CAJ | 학술논문

目的构建适合成都市本地资源优势和社会发展形势、可操作性强的霍乱预防控制策略框架并评价其应用效果. 方法 (1)对成都市1994-2004年本地霍乱疫情资料分析,确定本市霍乱防治工作存在的主要问题和已采用措施的有效性和不足,形成基本策略框架;(2)邀请55名专家对策略框架进行初步评分后,提取72项具体措施形成措施条目库,再由17名核心专家对各项措施的重要性和可操作性进行评分;(3)从疫情控制、健康教育和病原学监测结果分析三方面对策略框架效果进行评价. 结果 (1)框架以政府主导为工作主线,以信息化为工作辅线,以改善社会环境、完善监测预警体系和机制、提高疾控队伍应急处置能力为三个工作重心,包括35项具体工作措施,其重要性总体评分(4.20±0.86)分,可操作性总体评分(4.09±0.87)分;(2)自2002年逐步开始实施策略框架后,成都市2005-2009年连续5年保持霍乱零发病,霍乱病原学监测检出阳性的19件样品均为海(水)产品,品种包括甲鱼、白鲢、牛蛙;针对基层干部、基层医务工作者、游厨培训覆盖率达98.14%(198 452/202 220),培训合格率达98.17%(194 820/198 452),针对食品从业人员培训合格率达96.00%(912 470/950 489)以上,农村居民、基层干部、基层医务工作者、游厨及帮工霍乱防治知识知晓率达93.87%(1653/1761),良好卫生习惯养成率达70.58%(1243/1761). 结论本研究成功地构建了适合成都本地的霍乱预防控制策略框架,在周边地区霍乱疫情时有发生、进入成都市的海(水)产品霍乱弧菌持续存在等因素威胁不断的情况下连续5年保持霍乱零发病,证明其应用效果良好.
목적 구건괄합성도시본지자원우세화사회발전형세、가조작성강적곽란예방공제책략광가병평개기응용효과. 방법 (1)대성도시1994-2004년본지곽란역정자료분석,학정본시곽란방치공작존재적주요문제화이채용조시적유효성화불족,형성기본책략광가;(2)요청55명전가대책략광가진행초보평분후,제취72항구체조시형성조시조목고,재유17명핵심전가대각항조시적중요성화가조작성진행평분;(3)종역정공제、건강교육화병원학감측결과분석삼방면대책략광가효과진행평개. 결과 (1)광가이정부주도위공작주선,이신식화위공작보선,이개선사회배경、완선감측예경체계화궤제、제고질공대오응급처치능력위삼개공작중심,포괄35항구체공작조시,기중요성총체평분(4.20±0.86)분,가조작성총체평분(4.09±0.87)분;(2)자2002년축보개시실시책략광가후,성도시2005-2009년련속5년보지곽란령발병,곽란병원학감측검출양성적19건양품균위해(수)산품,품충포괄갑어、백련、우와;침대기층간부、기층의무공작자、유주배훈복개솔체98.14%(198 452/202 220),배훈합격솔체98.17%(194 820/198 452),침대식품종업인원배훈합격솔체96.00%(912 470/950 489)이상,농촌거민、기층간부、기층의무공작자、유주급방공곽란방치지식지효솔체93.87%(1653/1761),량호위생습관양성솔체70.58%(1243/1761). 결론 본연구성공지구건료괄합성도본지적곽란예방공제책략광가,재주변지구곽란역정시유발생、진입성도시적해(수)산품곽란호균지속존재등인소위협불단적정황하련속5년보지곽란령발병,증명기응용효과량호.
Objective To construct an operable strategic framework for cholera prevention and control which mobilized the advantages of local resources and adapted to social developments in Chengdu,and to evaluate its application effects. Methods (1) After analyzing the local epidemic data of cholera in Chengdu from 1994 to 2004,we determined the main problems of cholera prevention and control works as well as the efficiency and deficiency of employed measures,and then formed a basic strategic framework.(2) After 55 invited experts preliminarily scored the strategic framework,we selected 72 specific measures to establish a measure entry database,and then the importance and operability of each measure were scored by 17 core experts.(3) Finally,the effectiveness of this strategic framework was evaluated according to the analyzing results of infection control,health education and etiological monitoring. Results (1) The framework took government leadership as main scenario and the informatization as subordination scenario.Meanwhile,it focused on three points:the improvement of social environment,the completion of system and mechanisms for monitoring and early warning,and the enhancement of CDC response to public health emergencies.Total importance score and operability score of 35 specific measures included in this framework was 4.20 ± 0.86 and 4.09 ± 0.87,respectively.(2) Chengdu had maintained zero cholera incidence for five consecutive years from 2005 to 2009 since it gradually began to implement the strategic framework in 2002.There were 19 positive cholera cases detected by etiological monitoring and all of them were seafood or fishery products including soft-shelled turtles,silver carps and bullfrogs.The coverage rate and qualification rate of the training for grassroots cadres,grassroots medical workers,mobile cooks and their assistants was 98.14% (198 452/202 220) and 98.17% (194 820/198 452) in average,respectively.The qualification rate of the training for employees in food industry was over 96.00% (912 470/950 489).The average awareness rate of cholera prevention and cure knowledge in rural residents,grassroots cadres,grassroots medical workers,mobile cooks and their assistants was 93.87% (1653/1761) and the average formation rate of good hygiene habits was 70.58% (1243/1761). Conclusion A strategic framework suitable for cholera prevention and control in Chengdu has been successfully established in this study.The incidence rate of cholera has maintained zero in Chengdu for five consecutive years under incessant threatening conditions such as the occurrence of cholera cases from time to time in its surrounding areas and the continuous existence of Bacillus comma in seafood or fishery products that entered local markets.Therefore,it demonstrated a good application effects.