248例流行性乙型脑炎临床流行病学分析

目的:了解乙脑的发病率及住院病人的病死率变化趋势。方法：搜集1986－1999年在开江县医院住院诊治的乙脑病例,进行临床流行病学分析。结果：15年中在县医院诊治的乙脑患者共248例,占全县乙脑总病例的68．70％,病死率为2．49％（6／248）。发病年龄以2－6岁为多,占79．84％,发病时间集中在8月,占83．04％,农村发病与城镇之比为40．33：1,随着年龄增大重型和极重型病例呈增多趋势,248例中仅有11．29％的患者接种过乙脑疫苗,结论：乙脑的防治工作,重点应放在10岁以下的农村儿童,采取以防蚊灭蚊和按时全程足量接种乙脑疫 等综合措施,以控制和预防本病的发生和流行。     

44例乙型脑炎流行病学分析

４４例乙型脑炎流行病学分析李保军，张孔玉，牛艳玲据疫情报告，１９９１年７－９月份荥阳市共发生乙脑病人４４例，占全年传染病发病总数的５％，死亡３例，占死亡总数的４０％，病死率为６．８％，是建国以来荥阳市乙脑发病较多的一年，严重危害了人们的生命健康。为了...     

永州市40年间流行性乙型脑炎流行病学分析

本文对永州市１９５６￣１９９６年乙脑发病情况作了流行病学分析，平均发病率为８．５９／１０万。病例主要集中在６￣８月，占全年总发病率的９３．５％，流行高峰时间比国内报导时间提前一个月。山南气候区（高山、丘陵）居民乙脑发病率高于山北气候区（丘陵）；五岁以下散居儿童是乙脑的主要侵害对象，男性发病高于女性，男女性别比为１．５３：１。     

思茅市2003年乙型脑炎流行病学调查报告

目的了解2003年思茅市乙脑流行特点和流行原因。方法进行乙脑病例个案调查，对住院后未死亡患者进行后遗症访视。结果乙脑发病率比2002年上升305．6％，死亡率上升24倍，发病分布占全市乡（镇）数的30．9％，农村病例为城镇病例的8．1倍，坝区发病人数显著高于山区，发病年龄明显高移，≥20岁者占32．9％，学生发病33例，占45．2％。6～9月发病人数占病例数的90．41％。乙脑患者病死率为32．2％，残疾率为26．3％。所有患者均无乙脑疫苗免疫史，患者蚊帐和灭蚊剂使用率分别为36．99％和4．1％。结论因多年低疫苗接种率和低发病率，使人群易感性增加，加之乙脑预防措施削弱，是造成乙脑流行的主要原因。     

虞城县农药中毒的流行病学调查研究

为了解农村责任承包制后，农药中毒的趋势，我们于１９８４年８月至１９９１年８月七年时间共调查农药中毒病例１０５３例，其中死亡３７６例，年龄分布以１７～３５岁最多，占总病例的７８。９２％，死亡占总死亡人数的７９．５２％；性别分布女性显著高于男性：非生产性农药中毒死亡人数高于生产性农药中毒死亡人数：８８．５１％的中毒病例和９２．３５％死亡病例是由使用方法不当和防护不严引起；非生产性农药中毒中９０．２７％的中毒病例、９４．３８％的死亡病例是由轻生者服用引起；生产性农药中毒多发生在７、８、９月份，非生产性农药中毒季节性不明显。笔者建议：在防护上主要是加强农药的管理。     

日照市1046例腹泻病人调查分析

为了解腹泻病的流行特征及临床治疗现状，为制定控制对策提供科学依据，作者对１９９８年就诊的１０４６例腹泻病人进行了调查分析。结果发现存在以下特点：①发病以腹泻、腹痛为主要临床表现，急性肠炎病人占７８．２０％，其中嗜盐菌食物中毒病人占邻１２．３５％，并引起局部爆发。②以散居儿童和农民发病率最高，分别占３６．３３％和３３．７５％且具有明显的季节性，７、８、９月为发病最高期。③病例以门诊治疗为主，占９０．     

一起敬老院菌痢爆发流行调查

１９９０年６月上海市南汇县新场镇敬老院发生一起福氏痢疾杆菌Ｙ血清型的爆发流行，现将调查结果报告如下：一、发病情况新场镇敬老院共５３人。其中老人３８人，职工１５人。本次患病２４例，罹患率４５．２６％。其中住院１６例，住院率６６．７％。２４例中男８例，女１６例。年龄最大１００岁，最小３４岁，平均７１．５岁，其中９０岁以上３例，８０～９０岁８例。２４例中老人２０例，职工４例。２４例中８例大便培养检测到福氏痢疾杆菌Ｙ血清型阳性。另外检测到２例健康带菌者。首例患者女，６４岁，敬老院护工。６月１５日晚上８时…     

再次接种乙脑疫苗致全身荨麻疹一例

再次接种乙脑疫苗致全身荨麻疹一例吴宣亮（安徽淮南潘二矿职工医院２３２０９１）１发病与治疗经过患儿，女，８岁。于１９９７年４月１７日９时在学校按常规接种乙脑疫苗（卫生部上海生物制品研究所生产，批号为９６１２３１－５）。约４０分钟后，患儿自诉眼睛刺痛，心...     

随州市1951—1993年疟疾疫情分析

对随州市１９５１－１９９３年疟疾发病动态分析结果表明：发病率最高年份是１９７３年为９．０１％，最低年份是１９８８年为０．００１７％，常年发病率为０．２３％；７０年代发经为３９３．０９／万，居各年代之首；年发病月分布以８月份最高占２４．４７％。从历年发病率显示：本地区疟疾发病具有一定的周期性。即８年左右一个周期和２０年一次疫情大幅度上升。根据历史上的两次暴发流行和近年来疟疾回升的特点，提出疟疾防治工     

湛江市1984～2003年流行性乙型脑炎流行特征分析

目的 分析湛江市1984～2003年流行性乙型脑炎(简称乙脑)流行特征，为有效控制乙脑发病及流行提供科学依据。方法对1984～2003年湛江市乙型脑炎疫情资料进行统计分析。结果1984～2003年共发病2232例，年平均发病率为2．01／10万，死亡173例，病死率为7．7％；无免疫史1232例，占总病例数的55．2％，免疫史不详者384例，占17．2％，未免疫及免疫史不详者占总病例数的72．4％。1～6岁儿童发病1887例，占总病例数的84、5％；廉江和雷州两市病例为13-41例，占病例总数的60．1％：每年的6月为高发季节(占68．3％)。结论 湛江市乙脑流行多年，以季节性突击接种疫苗不能彻底控制乙脑疫情，应改为常年免疫门诊接种，进而提高接种率，彻底控制乙脑流行。     

山西省肿瘤医院1989～1999年大肠癌手术病例特征及趋势分析

目的 通过对山西省肿瘤医院９０年代手术大肠癌患者临床流行病学特点的分析，探讨本地区９０年代大肠癌流行规律及变化趋势。方法 统计１９８９～１９９９年在该院住院的大肠癌所有病例，并进行分析。结果 １１年共收治大肠癌３０５０例，其中手术２２４６例，占７３．６４％，男女之比为１．０８：１，男性略高于女性。１９９１～１９９４年住院人数变化不明显，但高于１９８９年和１９９０年。１９９５～１９９９年有逐年上升的     

Morbidity Measures Predicting Mortality in Inpatients: A Systematic Review

ObjectivesMorbidity is an important risk factor for mortality and a variety of morbidity measures have been developed to predict patients' health outcomes. The objective of this systematic review was to compare the capacity of morbidity measures in predicting mortality among inpatients admitted to internal medicine, geriatric, or all hospital wards.DesignA systematic literature search was conducted from inception to March 6, 2019 using 4 databases: Medline, Embase, Cochrane, and CINAHL. Articles were included if morbidity measures were used to predict mortality (registration CRD42019126674).Setting and ParticipantsInpatients with a mean or median age ≥65 years.MeasurementsMorbidity measures predicting mortality.ResultsOf the 12,800 articles retrieved from the databases, a total of 34 articles were included reporting on inpatients admitted to internal medicine, geriatric, or all hospital wards. The Charlson Comorbidity Index (CCI) was reported most frequently and a higher CCI score was associated with greater mortality risk, primarily at longer follow-up periods. Articles comparing morbidity measures revealed that the Geriatric Index of Comorbidity was better predicting mortality risk than the CCI, Cumulative Illness Rating Scale, Index of Coexistent Disease, and disease count.Conclusions and ImplicationsHigher morbidity measure scores are better in predicting mortality at longer follow-up period. The Geriatric Index of Comorbidity was best in predicting mortality and should be used more often in clinical practice to assist clinical decision making.     

Hospital-based surveillance of malaria-related paediatric morbidity and mortality in Kinshasa, Zaire

Although Plasmodium falciparum malaria is a leading cause of paediatric morbidity and mortality in Africa, few quantitative estimates are available about the impact of malaria on childhood health. To quantify the impact of the disease in an urban African setting, we reviewed the paediatric ward and mortuary records at Mama Yemo Hospital in Kinshasa, Zaire. From June 1985 to May 1986, 6208 children were admitted to the hospital, 2374 (38.2%) of whom had malaria; 500 of those with malaria died (case fatality rate, 21.1%). During this same period, there were 10,036 paediatric deaths, 1323 (13.2%) of which were attributed to malaria; 823 (62.2%) of these occurred in the emergency ward prior to hospitalization. Minimum population-based malaria mortality rates were highest for children aged less than 1 year (4.0 per 1000 per year). Over 70% of children admitted with malaria and greater than 80% of children who died from the disease were less than 5 years old. The total number of paediatric admissions and deaths remained relatively constant between 1982 and 1986; however, the proportional malaria admission rate increased from 29.5% in 1983 to 56.4% in 1986, and the proportional malaria mortality rate, from 4.8% in 1982 to 15.3% in 1986. These increases were temporally related to the emergence of chloroquine-resistant Plasmodium falciparum malaria in Kinshasa. Malaria is therefore a major cause of paediatric morbidity and mortality in the city, and this study indicates that hospital-based surveillance may be useful in monitoring disease-specific morbidity and mortality elsewhere in Africa.     

妇幼保健院住院患者梅毒的筛查与分析

目的了解我院2001～2004年问住院患者中梅毒的发病情况，探讨预防医院中梅毒感染的措施。方法对我院2001～2004年间住院患者中筛查出梅毒患者的病历资料进行统计分析。结果18955例住院患者中筛查出梅毒患者44例，梅毒患者占筛查人数0．23％，其中显性梅毒5例，潜伏梅毒32例，先天梅毒7例；住院患者中梅毒患病人数逐年增多；显性梅毒和潜伏梅毒在20-40岁年龄段患病人数明显多于其他年龄段；先天梅毒分布于儿科，显性梅毒主要分布于妇科，潜伏梅毒大部分分布于产科。结论住院患者中梅毒患病率呈逐年上升趋势，其中主要为潜伏梅毒；因此，对存在高危因素的住院患者进行常规梅毒筛查，是及早发现潜伏梅毒并防止其传播的有效防治措施之一。     

Healthcare Resource Utilization of Patients With COVID-19 Visiting US Hospitals

ObjectivesSevere cases of COVID-19 have overwhelmed hospital systems across the nation. This study aimed to describe the healthcare resource utilization of patients with COVID-19 from hospital visit to 30 days after discharge for inpatients and hospital-based outpatients in the United States.MethodsA retrospective cohort study was conducted using Premier Healthcare Database COVID-19 Special Release, a large geographically diverse all-payer hospital administrative database. Adult patients (age ≥ 18 years) were identified by their first, or “index,” visit between April 1, 2020, and February 28, 2021, with a principal or secondary discharge diagnosis of COVID-19.ResultsOf 1 454 780 adult patients with COVID-19, 33% (n = 481 216) were inpatients and 67% (n = 973 564) were outpatients. Among inpatients, mean age was 64.4 years and comorbidities were common. Most patients (80%) originated from home, 10% from another acute care facility, and 95% were admitted through the emergency department. Of these patients, 23% (n = 108 120) were admitted to intensive care unit and 14% (n = 66 706) died during index hospitalization; 44% were discharged home, 15% to nursing or rehabilitation facility, and 12% to home health. Among outpatients, mean age was 48.8 years, 44% were male, and 60% were emergency department outpatients (n = 586 537). During index outpatient visit, 79% were sent home but 10% had another outpatient visit and 4% were hospitalized within 30 days.ConclusionsCOVID-19 is associated with high level of healthcare resource utilization and in-hospital mortality. More than one-third of inpatients required post hospital healthcare services. Such information may help healthcare providers better allocate resources for patients with COVID-19 during the pandemic.     

Morbidity and mortality patterns among pediatric patients in Dominica (West Indies)

Morbidity and mortality patterns were examined among 968 pediatric patients on the island of Dominica. These children, whose ages ranged from newborn to 13 years, were seen by the consulting pediatrician at Princess Margaret Hospital during a 9-month period in 1978-79; 852 children were seen as inpatients. A total of 477 cases of infectious disease were diagnosed among inpatients alone. Stool examination in a subsample of these children revealed parasites (mostly Trichuris) in roughly half. Also found was a relatively high prevalence of chronic health problems, especially rheumatic heart disease (34 cases), mental retardation (28 cases), epilepsy (31 cases), and sickle cell anemia (21 cases). Examination of the hospital records of 100 of the inpatients ages 6 months-5 years demonstrated that 34% were low weight-for-age according to the World Health Organization classification. There were 34 deaths (9 pediatric patients and 255 newborns). The high neonatal mortality is attributed to an unusually high incidence of immaturity and prematurity, irregular and insufficient hospital oxygen supply, and a septicemia epidemic. Although these findings reflect patterns of the more serious diseases, they could be useful in planning preventive health measures. The high prevalence of malnutrition points to a need for nutrition education, promotion of breastfeeding, promotion of vegetable growing, and the introduction of a home-based growth chart. The high incidence of diarrhea, typhoid fever, and helminthiases highlights problems with general hygiene, latrines, and water supply. There is also a need for follow-up facilities for children with rheumatic heart disease, epilepsy, and sickle cell anemia. It is suggested that hospital care could be improved by dividing pediatric and neonatology wards into 5 units: isolation ward, malnutrition ward, semi-intensive care unit, general pediatrics, and pediatric surgery.     

2002～2006年潍坊市奎文区麻疹流行病学分析

[目的]掌握麻疹的流行病学特征，为制定和调整消除麻疹策略提供科学依据。[方法]对潍坊市奎文区2002～2006年报告的麻疹病例进行描述流行病学分析。[结果]2002～2006年潍坊市奎文区麻疹发病呈上升趋势，流行特点为散发，发病高峰为3～6月；≤8月龄儿童发病率高于其他年龄组，≥15岁人群发病25例（占发病总数的53．19％），“双相移位”现象较为明显；本区发生麻疹病例中，城乡结合部人群发病率明显高于农村及城区。[结论]在提高适龄儿童全程接种率和及时接种率的基础上，严格执行入托入学儿童预防接种证查验制度，适时开展大年龄段人群免疫接种，加大流动儿童管理力度，消除免疫空白，以加速控制、消除麻疹。     

我国医疗卫生机构儿科服务现状研究

目的通过调查了解全国不同地区不同级别医疗卫生机构儿科服务提供现状、变化趋势以及儿科服务能力,发现我国儿科服务中存在的问题。方法在全国随机抽取44个城市,对提供儿科住院服务的医疗卫生机构进行问卷调查。结果县区级医疗卫生机构儿科出院人次占辖区儿科总出院人次的比例最高（51．2％）;2008—2010年不同级别的机构儿科出院人次均呈逐年上升趋势,以县区级机构增长幅度最大,2010年增长幅度达到16．1％。能提供综合性新生儿科服务的机构中,以市级及以上机构比例最高（70．O％）,其次是县区级机构（64．9％）,乡级机构最低（16．0％）。23．6％的乡级机构尚不能提供基本新生儿科服务。新生儿死亡病例以发生在县区级机构比例最高（46．3％）,其次是乡级机构（32．6％）。新生儿死亡原因以早产和低出生体重、出生窒息死亡比例最高。结论县区级医疗卫生机构在我国儿科医疗服务中发挥了重要作用;提高儿科服务能力．需重点关注基层医疗卫生机构;加强儿科适宜技术在基层医疗卫生机构的推广,提高其服务能力。     

Standard management of acute respiratory infections in a children's hospital in Pakistan: impact on antibiotic use and case fatality.

Acute respiratory infections (ARI) are a leading cause of childhood morbidity and mortality in Pakistan. The National ARI Control Programme was launched in 1989 in order to reduce the mortality attributed to pneumonia, and rationalize the use of drugs in the management of patients with ARI. WHO''s standard ARI case management guidelines were adopted to achieve these objectives. The medical staff at the Children''s Hospital, Islamabad, were trained in such management in early 1990; further training sessions were conducted when new staff arrived. Data on outpatients were obtained from special ARI abstract registers, which have been maintained in the outpatient department since January 1990. Details on inpatients who were admitted with ARI were obtained from hospital registers. During the period 1989-92, the use of antibiotics in the outpatient department decreased from 54.6% to 22.9% (P < 0.0001). The case fatality rate (CFR) in children admitted with ARI fell from 9.9% to 4.9% (P < 0.0001), while the overall case fatality rate fell from 8.7% to 6.2%. Our results from a tertiary health care facility show that standard ARI case management reduced both antibiotic use and expenditure on drugs. Although the ARI case management criteria, which are more sensitive than the conventional diagnostic criteria of auscultation and radiography, led to more admissions, we believe that this strategy contributed to a significant reduction in the ARI case fatality rate.     

儿童麻疹55例临床分析

目的分析2004-2006年四川省人民医院麻疹患儿的临床及流行病学特点。方法从性别、年龄分布、疫苗接种情况,并发症等方面回顾性分析2004-2006年55例麻疹住院患儿的临床资料。结果55例患儿中≤8个月及≥6岁麻疹发病构成比例较高。临床上仍以典型麻疹患者为主,麻疹合并肺炎22例,占40.00%。结论婴幼儿和学龄儿童为麻疹的高发人群,是否接种麻疹疫苗与麻疹发病有密切关系。肺炎仍是麻疹的常见并发症。