气压与气温对SARS发病流行的影响分析

目的 分析SARS发病率与气压、气温的关系，探讨影响SARS发病流行的自然环境因素。方法 应用描述流行病学、相关与回归分析方法研究广州和香港SARS发病率与当地平均气压、平均气温的相关和多元线性回归关系。结果 广州和香港SARS暴发期与消退期相比，平均气压分别高5．5hPa和6．2hPa，平均气温分别低4．3℃和6．0℃。SARS发病率与平均气压成正相关，与平均气温成负相关，多元线性回归分析结果表明，SARS发病与气压气温的回归关系有显性差异。结论 SARS的发病流行受气压、气温等自然环境因素的影响。     

严重急性呼吸综合征爆发的大气环境和院内感染的职业卫生因素

目的　探讨大气环境和医院职业卫生因素对非典型肺炎爆发的影响。方法　 (1)对全球 9个城市 (广州、北京、天津、太原、香港、台北、新加坡、多伦多和河内 ) 2 0 0 3年严重急性呼吸综合征(SARS)爆发前后的气象参数进行分析 ;(2 )从职业卫生的角度分析医院院内感染的原因。结果　 (1)大多数城市在SARS爆发前后 ,都出现气温、气压和气温日较差的大幅波动 ,风力微弱。在疫情最严重的城市 ,SARS爆发前大气悬浮物增多。各地SARS爆发前 10d的平均气温为 16 .6℃± 7.6℃ ,提示目前被认为造成SARS的冠状病毒可能在 9℃～ 2 4℃之间最活跃 ;(2 )医院的职业卫生是SARS爆发的重要社会行为因素 ,医院院内感染与职业卫生各个环节有密切关系。结论　冬春季节气温急剧变化、大气悬浮物增多和医院不良的职业卫生条件是SARS爆发的重要触发因素。加强天气变化和大气污染的预警 ,完善医院的职业卫生管理 ,对预防SARS爆发和季节性重现具有重大意义。     

环境因素与传染病流行

传染病的发生、发展和传播是病原体和宿主、病原体和外界环境相互联系、相互作用和相互斗争的结果。传染病在人群中的流行过程,即病原体从已受感染者体内排出,通过一定的传播途径侵人易感者机体形成新的感染造成不断发生、发展的过程。     

The impact of the SARS epidemic on the utilization of medical services: SARS and the fear of SARS

Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impacts of the severe acute respiratory syndrome (SARS) epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, significant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People's fears of SARS appear to have had strong impacts on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS should not be overlooked.     

广州市某医院预防SARS感染防护措施效果分析

目的 寻找院内感染SARS的危险因素，评估医院预防控制措施效果。方法 访谈了解医院防治SARS和医务人员发病的总体情况；现场考察相关病区的环境状况；问卷调查78名参加SARS救治工作的医务人员卫生习惯、预防措施的执行情况，并用ELISA法检测其中67人血清中的抗-SARS抗体。结果 该院共收治确诊和疑似SARS患281例，医务人员罹患率为1％(4／395)。隔离病区有2名护工感染发病，ICU有2名医生发病，1人死亡。医院采用通风良好的外廊式楼房做隔离病区，ICU收治重症患。隔离病区采取一系列严格的消毒隔离措施。医务人员有良好的个人防护和卫生习惯，100％戴口罩和洗手消毒，戴手套、穿隔离衣、穿鞋套、戴眼罩、漱口、粘膜保护等防护措施的采用率分别为74．4％、66．7％、46．2％、9．0％、24．4％和9．0％；医务人员预防服药率为57．7％。67份血清抗-SARS抗体全部阴性。结论 良好的卫生习惯和防护意识、对隔离防护制度的严格执行是防止SARS院内感染的关键环节，消毒、隔离、个人防护等主要干预措施是保护医务人员的重要防线。     

广州市某医院医务人员传染性非典型肺炎医院内感染情况调查分析

目的　探讨广州市某医院医务人员医院内感染传染性非典型肺炎 (SARS)的影响因素。方法　访谈了解医院收治患者、医务人员感染发病等情况 ,现场调查病区环境和消毒情况 ,采用统一问卷调查医护人员与患者接触程度及防护行为。结果　医院共收治 10 4例SARS患者 (其中 4 0例重症患者 ) ,2 5名医务人员感染发病 ,其中ICU罹患率最高 ,为 9 6 % (12 /12 5 )。感染发病和未感染发病医务人员在个人防护上 ,戴口罩、穿隔离衣、用鞋套、戴手套、消毒洗手和及时洗澡换衣等措施的采用差异有显著性 (P <0 0 1)。结论　医务人员院内感染可能受病区环境 (条件 )、消毒措施、患者的传染性、医务人员与患者接触程度及个人防护等多方面的影响 ;个人防护是医务人员预防感染的最后防线     

院感专业培训对医院感染管理效果的影响

目的探究院感专业培训对医院感染管理效果的影响。方法选取2019-01至2019-12滨州医学院附属医院住院患者543例和在职医务人员374名为研究对象。2019-01至2019-06实施常规感染管理,2019-07至2019-12实施院感专业培训控制医院感染。对比院感专业培训实施前后医院感染控制效果和护士防感染知识掌握情况。结果院感专业培训实施前,参加研究的543例患者感染率为10.50%,374名医务人员院感防控知识掌握平均分为(78.93±2.57)分。培训实施后,感染率为2.03%,感染防控知识掌握平均分为(88.63±2.39)分。与培训实施前相比,差异均有统计学意义(P<0.05)。结论医院感染管理过程中实施院感专业培训,可有效降低感染率,提高医院相关人员对院感防控知识掌握能力,值得临床推广。     

Fear and stigma: the epidemic within the SARS outbreak

Because of their evolving nature and inherent scientific uncertainties, outbreaks of emerging infectious diseases can be associated with considerable fear in the general public or in specific communities, especially when illness and deaths are substantial. Mitigating fear and discrimination directed toward persons infected with, and affected by, infectious disease can be important in controlling transmission. Persons who are feared and stigmatized may delay seeking care and remain in the community undetected. This article outlines efforts to rapidly assess, monitor, and address fears associated with the 2003 severe acute respiratory syndrome (SARS) epidemic in the United States. Although fear, stigmatization, and discrimination were not widespread in the general public, Asian-American communities were particularly affected.     

A hospital epidemic of vancomycin-resistant Enterococcus: risk factors and control.

OBJECTIVE: To determine risk factors for vancomycin-resistant Enterococcus (VRE) colonization during a hospital outbreak and to evaluate Centers for Disease Control and Prevention (CDC)-recommended control measures. DESIGN: Epidemiological study involving prospective identification of colonization and a case-control study. SETTING: A university hospital. PARTICIPANTS: Patients on eight wards involved in outbreak from late 1994 through early 1995. METHODS: Cases were matched by ward and culture date with up to two controls. Risk factors were evaluated with four multivariate models using conditional logistic regression. The first evaluated proximity to other VRE patients and isolation status. The second evaluated proximity to unisolated VRE cases and three variables independently predictive after adjustment for proximity. The third evaluated seven significant univariate predictors in addition to proximity to unisolated VRE in backward, stepwise logistic regression. The fourth assessed proximity to VRE with all other variables collected, clustered in a principal components analysis. Pulsed-field gel electrophoresis was performed to assess clonality of two outbreak strains. RESULTS: The incidence of transmission declined significantly after CDC guidelines were implemented. Proximity to unisolated VRE cases during the prior week was a significant predictor of acquisition in each of four multivariate models. Other significant risk factors in multivariate models included a history of major trauma and treatment with metronidazole. Pulsed-field gel electrophoresis confirmed the clonality of two outbreak strains. CONCLUSIONS: VRE was transmitted between patients during a hospital epidemic, with proximity to previously unisolated VRE patients being an important risk factor. Weekly surveillance cultures and contact isolation of colonized patients significantly reduced spread     

院内感染的护理原因和管理措施研究

本文通过分析院内感染的护理因素和护理环节,针对每个潜在因素制定解决方法和管理措施来监督并规范护理工作的实施,结果加强临床护理的监督和管理后,护理质量得到了显著提高,院内感染的发生率明显下降.     

积极预警有效防范医院感染

目的 探索病毒性腹泻暴发流行的预防控制措施,为控制医院感染暴发流行积累经验,提高医院应对突发事件的能力.方法 采取鼓励缺陷报告、信息公开提前预警、信息化平台前瞻性监测以及各部门密切合作落实干预措施等积极应对策略.结果 在多年秋季病毒性腹泻暴发流行的情况下,2009年以来有效地阻断了病毒性腹泻在医院暴发流行.结论 建立健全医院危机管理体系,加强医院感染监测网络的建设,敏感地发现医院感染流行趋势,及时的信息交流可防止医院感染蔓延.     

惠州市传染性非典型肺炎流行病学调查分析

自 2 0 0 2年 1 1月起 ,我国部分地区发生了一种新的传染性极强的呼吸系统疾病 ,这种至今原因尚未完全明了的以近距离空气飞沫和密切接触为主要传播途径的呼吸道传染病称为传染性非典型肺炎 (SARS)。广东省惠州市从 2 0 0 3年 2月 1 4日至 4月 2 3日累计发生SARS 1 0例。为了了     

Tuberculosis infection and disease among schoolchildren: the influence of the HIV epidemic and of other factors

BACKGROUND: The HIV/AIDS epidemic has caused an excess of tuberculosis cases in Spain and in other countries, but its impact on tuberculosis infection is less well understood. This study presents a massive screening undertaken to estimate the prevalence of tuberculous infection in a cohort of primary school entrants. The evolution of the risk of infection is studied by comparison with previous data in the same population. METHODS: Tuberculin skin test screening with 2TU of PPD RT 23 of first grade students in the primary schools of Barcelona, in the 1994-95 school year (cohort born in 1988). Information was also sought from families of unscreened children. Contacts of PPD+ children were traced to locate index cases. The results were also linked to the case registry of the tuberculosis control programme. RESULTS: The prevalence of tuberculin reactors free of BCG vaccination among the 11,080 schoolchildren screened belonging to the 1988 cohort was 0.76%. A 3% annual decline in the annual risk of infection is estimated by comparison with previous data. The identification of 24 cases with a previous history of tuberculosis disease and of 13 cases with active disease diagnosed after the screening was possible by the follow up of these tuberculin positive children and of the information provided by families of unscreened pupils. The screening detected 1.5 new cases of tuberculosis per 1000 tuberculin tests performed. Tuberculosis infection could be traced to HIV infected tuberculosis cases for at least 6% of the positive schoolchildren. CONCLUSIONS: The decline of the annual risk of infection continues in Barcelona, although at a slower pace than before the HIV/AIDS epidemic, probably attributable to the influence of injecting drug users with smear positive tuberculosis and HIV/AIDS.     

气候变化背景下温度对人体健康影响研究进展

  目的   了解广东省深圳市极端体感温度（AT）对高血压患者120急救量的影响,为建立或修改与高血压患者相关的公共卫生政策和调整救护车分布等提供参考依据。  方法  收集深圳市急救接报平台2013年1月 — 2020年12月高血压患者120急救数据及深圳市同期气象数据资料,应用分布滞后非线性模型（DLNM）分析极端AT对高血压患者120急救量影响的单日滞后和累积滞后效应的相对危险度（RR）,并估计人群归因危险因素百分比（PARP）。  结果  深圳市2013 — 2020年高血压患者120急救量为14491例,日急救量最少1例,最多28例,日均急救量为（9.28 ± 0.90）例;同期AT最低 – 4 ℃,最高39.4 ℃,平均AT为（25.62 ± 7.95） ℃。AT对高血压患者急救量影响的3D图及复合图显示,极端AT对高血压患者120急救量的影响呈非线性趋势,高血压患者急救量随AT的升高呈降低趋势,但在30 ℃之后又呈上升趋势。累积滞后效应分析结果显示,与适宜AT相比,极端体感低温和极端体感高温对高血压患者120急救量影响滞后0～21 d的累积滞后效应RR值分别为1.783（95%CI = 1.303～2.433）和1.315（95%CI = 0.994～1.747）,其中极端体感低温对男性和 < 65岁高血压患者120急救量影响的RR值分别为1.721（95%CI = 1.050～2.811）和1.872（95%CI = 1.184～2.982）。有13.64%的高血压患者急救量归因于极端体感低温,其中男性和 < 65岁人群更易受极端体感低温的影响。  结论  深圳市极端体感低温对高血压患者急救量的影响较大,尤其对男性和 < 65岁高血压患者的影响更大。     

在校大学生面部蠕形螨感染状况调查及流行因素分析

目的 了解在校大学生面部蠕形螨感染现状及其影响因素.方法 采用略加改进的透明胶纸法,对某校640名在校生进行面部蠕形螨检查,同时对个人卫生习惯等相关因素进行问卷调查.结果 该校在校生总感染率为17.19％.不同性别、不同年级学生之间的感染率差异均无统计学意义;与家人共用洗具者的感染率高于独用洗具者,二者差异有统计学意义;面部有、无皮肤疾病组感染学生,均以轻度感染为主,两组感染程度比较差异无统计学意义.结论 该校在校生蠕形螨感染率较低,其感染与个人卫生习惯、面部有无皮肤疾患等因素密切相关.