娄底市麻疹流行病学分析

目的 详细了解娄底市麻疹流行情况及其流行病学特征,为有效控制麻疹提供科学依据供各级领导和专业人员参考.方法 全部资料录入或导入MS-Excel 进行统计并作图,比较分析用SPSS 13.0版完成.结果 1978～2005年共报告麻疹31 963例,年均发病率31.18/10万, 历年发病率与接种率呈明显负相关(r-0.802,P＜0.01).发病从高到低后回升,可分为3个时段,年均发病率分别为95.94/10万、4.06/10万和9.66/10万,各时段各县市区发病率差异极其显著(χ254 636.36,P＜0.000 1).整个发病趋势第1时段形成3个高峰之后,1987～2000年一路走低,其中1993～1994年形成一个低谷,至2004年再度形成一个相对高峰.共报告麻疹死亡76例,病死率0.24%.1991～2005年整个发病季节集中在3～6月,但在2004年回升高发时发病高峰在2～4月.2001～2005年麻疹发病数男女性别比为1.94: 1,年龄分布最小23日,最大60岁,5岁以下儿童占56.89%,散居儿童发病数占总数的53.87%,其发病率与幼托儿童和学生比较有统计学意义(χ2921.46,P＜0.000 1).结论 娄底市麻疹发病率总体下降89.93%,但近年有上升趋势,上升原因主要为计划免疫滑坡,存在免疫空白人群.

Epidemiology of Measles in Loudi City, Hunan Province

Objective This study was conducted to get a comprehensive understand of the true morbidity and the epidemiologic features of measles in Loudi City,to provide public health professionals and policy-makers with scientific basis and suggestions in measles control. Methods Measles cases,including clinic and serological confirmed,were notified through the network system of disease surveillance or collected by an offline database. Analysis were made using MS-Excel and SPSS software package. Results A total number of 31 963 measles cases were notified in the period of 1978-2005,accounting for an average annual incidence of 31.18/100 000, and annual incidences were negatively correlated to annual vaccination coverage rates(r-0.802,P＜0.01).The whole epidemic could be divided into 3 periods with average annual incidences of 95.94,4.06 and 9.66 per 100 000 for each period, respectively,which were significantly different among the periods(χ254 636.36,P＜0.000 1)and districts.Major peaks occurred in 1979,1981 and 1984, starting from 1987, epidemics had run low with a valley during 1993-1994 until a minor peak recurred in 2004.A total number of 76 deaths with a fatality rate of 0.24% were reported. Cases were mostly reported from March to June during 1991-2005,while in 2004,when the incidence returned to be higher,peak months were seen in February to April.Analysis of the 2001-2005 data showed that male to female ratio was 1.94∶ 1,age ranged from 23 days to 60 years,but 56.89% of the cases were under 5 years. Dispersed children accounted for 53.87% of the total number with an average annual incidence of 61.75/100 000,significantly higher than kindergarten and school children (χ2921.46,P＜0.000 1). Conclusions Incidence of measles decreased 89.93% in Loudi City during 1978-2005, while in recent years a recurring increase has been seen,which may have resulted from relatively low immunization coverage and gaps in population immunity.More than a half of the measles patients being dispersed children suggests that the government should take special care of the young children in disadvantaged countryside through effective measles controlling campaigns.And it is important to further improve and make full use of the existing "China Information System for Disease Control and Prevention" to get measles under control and toward the goal of elimination.