中国消除新生儿破伤风现场认证调查

目的 现场调查认证中国是否消除新生儿破伤风（NT）。方法 采用批质量保证-群抽样（LQA-CS）方法，现场人户调查中国NT发病风险最高的广东省江门市和广西壮族自治区河池市各随机抽取的96个调查点、每个点调查12名符合条件（调查前一年内出生）活产儿的NT发病情况。结果 江门市共调查23465户家庭、1153名合格活产儿，河池市共调查21623户家庭、1152名合格活产儿。现场认证调查所设立的各项质控指标均符合要求。调查中两市均未发现因NT引起的死亡或者住院病例，已达到消除NT的标准，结合现场调查各项可靠质控指标，也证实调查点已消除NT。结论 在中国2个NT发生最高危的地区已调查证实消除了NT，据此可以推断其他地区也应消除了NT。按照WHO认证程序，中国已实现消除NT，建议此后工作重点应转为维持消除NT状态。

Validation on the elimination of neonatal tetanus programs through Lot Quality Assurance-Cluster Sample Survey in China

Objective Field surveys were performed under WHO recommended validation procedures, using the Lot Quality Assurance-Cluster Sample (LQA-CS) method to validate the elimination status regarding neonatal tetanus in China. Methods LQA-CS surveys were conducted in two areas under the highest risk of neonatal tetanus-Jiangmen prefecture in Guangdong and Hechi in Guangxi. Random sampling method was conducted on 96 survey clusters in each prefecture with 12 eligible live births ( live birth born one year before the survey ) for each cluster, by trained investigators.Results There were 1 153 eligible live births from 23 465 families surveyed in Jiangmen and 1 152 eligible live births from 21 623 families being studied in Hechi. All the indices on quality control were strictly followed. There was no neonatal tetanus case which met the criteria of neonatal elimination found in either of the areas. Data showed that neonatal tetanus had been eliminated in both Jiangmen and Hechi cities. Conclusion Since both Jiangmen and Hechi were cities having the highest-risk in China, it was most likely that neonatal tetanus had also been eliminated in other prefectures at lower risk. Elimination programs on MNT was therefore considered validate in China when the study was carried out. However, the achievements needed to be maintained.