住院隔离在登革热疫情中期控制效果的评价研究

目的 评价住院隔离在登革热疫情中期的控制效果。方法 选择广州市采取住院隔离措施后2014年10月27日～12月14日为研究时间段，以住院隔离率为研究因素，以报告发病率、平均报告街镇率为结局指标进行多重线性回归分析。结果 2014年10月27日~12月14日，全市共报告2 956例，应住院隔离2 039例，实际住院隔离1 264例，住院隔离率61.99%。周平均报告422例，周平均报告发病率3.29/10万，周平均报告街镇率49.70%。在校正人口密度、平均布雷图指数后，随着住院隔离率的上升，分区县总报告发病率（R²=0.613 8，P=0.045）、分区县周平均报告发病率（R²=0.625 3，P=0.041）、分区县周平均报告街镇率（R²=0.634 1，P=0.037）均随之下降。在校正周次、人口密度和滞后2周的周平均气温、周平均降雨量、周平均布雷图指数后，随着分区县周住院隔离率的上升，周报告发病率（R²=0.520 4，P<0.001）、周平均报告街镇率（R²=0.681 3，P<0.001）亦下降。结论 传染期登革热患者采取住院隔离措施可以降低新病例的发生速度和地理扩散速度，今后应重视住院隔离措施在疫情防控中的积极作用。

The effect of hospital isolation in mid-stage dengue epidemic control

Objective To evaluate the effect of hospital isolation in mid-stage dengue epidemic control. Methods The interval between Oct 27 and Dec 14,2014 after the implement of hospital isolation was slected as the study period, the hospital isolation rate and reporting incidence rate were investigated, the average reporting community rate was selected as the effective indicators for multiple linear regression analysis. Results A total of 2 956 cases were reported with reporting incidence rate 23.02 per 100 000, 1 264(61.99%) cases were actually isolated in total 2 039 patients who should received isolation. Weekly average reporting cases was 422 with weekly average reporting incidence rate 3.29 per 100 000 and weekly average community rate 49.70%. With population density and average Breteau Index adjusted, along with hospital isolation rate increasing, the district reporting incidence rate(R2=0.613 8,P=0.045), weekly district average reporting incidence rate(R2=0.625 3,P=0.041), weekly district average reporting community rate(R2=0.634 1,P=0.037) was decreasing. With week, population density, and lag of 2 weeks for weekly average air temperature, weekly average rainfull and weekly average Breteau Index adjusted, and with the weekly district hospital isolation rate increasing, the weekly average reporting incidence rate (R2=0.520 4,P<0.001), and the average reporting community rate(R2=0.681 3,P<0.001)were decreasing. Conclusions Hospital isolation of cases in the period of communicability plays an important role in reducing the velocity of incidence and geographical diffusion, and should be aroused more attention in dengue control.