2008－2016年上海市传染病自动预警信号的流行病学特征分析

目的 分析2008－2016年上海传染病自动预警信号特点,为传染病自动预警系统优化提供依据。 方法 通过“传染病自动预警信息系统”模块下载、整理传染病自动预警信号资料,分别按年份、预警信号类型、病种、预警信号响应情况等因素进行整理分析。 结果 2008－2016年上海市共计预警传染病32种59 603次。预警信号数排在前5位的分别为:水痘、麻疹、其它感染性腹泻病、流行性腮腺炎和手足口病。不同病种的预警类型不尽相同,不同病种预警信号随着年份变化趋势也不同。经核实判定为疑似事件的信号数为1 952次,预警信号有效率为3.28％,其中单病例预警有效率(12.50%)最高,其次为时间预警(1.73%),最低为时空预警(1.01%),差异有统计学意义(P＜0.001)。预警信号处理及时率85.69％(51 071/59 603),其中单病例预警信号处理及时率最高(91.47%),其次为时间预警(86.34%),最低为时空预警(80.69%),差异有统计学意义(P＜0.001)。 结论 2008－2016年上海市传染病自动预警系统整体运行情况良好,但存在预警信号有效率低,处理不及时等问题,今后应进一步完善系统功能及参数设置,提高工作人员处置能力和报告意识。

Epidemiological characteristics of infectious disease automaticearly warning signals in Shanghai, 2008-2016

Objective To analyze the features of infectious disease automatic early warning signals in Shanghai from 2008 to 2016, and to provide a basis for optimizing the infectious diseases automated-alert and response system. Methods We downloaded the data regarding infectious disease automatic early warning signals from the China infectious diseases automated-alert and response system (CIDARS), then described and analyzed according to the factors like year, type of early warning signal, type of disease and early warning signal response. Results A total of 59,603 signals were issued by the CIDARS in Shanghai from 2008 to 2016, involving 32 kinds of infectious diseases. The signals occupied the first five places were chicken pox, measles, other infectious diarrhea, mumps and hand-food-mouth disease. The types of early warnings of different diseases were different, and the early warning signals of different diseases varied with the years. 1,952 signals were verified as suspected outbreaks. The effective rate of early warning signals was 3.28%, of which the efficiency of single-case early warning was the highest (12.50%), followed by the time warning (1.73%) and the space-time warning (1.01%), with a statistically significant difference (P<0.001). The timely processing rate of early warning signals was 85.69% (51,071/59,603), of which the timely processing rate of single-case early warning signals was the highest (91.47%), followed by the time warning (86.34%) and the space-time warning (80.69%), with a statistically significant difference (P<0.001). Conclusions The overall running status of the CIDARS in Shanghai during 2008-2016 was good, but there were still problems like high proportion of false-positive early warning signals and delayed response. It is necessary to further improve functions and parameter setting of the CIDARS and promote medical workers’ disposal ability and reporting consciousness.