accounting for 68.78% of them, among which 37.78% were self-raising dogs, followed by 16.45% mice, and 44.08% (3269/7419) Accounting for 28.09% (2 083/7 419). After exposure to rabies exposure treatment outpatient treatment accounted for 82.39%; 4704 cases of exposure to Ⅲ-level exposure, accounting for 63.63%, 434 cases of human immunoglobulin, accounting for only 9.23 %, Rabies vaccines not fully vaccinated accounted for 30.06%. Conclusion There is still a lack of knowledge about the prevention and control of rabies in Qionghai. After exposure, the wounds are not treated, the vaccination coverage is low, and the anti-rabies serum usage rate after Ⅲ-level exposure is extremely low, which presents a great risk of morbidity. It is suggested to strengthen the propaganda of popular science knowledge of rabies and to include anti-rabies serum in rural health insurance so as to reduce the incidence of exposure.