西藏自治区1976-2010年甲、乙类传染病流行趋势分析

目的 了解西藏自治区1976-2010年甲、乙类传染病的流行趋势，为该地区的传染病防治工作提供参考依据。方法 收集西藏自治区1976年1月-2010年12月甲、乙类传染病的疫情报告数据，根据各年的人口数计算相关传染病的发病率、死亡率和病死率，分析其流行趋势。结果 西藏自治区甲、乙类传染病的总发病率、死亡率和病死率分别从1976年的2 572.20/10万、10.49/10万和0.41%下降到2010年的530.19/10万、1.67/10万和0.31%，发病率、死亡率和病死率总体均呈下降趋势（均P<0.05）；1976-2010年西藏自治区发病率居于前5位的甲、乙类传染病依次为细菌性痢疾（909.01/10万）、麻疹（194.06/10万）、百日咳（92.49/10万）、肺结核（76.83/10万）、病毒性肝炎（60.81/10万），占甲、乙类传染病报告数的82.31%；死亡率居于前5位的甲、乙类传染病依次为病毒性肝炎（7.78/10万）、细菌性痢疾（3.32/10万）、麻疹（2.26/10万）、百日咳（0.89/10万）和流行性乙型脑炎（0.67/10万），占甲乙类传染病报告数的95.86%；病死率居于前5位的甲、乙类传染病依次为鼠疫（56.32%）、艾滋病（27.27%）、炭疽（13.92%）、病毒性肝炎（12.79%）和流行性乙型脑炎（10.84%）。结论 西藏自治区甲、乙类传染病的发病率、死亡率和病死率总体上均呈下降趋势，但细菌性痢疾、麻疹、百日咳、肺结核、病毒性肝炎、流行性乙型脑炎、鼠疫、艾滋病、炭疽仍为西藏自治区应重点防治的甲、乙类传染病。

Epidemic trend of class A and B infectious diseases in Tibet Autonomous Region,1976-2010

Objective To examine epidemic trend of class A and B infectious disease in Tibet Autonomous Region(Tibet) from 1976 to 2010 and to provide evidences for the prevention and treatment of infectious diseases in Tibet.Methods Data on class A and B infectious diseases in Tibet from January 1976 through December 2010 were collected;morbidity rate,mortality rate,and case fatality rate of all the national notifiable infectious diseases were calculated annually based on the population size.Results The total morbidity,mortality,and case fatality rate of infectious diseases among Tibetan people decreased from 2 572.20/100,000,10.49/100,000,and 0.41% in 1976 to 530.19/100,000,1.67/100,000,and 0.31% in 2010,respectively,all with a statistically significant decrease (P<0.05 for all);the top 5 class A and B infectious diseases with high morbidity were dysentery (909.01/100 000),measles (194.06/100 000),pertussis (92.49/100 000),tuberculosis (76.83/100 000),and viral hepatitis(60.81/100 000),accounting for 82.31% of all the class A and B infectious diseases reported;the top 5 infectious disease with high mortality rate were viral hepatitis (7.78/100 000),dysentery (3.32/100 000),measles (2.26/100 000),pertussis (0.89/100 000),and epidemic encephalitis (0.67/100 000),accounting for 95.86% of all class A and B infectious diseases reported;the top 5 infectious diseases with high case fatality rate were plague (56.32%),acquired immunodeficiency syndrome (AIDS)(27.27%),anthrax (13.92%),viral hepatitis (12.79%),and epidemic encephalitis B (10.84%).Conclusion Mortality,morbidity and case fatality of class A and B infectious disease were declining,but dysentery,measles,pertussis,tuberculosis,viral hepatitis,epidemic encephalitis B,plague,AIDS,and anthrax are the focal point of prevention and control of A and B infectious diseases in Tibet.