我国部分脊髓灰质炎高发省急性弛缓性麻痹病例发病情况调查

１９９４年６月中旬卫生部疾病控制司专业考察小组,在我国一个脊髓灰质炎（脊灰）高发省份随机抽取２０个地区,对其４５所地（市）级和１３所县级医院进行了ＡＦＰ病例的主动搜索,共查出１９９１～１９９４年５月发病的ＡＦＰ病例６８１例,分布于１０１个县市。结果表明：０～１４岁儿童ＡＦＰ、脊灰、非脊灰ＡＦＰ及ＧＢＳ年平均发病率分别为１．０４／１０万、０．４８／１０万、０．５７／１０万及０．３１／１０万,其中脊灰发病率明显较１９９１年下降,其构成比由１９９１年的第一位逐年降低;此外,约９５％的脊灰患者分布于０～４岁组,表明０～４岁儿童应为今后监测和保护的重点;非脊灰ＡＦＰ发病率具有明显的地区性差异,认为采用“０～４岁非脊灰ＡＦＰ发病率＞１／１０万”作为监测系统敏感性指标似更合乎国情。

An Investigation on Acute Flaccid Paralysis (AFP) Cases in some Provinces with high Risk of Poliomyelitis of China

In the mid Jun, 1994, a study team organized by MOPH investigated AFP cases in 10 provinces with high prevalence of poliomyelitis (polio). Twenty prefectures and ten counties were selected randomly from each of 10 provinces and relevant prefectures. The team identified 681 AFP cases under 15 years old from 45 hospitals at prefecture level and 13 hospitals at county level based on hospital records from cases occurred during 1991-1994. AFP, Polio, Non-polio AFP and GBS (Guillian-Barre Syndrome) cases aged from 0-14 years scattered around 101 counties (cities) among target population and their average incidences by year were 1.04, 0.48, 0.57 and 0.31 (per 10⁵) respectively. Noticingly, the incidence of polio had reduced significantly since 1991, and its proportion among AFP was also reducing from first place yearly since 1991. In addition, over 95%of the polio cases were concentrated in the 4 year olds which indicated that the target population for surveillance and prevention should mainly be focusing on 0-4 year olds. As the incidence of non -polio AFP has been used as a current sensitive index of surveillance system, we noticed that the incidence rates had been significantly different from various regions. According to the analytic data, we recommend that "Rate of non-polio AFP in children 0-14 years of age greater than 1/10⁵" might be a better and more sensitive index for surveillance program in China.