黔西南州2004年急性弛缓性麻痹病例流行病学分析

目的了解黔西南州急性弛缓性麻痹(AFP)病例流行病学特征,找出薄弱环节,为消灭脊灰提供科学依据。方法对2004年报告的AFP病例进行流行病学分析。结果2004年黔西南州共报告AFP病例67例,其中20例被贵州省脊灰诊断小组和国家AFP专家诊断为非AFP病例,剩余47例AFP病例中有7例被诊断为临床符合病例,7例临床符合病例中有2例为VDPV病例;除合格便采集率外,其余各项指标均达标准;首诊报告率为55.32%,村级仅为2596;病例的发病时间和地区分布上在贞丰县有明显的聚集趋势;有40.43%的儿童未完成全程免疫,零剂次儿童占总病例的19.15%。结论黔西南州在接种率及县、乡医院监测系统的敏感性和特异性方面存在较严重的问题。今后应加强计划免疫工作以提高脊灰疫苗的有效接种率:同时加强县、乡各级医务人员的业务技术培训、提高首诊报告率;在提高AFP监测敏感度的同时提高其特异性,有效防止VDPV病例的发生。

Epidemiological Analysis on Acute Flaccid Paralysis Cases in 2004 in Qianxinan Prefecture

Objective This study was conducted to find out the epidemiological characteristics of acute flaccid paralysis (AFP) in Qianxinan prefecture to provide a scientific basis for the eradication of AFP. Methods Epidemiological analysis was made on the data of AFP cases reported in 2004. Results 67 cases of AFP were reported in 2004 in Qianxinan prefecture, of whom 20 cases were diagnosed as non-AFP by Guizhou Provincial Poliomyelitis Diagnosis Group and the National AFP Specialist In 47 AFP cases, there were 7 cases diagnosed as clinically definite cases, of whom 2 cases were found to be caused by vaccine -derived polioviruses (VDPV). Except adequate stool collection rate, all other indices met the standards. The rate of reporting at the first consultation was 55.32%,with the rate being 25% in rural areas. An overt aggregation tendency was seen in Zhengfeng county as to onset and distribution of the epidemic. Children who were not fully immunized accounted for 40.43% ,with zero-dose children constituting 19.15% of total cases. Conclusion There do exist serious problems with immunization rate and, sensitivity and specificity of the surveillance systems in county an township hospitals. Scheduled immunization is to be strengthened to improve the immunization rate of poliomyelitis vaccine. In addition, technical training of medical staff in the facilities at the level of county and township should be taken seriously to improve the rate of reporting at the first consultation. Sensitivity and specificity of AFP surveillance remain to be bettered further.