农村地区建立传染病症状监测系统的可行性——以江西省2县为例

目的：从村卫生室服务能力入手，探索在农村地区建立传染病症状监测系统的可行性。方法：通过问卷调查和小组访谈分析江西省2个县15个乡镇155家村卫生室的资源配置以及253名村医开展传染病症状监测的能力，以及相应的期望和建议。结果：“一村一所”管理模式下的村卫生室门诊量大，病人集中，更适合症状监测的开展；网络直报是症状监测数据报告的首选方式，但有12．5％的村卫生室负责人不会使用电脑；村医接触最多的五种传染性疾病是上感、其他感染性腹泻、流行性腮腺炎、水痘和痢疾，分别有84．6％和71．5％的村医能够通过临床症状诊断流行性腮腺炎和水痘；75．9％的村医发现传染病人后会立即报告乡镇卫生院，77．1％的村医参与过传染病的调查核实。结论：依托村卫生室构建传染病症状监测系统具有可行性，但需完善村卫生室管理模式，提高卫生服务可及性；明确目标监测疾病，促进资源的有效利用；充分利用信息网络技术，搭建症状监测报告平台；大力推进乡村一体化管理，完善监测信号响应机制。

The feasibility of developing a syndromic surveillance system in rural China: A case study of two counties in Jiangxi province

Objective：In this paper, we determine the feasibility of developing a syndromic surveillance system in rural China for detecting infectious diseases early. Methods：In total, 253 village doctors from 155 village health clinics were investigated. We designed questionnaires and conducted focus group discussions to collect information a- bout resource allocation in village health clinics. We also collected information about doctors＇ capacity to implement syndromic surveillance and their perceptions of this. Results：Village health clinics under standard management are well suited to implementation of syndromic surveillance. Internet is the best way to report surveillance data. 12.5% of the directors of the village clinics were unable to use computers. Upper respiratory infection, infectious diarrhea, mumps, chicken pox and dysentery were the most common infectious diseases in rural villages. 84.6% of the village doctors could diagnose mumps by clinical symptoms, and 71.5% could diagnose chicken pox. 75.9% of the village doctors tended to report infected patients to township hospitals, and 77.1% of the village doctors were involved inverifying and investigating infectious diseases in the field. Conclusions： Establishing syndromic surveillance systems in village health clinics is feasible, and the following should be the focus of attention ： （ 1 ） improving the management model of village health clinics for better accessibility to public health service; （2） identifying specific infectious dis- eases so that health resources can be effectively utilized; （3） taking full advantage of IT and building a syndromic surveillance reporting platform; and （4） promoting village-wide integrated management for rapid response to warning signals.