ＡＲＩＭＡ 乘积季节模型在手足口病发病预测中的应用研究

摘要：目的　构建时间序列ＡＲＩＭＡ 乘积季节性模型,预测武汉市２０１５年１～１２月手足口病发病趋势和流行强度,探讨该模型在手足口病发病率预测中的应用。方法　应用中国疾病监测信息报告系统２００８年１月至２０１４年１２月武汉市手足口病月发病资料,使用ＰＡＳＷＳｔａｔｉｓｔｉｃｓ１８．０专家建模器,考虑季节性因素建立ＡＲＩＭＡ 乘积季节性模型,并将所建模型对２０１５年手足口病月发病率进行外推预测。结果　模型残差序列为白噪声,ＡＲＩＭＡ （１,０,１）（０,１,１）１２模型为最佳模型,预测结果显示：２０１５年手足口病年发病率预测值为１９７．５２／１０万,流行强度较２０１４年报告发病率１６８．０７／１０万上升１７．５２％;２０１５年手足口病月发病高峰将出现在４、５、６三个月（５月达到最高峰值４３．８３／１０万,９５％CI：２．９６／１０万～２０８．２８／１０万）,至１１、１２月出现次要高峰。结论　专家建模器构建乘积季节性模型拟合效果较好,在实际工作中要充分考虑社会、自然等影响因素,综合分析,针对性地开展病例的发现、诊治,做好传染源管理和聚集性疫情的疫点消毒卫生处理,为防控工作提出理论与实证依据。     

ＡＲＩＭＡ 模型在衢州市梅毒发病率预测中的应用

摘要：目的　探讨应用ＡＲＩＭＡ 模型预测梅毒发病趋势的可行性，为预防控制梅毒流行提供依据。方法　应用ＳＰＳＳ１８．０对２００５－２０１４年衢州市梅毒逐月发病率建立ＡＲＩＭＡ 模型，并对２０１５年梅毒发病率进行预测分析。结果　ＡＲＩＭＡ （２，１，１）（０，１，１）１２能较好拟合既往梅毒的发病率，２０１４年梅毒月发病率预测值和实际值的平均相对误差为１１．８９％，实际值均在预测９５％ 犆犐内。结论　ＡＲＩＭＡ 模型能有效地预测梅毒发病趋势，为制定防控措施和策略提供科学的依据。     

1994年全国急性弛缓性麻痹监测系统工作状况评析

１９９４年全国ＡＦＰ监测系统共报ＡＦＰ病例３１４２例，比１９９产加４０．２％，全国有１２９７个县报告了ＡＦＰ病例，占全国总县数的４５．１％。其中确诊脊为３０７例，波及２２５个县。１５岁以下儿童ＡＦＰ报告发病率为１．１／１０万，非脊灰ＡＦＰ报告发病率为０．８１／１０万，比１９９３年的０．３７／１０万有较大幅度的上升。     

我国部分脊髓灰质炎高发省急性弛缓性麻痹病例发病情况调查

１９９４年６月中旬卫生部疾病控制司专业考察小组,在我国一个脊髓灰质炎（脊灰）高发省份随机抽取２０个地区,对其４５所地（市）级和１３所县级医院进行了ＡＦＰ病例的主动搜索,共查出１９９１～１９９４年５月发病的ＡＦＰ病例６８１例,分布于１０１个县市。结果表明：０～１４岁儿童ＡＦＰ、脊灰、非脊灰ＡＦＰ及ＧＢＳ年平均发病率分别为１．０４／１０万、０．４８／１０万、０．５７／１０万及０．３１／１０万,其中脊灰发病率明显较１９９１年下降,其构成比由１９９１年的第一位逐年降低;此外,约９５％的脊灰患者分布于０～４岁组,表明０～４岁儿童应为今后监测和保护的重点;非脊灰ＡＦＰ发病率具有明显的地区性差异,认为采用“０～４岁非脊灰ＡＦＰ发病率＞１／１０万”作为监测系统敏感性指标似更合乎国情。     

福建省ARI项目是5岁以下儿童监测结果初步分析

本文对福建省宁化、顺昌两个急性呼吸道感染（简称ＡＲＩ）项目是５岁以下儿童１９９４年１月１日－－１９９５年１２月３１日间的监测资料进行整理、分析。结果表明：（１）项目是１９９４年ＡＲＩ发病率为８１．４２％；１９９５年发病率为７３．６１％。（２）ＡＲＩ四季都有发病，高峰大致在春、秋两季。（３）２月龄以内ＡＲＩ婴儿患重度肺炎和极重症的比例为１９．１４％，是２－１１月龄组的７倍、１－４岁组的１７倍；而２月     

淮南市急性驰缓性麻痹病例基础发病情况的调查分析

本文通过对１３家综合性医院调查，我市１５岁以下儿童ＡＦＰ、脊髓灰质炎、非脊炎ＡＦＰ的年均发病率（１／１０万）分别为０．６９、０．４８、０．２１；由于诸多因素影响，经校正后的ＡＦＰ、脊灰、非脊灰ＡＦＰ发病率（１／１０万）则分别为４．１８、２．９１、１．２７；其中非脊灰ＡＦＰ发病率１．２７／１０万，接近实际１．１２／１０万并超过了国家１．００／１０万指标。调查还提示０￣３岁组儿童仍是消灭脊灰重点监测人     

某部队急性腹泻病监测报告 Ⅰ.流行病学部分

１９９１年６月～１９９２年５月在驻粤某部队进行了急性腹泻病的主动监测。年发病率为０．６４～１．０次／人／年。发病率与相对湿度（Ｘ２）、气温（Ｘ３），特别是雨量（Ｘ１）的关系经多元回归分析表明呈正相关。ｙ＝１．９８＋０．０２ｘ１＋０．０２ｘ２＋０．０７ｘ３，ｒ＝０．８７２７，Ｐ＜０．０１。病例－对照研究结果提示，饭前、便后不洗手等生活习惯用腹泻发病有密切关系。２６．３％的患者有淋雨、腹部受凉或感冒等     

季节性ＡＲＩＭＡ 模型在广州市手足口病疫情预测中的应用

摘要：目的　探讨应用季节性ＡＲＩＭＡ 模型预测广州市手足口病发病情况的可行性。方法　利用“传染病报告信息管理系统”数据，应用ＳＰＳＳ１３．０统计软件对广州市２００９年１月至２０１４年６月手足口病发病数建立季节性ＡＲＩＭＡ 模型，使用所建模型对２０１４年７～１２月发病情况进行预测。结果　广州市手足口病发病特征以年为流行周期， 每年有２ 个发病高峰； 应用季节性ＡＲＩＭＡ 方法进行模型识别与估计后， 建立ＡＲＩＭＡ （１，０，１）（２，１，０）１２模型，预测平均相对误差为０．２２，预测效果较好。结论　季节性ＡＲＩＭＡ模型能较好的拟合广州市手足口病发病序列并进行短期的有效预测。     

江苏省急性弛缓性麻痹(AFP)病例主动监测质量调查

为发现江苏省急性弛缓性麻痹（ＡＦＰ）病例主动监测中的问题，进一步全面提高ＡＦＰ病例监测质量，我们在全省范围内开展ＡＦＰ病例主动监测调查，１９９５～１９９７年３月共发现ＡＦＰ病例３０９例。３年中ＡＦＰ病例漏报率分别为１１．８％、１８．０％和１１．５％，平均漏报率为１４．２％。其中市级哨点医院漏报率为１５．３％，县级为１３．４％。这说明我省ＡＦＰ病例报告发病率虽然已连续３年达到１／１０万指标，但监测质量仍须进一步提高，以减少ＡＦＰ病例的漏报。为防止在消灭脊髓灰质炎后期阶段发生输入病例，必须认真做好主动监测工作。     

河北省1990~1992年急性弛缓性麻痹发病情况调查

笔者报告了１９９３年９月对河北省１９９０～１９９２年０～１４岁儿童住院的急性弛缓性麻痹（ＡｃｕｔｅＦＬａｃｃｉｄＰａｒａｌｙｓｉｓ，ＡＦＰ）进行调查的情况。结果表明，３年平均ＡＦＰ、非脊髓灰质炎急性弛缓性麻痹（Ｎｏｎ－ｐｏｌｉｏＡＦＰ）调查发病率分别为１．４９８／１０万、０．９８８／１０万；０～４岁儿童３年平均发病率二者分别为２．９１７／１０万和１．５９１／１０万。格林巴利综合征（ＧＢＳ）占全部ＡＦＰ病例的５４．０６％。     

Risk factors for acute respiratory infections in underfives in a rural community

The risk factors for acute respiratory infection (ARI) were investigated in a 6-month study of 366 children under 5 years of age from a rural zone of Delhi, India. Home visits were made to each child enrolled in the study every 2 weeks. 242 children (65.9%) had adequate nutritional status, 95 (26%) had mild malnutrition, and 30 (8.1%) had moderate to severe malnutrition. The annual ARI incidence was 3.27 episodes per child in the moderate to severely malnourished children, 2.82 episodes in mildly malnourished children, and 2.26 episodes in adequately nourished children. Lower respiratory infection was more affected by adverse nutritional status than upper respiratory infection. ARI incidence was also significantly lower among children living in well-ventilated homes (1.79 episodes/child/year) than those living in poorly ventilated homes (2.87 episodes/child/year). Since none of the mothers smoked and adequate breast feeding was practiced by 95% of mothers, the influence of these two risk factors on ARI was not relevant in this study.     

Acute respiratory infections in children: a community based longitudinal study in south India

A community based longitudinal study was conducted in Malpe, a coastal village of Udupi district, Karnataka state, to investigate acute respiratory infections (ARI) in children. A cohort of 91 children under 3 years of age were followed up for 1 year, leading to 2047 fortnightly observation. On an average every child had 11.3 months of follow up. The overall incidence of ARI was 6.42 episodes per child per year. On an average each episode lasted for 5.06 days. Mean duration of ARI during one year was 32.5 days per child. Most of the ARI episodes in children (91.3%) were of simple Cough & Cold (no pneumonia). However, 8.2% developed pneumonia and only 0.51% had severe pneumonia. Incidence of ARI was almost same in male and female children. There was no significant difference in incidence among various age groups. But the incidence of pneumonia was significantly higher among infants (p<0.00002). Children of poor housing with smoke producing conditions suffered more frequently (p,002).     

湖南省攸县5岁以下儿童腹泻病监测研究

１９９２年６月～１９９３年５月对攸县农村１０个村所有５岁以下儿童及在村卫生室就诊的腹泻病病例的治疗情况进行了监测分析。全年平均监测５岁以下儿童１３４６人，报告发病２２３人次，腹泻病报告年发病率为０．１７次／人·年。腹泻发病率与性别无关，０．５岁和１岁组发病率较高，５～８月为发病高峰期，８月为高峰月。口服补液盐（ＯＲＳ）使用率为８７．８９％，平均每人次使用１．５６包（５００ｍｌ／包），脱水病例ＯＲＳ使用率为９５．５２％，平均每人使用２．０２包。静脉补液使用率为１．７９％。粘液脓血便发生率为１２．６４％，抗菌药物使用率为５８．７４％，合并使用ＯＲＳ和抗菌药物的人次数占发病人次数的４７．０８％，使用抗菌药物的病例有１６．０３％使用了２种。各项指标比１９９１年９月在该县进行的调查结果均有所提高。     

Effect of vitamin A supplementation on diarrhoea and acute respiratory tract infection in children

To determine the effect of a massive single oral dose of Vitamin A (200,000 IU) supplementation on diarrhoea and acute respiratory infection (ARI), a double blind placebo controlled trial involving 174 children under six years of age (excluding infants) was carried out in a Calcutta slum community. Ninety-one children received vitamin A supplementation (experimental group) and 83 children received a placebo (control group). All the children were followed up for six months by active fortnightly surveillance for occurrence of diarrhoea or ARI and their duration. There was no statistically significant difference in the incidence of diarrhoeal episodes or ARI. However, there was a significant difference (p<0.05) in the average duration of diarrhoea per episode (2.1 vs. 3 days) between the experimental and control groups. Possible beneficial effects of a single oral dose of vitamin A supplementation on the incidence of diarrhoea and ARI could not be demonstrated in the present study.     

Burden of acute gastroenteritis and healthcare-seeking behaviour in France: a population-based study

In France surveillance underestimates the true burden of acute gastroenteritis (AG). We conducted a population-based, retrospective cross-sectional telephone survey between May 2009 and April 2010 in order to obtain more accurate estimates of the incidence and the burden of AG and to describe healthcare-seeking behaviour for AG. Of the 10 080 persons included in the survey, 260 respondents reported 263 episodes of AG. The incidence rate of AG was estimated at 0·33 cases/person-year (95% CI 0·28-0·37). It was highest in children aged <5 years and declined with age. Thirty-three percent (95% CI 27-40) of the AG cases consulted a physician and 76% (95% CI 70-82) used medication. Our results indicate that there are more than 21 million episodes of AG each year in France. These results allow a more accurate interpretation of the data derived from existing AG surveillance systems.     

Population-based study of acute respiratory infections in children,Greenland

Acute respiratory infections (ARI) are frequent in Inuit children, in terms of incidence and severity. A cohort of 294 children <2 years of age was formed in Sisimiut, a community on the west coast of Greenland, and followed from 1996 to 1998. Data on ARI were collected during weekly visits at home and child-care centers; visits to the community health center were also recorded. The cohort had respiratory symptoms on 41.6% and fever on 4.9% of surveyed days. The incidence of upper and lower respiratory tract infections was 1.6 episodes and 0.9 episodes per 100 days at risk, respectively. Up to 65% of the episodes of ARI caused activity restriction; 40% led to contact with the health center. Compared with studies from other parts of the world, the incidence of ARI appears to be high in Inuit children.     

Oral rehydration therapy in the home by village mothers in Burma

Acceptability and effectiveness of oral rehydration therapy (ORT) when given by mothers in the home under village conditions was investigated in six (two control and four test) communities at Htauk-kyant near Rangoon, Burma. The control and test village communities had populations of 2085 and 4278 respectively, of which 218 and 623 were children under five. In the test villages, Oral Rehydration Salts (ORS) were made constantly available by providing each household with one packet of ORS, which was replenished whenever a used packet was returned to the field workers during their daily surveillance rounds. In control villages ORS packets were not provided. Daily diarrhoea surveillance was made for one year, including daily weighing of each child with diarrhoea, and across-episode weight changes were calculated. Monthly mass anthropometric measurements (weight and height) were carried out on over 90% of all children in test and control villages. Stool samples were investigated for bacterial aetiological agents. In test villages 327 children developed diarrhoea (52% of all children) with a total of 639 episodes and an incidence of 1.3 episodes per child per year. 314 diarrhoea episodes (49% of all) occurred in 67 children who had three or more episodes each. ORS was readily accepted and administered by mothers in 96% of the diarrhoea episodes. The impact of ORS on mortality and morbidity could not be demonstrated as there was no death, nor necessity for admission to hospital for diarrhoea in either test or control village populations.(ABSTRACT TRUNCATED AT 250 WORDS)     

A one-year community study of under-fives in rural Ethiopia: patterns of morbidity and public health risk factors

A prospective weekly home surveillance study was undertaken to determine morbiditypatterns within the Butajira Rural Health project in central Ethiopia. Overall prevalence of illness was 5.8% in 1216 person-years observed among rural Ethiopian children aged under 5 years. Acute respiratory infections (ARI) (prevalence 2.8%) and acute diarrhoea (2.4%) were the commonest conditions. Episodes of illness were distributed unequally among children, with a mean of 2.34 episodes per child. These included an average of 1.13 episodes of ARI (of which 0.16 had lower respiratory symptoms [ALRI]) and 1.17 episodes of acute diarrhoea. Sanitation factors were the principal risks for gastroenteritis, while living in rural areas predisposed children to ARI. Parental factors such as illiteracy were also linked to morbidity.     

Longitudinal studies of infectious diseases and physical growth of children in rural Bangladesh. II. Incidence of diarrhea and association with known pathogens

Longitudinal studies were done in two villages rural Bangladesh to learn more about the interactions between infectious diseases and the nutritional status of children. Diarrheal diseases, identified by surveillance of 197 children aged 2-60 months, were studied for bacterial, viral and parasitic enteropathogens in 1978-1979. The annual incidence of diarrhea was highest in children aged 2-11 months, and declined progressively with age from seven to four episodes per child per year. An enteropathogen was identified from rectal cultures taken during diarrhea in 51% of episodes and from 6% of monthly cultures taken when diarrhea was not present. Enterotoxigenic Escherichia coli were the pathogens found most frequently, followed by shigellae and rotaviruses. Diarrheal episodes associated with shigellae had the longest duration, while episodes associated with Vibrio cholerae or with rotavirus were more frequently associated with dehydration. E. coli diarrhea had a peak incidence during the hot months, and shigellosis was more frequent during the cool, dry months.     

Childhood diarrhoea in a district in northeast Thailand: incidence and treatment choices

Diarrhoeal disease is a major public health problem in Thailand. We collected information on childhood diarrhoea from a district in northeast Thailand, using various approaches which focus on both consumers and providers. The overall incidence of diarrhoea in the study area was 2.1 episodes per child per 12 months, with children under two years of age having a higher rate at 3.0 episodes per child per 12 months. Many episodes were not recognized as diarrhoeal episodes by caregivers, and treatment was sought in just over half of all episodes. Although children received an average of 2.4 items of medicine per episode, there was relatively low use of oral rehydration solutions. This study highlights the importance of assessing local beliefs when collecting data on diarrhoeal diseases in children, and the importance of continuing efforts to improve public health education on the management of diarrhoeal diseases.