中国中部某农村地区艾滋病疫情发现和监测系统研究

目的探讨提高农村地区艾滋病病毒／艾滋病（HIV／AIDs）疫情发现和检测的有效方法与策略。方法选取中国中部某农村地区历年来所有报告发现的HIV／AIDs病例进行专项流行病学分析，包括对初次送检的原因、送检或报告机构及传播途径等进行分析。结果在全部报告发现的626例HIV感染者中，通过有偿供血或临床输血而感染的病例占86.1％（539例）；52．2％（327例）的病例是由医院送检或报告的；通过县级、地区级和省级机构报告或发现的HIV／AIDs病例分别为207例（33．1％）、303例（484％）、116例（185％）；近年来，通过专题流行病学调查和自愿检测而发现的感染者有所增加。经医院途径报告的HIV／AIDS病例中，门诊就诊时即被发现有HIV感染的比例在逐年升高。结论在我国中部农村有偿供血和临床输血为主要传播途径的艾滋病高发区，医院在艾滋病疫情发现和监测中发挥着并仍将继续发挥重要作用，地市级医疗、疾病预防控制中心和血液供应机构在艾滋病疫情发现和监测中的作用不容忽视。

Study on the identification of HIV/AIDS and its surveillance system in rural areas of central China

Objective To explore the effective strategies for human immunodeficiency virus(HIV) surveillance and identification in rural areas of central China. Methods In a selected rural prefecture area of central China,an epidemiological investigation was conducted for all reported HIV/AIDS cases. A historical and analytic review was performed, with particular interests in examining the HIV epidemic reporting and identification system. Results Among all 626 reported HIV-infected individuals in the selected prefecture, 86.1% (539/626) of them were infected through commercial plasma donation or clinically operated blood transfusion. With respect to disease surveillance and identification in the area,52.2% (327/626) of all the cases were reported by hospitals or clinics. The number and proportion of HIV/AIDS cases identified or reported at county, prefecture, and provincial levels were 207(33.1%) , 303 (48.4%) and 116(18.5%), respectively. The number and proportion of HIV/AIDS identified through specific epidemiological investigations and/or voluntary testing had been increased in recent years. In addition, among HIV/AIDS cases that were clinically identified, the proportion of those who were identified as outpatients had steadily increased, with the highest proportion(59.3%) observed in 2004. Conclusions In rural areas of central China where the major mode of HIV transmission was through commercial plasma donation or clinically operated blood transfusion, hospitals and clinics seemed to have played and would continue to play important roles regarding HIV identification and surveillance. The role of institutions or settings at the prefecture level regarding HIV identification and surveillance should not be ignored.